Anorectal Way Nutritional Support Experimental Research

1. Backgroud and ObjectiveEnteral Nutrition (EN) is a foundational therapeutic tool of surgery present. Because it hasthe incomparable merit with Parenteral Nutrition(PN)and fewer complication, the clinicianlike it more and more. It has been reported that 40～50% of inpatients are in malnutrition,and this has direct relationship with convalescence of patients and prognosis of disease. Sothe study about EN has got more attention by many scholars and has fairly rapid progress.Classics concept about EN is nutritional support in jejunum from up to down. Whether oralfeeding , nasal feeding or gastric stoma, jejunum stoma adopt this nutrition pathway, nutrientare elemental diet, or hydrolyzed protein and complete protein preparation. With clinicalpractice application, this kind of pathway of nutrition has been found not to adapt to allpatients, such as upper gastrointestinal tract carcinoma obstruction,and SBS patients. For thisreason, it's need badly to solve problem now that seeking effective succedaneous new ENsupport pathway. Several thousand years ago, Chinese medicine had per rectum defecation-promotingtherapy, which gained fine therapeutic effect. By means of this enter-point we based onChinese medicine theory"large intestine is interior and exterior with lung" ," all vesselsconverging in lung", successfully set up animal model. Then we observed influence ofimporting nutrition and "Jianpi Lianchang"decoction pre rectum.Some scholars thought largeintestine not only is associated with lung, but also with many organs by meridian , that isintestine collaterals, it's a new idea after collaterals of heart, brain, liver, which belongs thescope of disease of collaterals. "Jianpi Lianchang" herbal medicine is Professor Li Naiqing's empirical formula,itstherapeutical principle is nourishing Qi to invigorate spleen and antidarrhea with astringent.This drug has been in clinical application many years, it can improve quality of life andprolong life span. We based on the clinical study of tutor, applying modern medicine studymeans to investigate thoroughly on the level of organ ,tissue and gene. We intend to combineexperience medicine and evidence-based medicine to probe the best pathway per rectumnutrition support to retrieve lives and provide scientific evidence.2. Methods This study includes four parts: (1) establishment of animal model and traditional Chinesedrug's influence on survival rate. (2) Chinese drug's influence on nutrition index and mucosaof colon,immune function;(3)Astragalo-side absorptin degree in gastrointestinal tract of SBSrats; (4) Chinese drug's influence on mucosal barrier. We used symptom observation ,pathologic histology, electron microscope, HPLC-ELSD, evaporation laser light scattering6 经肛肠途径营养支持的实验研究detector, immunohistochemistry SP and image analysis means to observe "Jianpi Lianchang"herbal medicine impacting on each index of SBS rats.3. Results(1)Establishing of animal model and Chinese drug's influence on survival rate.Proximal end colon stoma intubation nutrition + every traditional Chinese drug dose groupobviously prolong rats' life span than model group(P<0.05) Proximal end colon stoma ;intubation nutrition model group's survival time and survival rate obviously is better than thatof distal end(P<0.05).Results hinting: Proximal end colon stoma intubation nutrition is thisseries ideal animal model.(2) Traditional Chinese drug treatment impacting on nutrition index of SBS rats. At different time traditional Chinese drug group's weight,HB, LC, TP, RBC,WBC,AlBand PA has significant different compared with model group(P<0.05) In previous 2 weeks, ;Chinese drug group is negative nitrogen balance, at the fourth week ,it's positive nitrogenbalance and has significant diffe...