Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Surgery, Otsu City Hospital, Otsu, Shiga, Japan.
Sci Rep. 2018 Jan 18;8(1):1091. doi: 10.1038/s41598-018-19550-4.
Daikenchuto (DKT), a traditional Japanese medicine, is widely used to treat various gastrointestinal disorders. This study aimed to investigate whether DKT could promote the anastomotic healing in a rat model. Pedicled colonic segments were made in left colon by ligation of the feeding arteries, and then intestinal continuity was restored. Colonic blood flow was analyzed by using ICG fluorescence imaging: Fmax, Tmax, T1/2, and Slope were calculated. Anastomotic leakage (AL) was found in 6 of 19 rats (31.6%) in the control group, whereas in 1 of 16 rats (6.2%) in the DKT group. The Fmax and Slope of DKT group were significantly higher than those of control group. DKT could promote the anastomotic healing, with the higher bursting pressure on postoperative day (POD) 2 and 5, the larger granulation thickness on POD 5, and neoangiogenesis on POD 5. Histological examination showed DKT exhibited a decreased inflammatory cell infiltration, enhanced fibroblast infiltration, and enhanced collagen density on POD 5. In the DKT group, the levels of TGFβ1 on POD 2 and VEGFα on POD5 were significantly higher, whereas the level of TNFα on POD 2 was significantly lower. Therefore, DKT could be effective for the prevention of AL following colorectal surgery.
大建中汤（DKT）是一种传统的日本药物，广泛用于治疗各种胃肠道疾病。本研究旨在探讨 DKT 是否可以促进大鼠模型中的吻合口愈合。通过结扎喂养动脉在左结肠中制作带蒂结肠段，然后恢复肠道连续性。通过 ICG 荧光成像分析结肠血流：计算 Fmax、Tmax、T1/2 和 Slope。在对照组的 19 只大鼠中有 6 只（31.6%）发现吻合口漏（AL），而在 DKT 组的 16 只大鼠中有 1 只（6.2%）。DKT 组的 Fmax 和 Slope 明显高于对照组。DKT 可促进吻合口愈合，术后第 2 天和第 5 天的爆破压更高，第 5 天的肉芽厚度更大，第 5 天的新生血管形成更多。组织学检查显示，DKT 在术后第 5 天表现出炎症细胞浸润减少、成纤维细胞浸润增强和胶原密度增加。在 DKT 组中，TGFβ1 水平在术后第 2 天和 VEGFα 水平在术后第 5 天显著升高，而 TNFα 水平在术后第 2 天显著降低。因此，DKT 可能对预防结直肠手术后的 AL 有效。
