| Background and objective:With the development of modern medicine,more and more surgical laparotomy operations have been performed.Whether traditional laparotomy or laparoscopic surgery,abdominal adhesions can not be avoided.Once abdominal adhesion occurs,it can cause abdominal distension,abdominal pain,intestinal obstruction and even female infertility.Modern society urgently needs a safe and effective treatment to prevent and cure the occurrence of abdominal adhesions.In recent years,traditional Chinese medicine has played different roles in the prevention and treatment of diseases in various clinical departments with its own advantages and characteristics.TCM classifies abdominal adhesions as abdominal pain,intestinal knot,Guangge,zhengjia and jiju,abdominal injury,abdominal normal Qi machine operation is blocked,Qi does not absorb blood,blood overflow,Qi does not transport blood,blood flow is not smooth,body deficiency after surgery,Qi and blood deficiency,can not normally run in the body,leading to stagnation of Qi and blood,causing abdominal pain;stasis for a long time generates heat,boils down body fluid,and then tangible things accumulate in the abdomen;stasis for a long time generates heat,boils down body fluid,and then tangible things accumulate in the abdomen;viscera dysfunction,body fluid can not be transported,phlegm will form agglomeration in the abdomen,oppress the gastrointestinal tract,gastrointestinal peristalsis disorders,transport disorders,cause constipation,abdominal pain,and form intestinal obstruction for a long time.Previous physicians in the treatment of abdominal pain,intestinal nodules,Guange and other diseases,mostly Tong-based,promoting blood circulation and removing blood stasis and tonifying qi,both attack and tonify,to achieve therapeutic purposes.Huoxue Tongfu Decoction is made of Dahuang Mudan Decoction,which can purge the viscera,promote blood circulation and remove blood stasis.Previous research by the tutor team found that Huoxue Tongfu Decoction can reduce the degree of adhesion and the incidence of adhesion.Its mechanism needs further study.The pathological mechanism of abdominal adhesions after operation is complex.The tutor team has discussed the cytokines and immune inflammation in abdominal microenvironment from various angles.Previous experimental results show that Huoxue Tongfu Prescription can regulate the abdominal microenvironment after operation.As an important immune cell in the body,macrophages play an important role in the occurrence and development of diseases.When stimulated by different stimulators,macrophages can form two different phenotypes:classical activated macrophages(M1)and alternative activated macrophages(M2).Stimulated by inflammatory microenvironment proinflammatory factors,macrophages transformed to M1 type,secreting cytokines such as interleukin-1(IL-1)and interleukin-6(IL-6)can promote inflammatory response,eliminate microorganisms and form pro-inflammatory feedback.Stimulated by anti-inflammatory cytokines,macrophages transformed into M2 type,and M2 macrophages secreted interleukin-4(IL-4),interleukin-13(IL-13)can reduce inflammation,forming a positive feedback mechanism of anti-inflammatory response.Previous studies of the research group found that Huoxue Tongfu Fang has a regulatory effect on the peritoneal microenvironment after operation.Therefore,by investigating the effects of Huoxue Tongfu Recipe on the cytokines in peritoneal adhesions of rats after operation,and exploring the mechanism of prevention and treatment of peritoneal adhesions through macrophage adjustment of immune microenvironment,it is of great significance to clarify the mechanism of Huoxue Tongfu Recipe in preventing and treating peritoneal adhesions.Methods:The abdominal adhesion model established by bruising cecum.The SD rats were randomly divided into five groups:sham operation group,model group,Simo Decoction group,fluvastatin group and Huoxue Tongfu recipe group.The status of abdominal adhesion was observed and the level of abdominal adhesion was evaluated by adhesion score.Masson staining was used to observe the adhesion of adhesive status in each group.The levels of IL-1,IL-6,TNF-a,IL-4,IL-10 and IL-13 cytokines in serum were detected by Elisa.The levels of IL-6,TNF-a and Arg-1 in adhesive tissue of each group were detected by RT-PCR.Result:Adhesion score and Masson staining section under microscope showed that the experimental model was successful.There was no abdominal adhesion in sham-operated group.The abdominal adhesion in model group was severe and difficult to separate.The degree of abdominal adhesion in drug group was lighter than that in model group.Compared with model group,Huoxue Tongfu Decoction prominently reduced the degree of adhesion under naked eye observation;at the same time,Huoxue Tongfu Prescription can reduce the expression of IL-6,TNF-alpha,increase the expression of Arg-1 and reduce the content of IL-1,IL-6,TNF-alpha cytokines;increase the content of IL-4,IL-10,IL-13 cytokines.Conclusion:1.In traditional Chinese medicine,abdominal adhesions are classified as abdominal pain,intestinal knot,Guange,symptoms and accumulation.It is found that abdominal adhesions are mostly caused by abdominal Qi and blood stasis.Drawing on the experience of previous physicians,the Huoxue Tongfu Prescription is used to purge and remove Fu organs,regulate qi and promote blood circulation,so as to achieve "Tong","Rong" and prevent adhesion.2.Huoxue Tongfu Recipe can inhibit the abdominal adhesion of rats after operation,and can significantly reduce the degree of abdominal adhesion.Its mechanism may be related to the regulation of macrophage content and the influence of immune microenvironment.3.The timely application of Chinese medicine after abdominal surgery can prevent and control the occurrence of postoperative complications. |
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