目的:观察益气解毒方在溃疡性结肠炎(UC)大鼠慢性期的远期疗效和对结肠炎性反应的影响,探讨益气解毒方对UC缓解期的抗复发作用。方法:采用家兔结肠黏膜组织致敏加三硝基苯磺酸(TNBS)-乙醇灌肠的免疫复合法造模,将100只Wistar大鼠随机分成正常组、模型组、益气解毒组和美沙拉嗪组,分别于造模后第1天、给药后第2周末、给药后第6周末3个时间点取材,观察大鼠的一般情况、结肠黏膜大体形态、结肠病理形态学改变,进行疾病活动指数(DAI)、大体形态损伤评分、组织学评分。结果:UC大鼠DAI、结肠大体形态损伤与组织学三者成正相关,且结肠炎性反应程度随着时间的推移呈现出逐渐下降的特点,慢性期明显低于急性期。黏膜溃疡、炎性细胞浸润、出血和水肿导致的局部病理改变,持续存在于UC的整个病变过程,慢性期这些病理现象有所减轻但没有消失。益气解毒方和美沙拉嗪均可明显降低疾病活动指数,益气解毒组在缓解期DAI评分低于美沙拉嗪组,更接近与正常组,大鼠的一般情况和结肠大体形态也恢复得更好。对比益气解毒组和美沙拉嗪组光镜下的病理改变,可观察到急性期美沙拉嗪可明显减少炎性细胞的浸润情况,益气解毒组在急性期炎细胞减少方面稍逊于美沙拉嗪组,但却早于美沙拉嗪组开始出现上皮增生修复情况,溃疡较快被成熟的肉芽组织所取代。慢性期,美沙拉嗪组才开始表现出溃疡愈合、上皮增生性修复和肉芽肿形成,此时益气解毒组的黏膜修复愈合效果已明显优于美沙拉嗪组。结论:慢性期结肠炎性反应的持续损伤,可能是引起UC复发的重要病理基础。急、慢性期的持续用药使结肠炎性反应得到了明显控制。其中,美沙拉嗪能够发挥良好的抗炎效果,适用于急性期的炎性损伤;而益气解毒方抗炎效果虽稍逊于美沙拉嗪,但在改善UC临床症状、加快溃疡愈合及黏膜增生修复的速度方面优于美沙拉嗪,其远期疗效更佳。 Objective: To observe the long-term efficacy of Yiqi Jiedu Decoction in chronic phase of ulcerative colitis (UC) in rats and its effect on colonic inflammatory reaction, and explore the anti-relapse effect of Yiqi Jiedu Decoction on UC remission. Methods: 100 Wistar rats were randomly divided into normal group, model group, Yiqi Jiedu group and mesalamine group by immunohistochemistry with rabbit colon mucosal tissue sensitized with TNBS-ethanol enema. The animals in each group were sacrificed on the first day after modeling, the second weekend after administration and the third weekend after the administration. The general conditions of the rats, the general morphology of colonic mucosa and the pathological changes of the colon were observed Disease activity index (DAI), gross morphological damage score, histological score. Results: The morphological changes of DAI and colonic colon in UC rats were positively correlated with histological changes. The degree of colonic inflammatory reaction decreased gradually with the passage of time. The chronic phase was significantly lower than the acute phase. Mucosal ulcers, inflammatory cell infiltration, hemorrhage and edema caused by local pathological changes persist in the entire course of the disease in UC, chronic disease, these pathological phenomena have been reduced but did not disappear. Yiqi Jiedu side and mesalazine can significantly reduce the disease activity index, Yiqi detoxification group in the remission DAI score was lower than mesalazine group, closer to the normal group, the general condition of the rat and the colon morphology recovered even more it is good. Comparing the pathological changes of the patients with Yiqi detoxification group and mesalazine group under the light microscope, we can observe the acute phase mesalazine can significantly reduce the infiltration of inflammatory cells, Yiqi detoxification group in the acute phase of inflammatory cell reduction is slightly inferior to the United States salad However, in the mesalazine group, epithelial hyperplasia repair started earlier than the mesalazine group, and the ulcer was replaced by the mature granulation tissue sooner. In the chronic phase, the mesalazine group started to show ulcer healing, epithelial hyperplastic repair and granuloma formation. At this time, the mucosal healing effect of the Yiqi detoxification group was significantly better than that of mesalazine group. Conclusion: The persistent injury of chronic inflammatory reaction of colonic mucosa may be the important pathological basis for the relapse of UC. Continued use of acute and chronic phase of the colonic inflammatory response has been significantly controlled. Among them, mesalazine can exert good anti-inflammatory effect, suitable for acute inflammatory injury; while the anti-inflammatory side effect of Yiqi Jiedu Fang slightly less mesalazine, but in improving the clinical symptoms of UC and accelerate the healing of ulcers and mucosal hyperplasia repair Is better than mesalazine in terms of its long-term efficacy.