羊燕群 王子威 郑泽娜 张静 张均倡 田广俊

[摘要]目的观察白术对黑变病结肠黏膜的治疗作用。方法将60只实验大鼠分为正常对照组、模型組、白术低剂量组、白术中剂量组、白术高剂量组，每组各12只，给予相应生大黄液及白术液，观察各组大鼠结肠黏膜一般情况及病理组织学改变。结果随着白术剂量升高，肉眼可见结肠黏膜着色呈逐渐变浅趋势，白术高剂量组与模型组差异有统计学意义（ P <0.05），显微镜下见黏膜层棕褐色颗粒状物质沉积亦随着白术剂量升高而相应变化。结论白术可改善结肠黑变病黏膜的黑变程度，减少结肠黏膜蒽醌类物质沉积，改善程度与白术液剂量呈正相关。

[关键词]白术;结肠黑变病;结肠黏膜;病理组织学改变

[中图分类号] R285  [文献标识码] A   [文章编号]2095-0616（2021）23-0027-04

Experimental observation of Baizhu regulating mucosal state of melanosis coli

YANGYanqun1 WANGZiwei1 ZHENGZe'na1 ZHANGJing1 ZHANGJunchang1 TIANGuangjun

1. Department of Traditional Chinese Medicine， Shenzhen Hospital of Southern Medical University， Guangdong， Shenzhen 518101， China;2. Zhuhai Branch of Guangdong Provincial Hospital of Traditional Chinese Medicine， Guangdong， Zhuhai 519015， China

[Abstract] Objective To observe the therapeutic effect of Baizhu on mucosa of patients with melanosis coli （MC）. Methods The 60 experimental rats were divided into the normal control group， model group， Baizhu low- dose group， Baizhu medium-dose group and Baizhu high-dose group，12 in each group. The corresponding rhubarb root and Dahuang liquid and Baizhu liquid were given， and the general conditions and histopathological changes of colon mucosa in each group were observed. Results With the increase of the dosage of Baizhu， the staining of colonic mucosa gradually became lighter with naked eyes， and there was a significant difference between the Baizhu high-dose group and the model group （P <0.05）. Microscopically， the deposition of brown granular substances in mucosal layer also changed correspondingly with the increase of the dosage of Baizhu. Conclusion Baizhu can improve the degree of melanosis of colon mucosa and reduce the deposition of anthraquinone in colon mucosa， and the improvement degree is positively correlated with the dose of Baizhu solution.

[Key words] Baizhu; Melanosis coli; Colon mucosa; Histopathological changes

随着现代生活压力增大及饮食结构的改变，慢性便秘发病率逐年提高。使用蒽醌类泻剂导致的结肠黑变病（melanosiscoli， MC）随着结肠镜检查的普及，其检出率也逐年升高，且往往伴有息肉、慢性结肠炎，甚至与肿瘤的发生也有相关性[1]。结肠黑变病伴有的腹胀、便秘、排便无力的症状，在中医理论中认为是“虎狼之剂”误下之后，脾虚气弱、伤津耗液之症，治疗当以健脾益气、补液生津为治则。中药白术具有健脾、益气、养阴的作用，是 meta 分析出来最常用的治疗便秘的中药之一[2]。研究显示白术或白术提取物对修复肠道黏膜、恢复肠道动力有确切治疗效果[3]。本研究旨在明确中药白术对结肠黑变病的治疗作用，并初探其对结肠黑变病治疗作用的改善位点。

1材料与方法

1.1材料

1.1.1中药制备项目所需白术（广州至信，批号：190810）、生大黄（南城建洪，批号：1907004）一次性购齐，所有药材品质符合《中华人民共和国药典》2015年版标准。……