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慢性前列腺炎与直肠炎相关性的实验研究及熊珍膏对二者的干预评价
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摘要
目的:探讨慢性前列腺炎与直肠炎是否具有相关性,及其可能的机制;观察熊珍膏直肠给药对CP模型大鼠的前列腺、直肠病理干预结果及对其行为改善情况,以拓宽慢性前列腺炎临床治疗思路。
     方法:以3种不同浓度的造模药物复制慢性前列腺炎大鼠模型,并设假手术对照组。造模1周后,分别将各造模浓度药物大鼠随机分为用药组及非用药组;用药组以熊珍膏每日灌肠治疗,非用药组常规喂养。用药3周后,以下列方法观察每只大鼠前列腺及直肠中的炎性相关改变:苏木素-伊红染色观察其病理结构改变,免疫组织化学方法测定其IL-17、COX-2的表达,ELISA法测定直肠IFN-r、TNF-a的表达;以及采用RT-PCR方法研究其共同神经支配系统——腰骶部脊髓细胞中NGF、TRPVlmRNA的表达情况。不同造模药物浓度的非用药组大鼠可观察其前列腺与直肠是否表现出具有相关性的炎症表现及其可能的产生机制,同一造模药物浓度的非用药组与用药组间可比较熊珍膏的治疗作用。在术后大鼠喂养过程中同时观察各组大鼠的行为学改变有无差异。
     结果:1、不同浓度的慢性前列腺炎造模动物均可引发直肠炎,且以高浓度的模型动物效应最为明显。2、在高、中、低各浓度造模药物的大鼠模型中,用药组大鼠前列腺与直肠组织的病理结构改变、炎性介质IL-17、COX-2、IFN-r、TNF-α等炎性介质表达水平与非用药组大鼠相比有不同程度的下降;但以高浓度造模药物模型最为明显。
     3、高、中、低各浓度造模药物的大鼠模型,无论用药组或非用药组,彼此间腰骶部脊髓神经细胞中NGF、TRPVlmRNA的表达差异不明显。4、各浓度造模药物的大鼠模型中,用药组大鼠的不良行为较未用药组得到改善;且以高浓度造模药物的大鼠模型组改善最为显著。
     结论:CP模型大鼠的前列腺炎与直肠炎之间存在正相关性。熊珍膏干预后,CP模型大鼠的前列腺与直肠炎症情况可减轻,同时不良行为学表现亦可得到改善。这种相关性可能与跨器官痛觉致敏(cross-organ sensitization)有关,在临床治疗慢性前列腺炎时同时治疗直肠炎是价值的。
Purpose:The objective of this study was to explore the correlation between chronic prostatitis and proctitis, and its possible mechanism. Authors observed the therapeutic effect and improvement of behavior of rat models with chronic prostatitis and proctitis by external application of traditional Chinese medicine Xiongzhen ointment medication, so as to extend clinical prospect for chronic prostatitis.
     Methods:authors used model drugs with three different concentrations to replicate rat models with chronic prostatitis, and set sham operation control group. After a week's modeling, authors divided rat models with different concentration drugs into medication group and non-medication group randomly. The medication group was treated by daily retention enema with Xiongzhen ointment, while non-medication group was fed with normal diet. After three weeks'treatment, authors observed the inflammation-related changes in prostate and rectum of each rat in the following methods:observation of pathological structure changes by hematoxylin-eosin staining, detection of the expression of IL-17and COX-2by immunohistochemical method, determination of the expression of IFN-r and TNF-a by ELISA method, and research of the expression of NGF and TRPVlmRNA by RT-PCR method in spinal cord cell in lumbosacral region, which were in common innervation system. In non-medication group, authors could observe whether the prostate and rectum of rats with different concentration drugs has the relevant of inflammation expression and its possible production mechanism, while rats with same concentration drug could compare the therapeutic effect of Xiongzhen ointment between non-medication group and medication group. In the process of rats feeding after the operation, authors could observe the difference in behavior change of rats in each group at the same time.
     Results:1. Model rats in different concentration drugs with chronic prostatitis could initiate proctitis, and those with high concentration drug had the most obvious effect.2. Among model rats with high concentration drug, the pathological structure changes in prostate and rectum tissues, the expression of inflammatory mediators IL-17, COX-2, IFN-r and TNF-α in medication group was obviously lower than that in non-medication group, but there was no significant difference in model rats with medium and low concentration drugs.3. Among model rats with high, medium and low concentration drugs, either medication group or non-medication group, the expression of NGF and TRPVlmRNA in spinal cord cell in lumbosacral region had no obvious difference.4. Among model rats with high concentration drug, the behavior change in medication group was better than that in non-medication group, but there was no significant difference in model rats with medium and low concentration drugs.
     Conclusions:there was a correlation between prostatitis and proctitis indeed, but this experiment could not yet conclude that they had dose-effect relationship. Xiongzhen ointment was effective to both diseases, and it could reduce rats'bad behavior and improve the quality of experimental animals'lives in the meantime. This correlation may be related with cross-organ sensitization, and it was valuable in the clinical treatment of chronic prostatitis when treating proctitis at the same time.
引文
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