Björck S, Dahlström A, Ahlman H
Dept. of Surgery, Lundby Hospital, Gothenburg, Sweden.
Scand J Gastroenterol. 1989 Nov;24(9):1061-72. doi: 10.3109/00365528909089256.
Rectal biopsy specimens from patients with ulcerative proctitis/proctosigmoiditis (UP/PS) were investigated immunocytochemically. In general, a changed mucosal innervation was demonstrated, with a marked increase in the number of nerve fibres and terminals with neuropeptide Y and tyrosine hydroxylase. In a few patients a hyperinnervation with VIPergic or SPergic nerves was seen. These findings indicate that hyperactive local nervous reflexes are of pathogenetic importance. To silence such activity, the diseased mucosa was treated with topically applied lidocaine. Such topical treatment with lidocaine gel in 21 consecutive patients with UP/PS for 3-8 weeks caused a rapid decrease of subjective and objective symptoms. During treatment mucosal integrity was restored, accompanied by depletion of OKT4 and OKT8 lymphocytes from the mucosa. However, the hyperinnervation pattern persisted during treatment.
对溃疡性直肠炎/直肠乙状结肠炎（UP/PS）患者的直肠活检标本进行了免疫细胞化学研究。总体而言，发现黏膜神经支配发生了改变，神经肽Y和酪氨酸羟化酶的神经纤维及终末数量显著增加。少数患者可见VIP能或SP能神经的神经支配亢进。这些发现表明，局部神经反射亢进具有致病重要性。为抑制这种活动，用局部应用的利多卡因对病变黏膜进行治疗。对21例连续的UP/PS患者用利多卡因凝胶进行这种局部治疗3至8周，导致主观和客观症状迅速减轻。治疗期间黏膜完整性得以恢复，同时黏膜中OKT4和OKT8淋巴细胞减少。然而，治疗期间神经支配亢进模式持续存在。
