目的 探讨消痔丸对巴豆油诱导大鼠肛门肿胀模型的药效作用及其作用机制。方法 雄性SD大鼠随机分为对照组、模型组及消痔丸低、中、高剂量（0.81、1.62、3.24 g/kg）组和柑橘黄酮片（0.27 g/kg）组和痔炎消片（0.86 g/kg）组，每组20只，连续ig给药7 d，于给药第4天，采用巴豆油涂抹肛管诱发肛门肿胀至72 h，通过测量肛门肿胀面积初步评估各给药组治疗效果；通过采集大鼠血液、肛门直肠组织进行生化指标及组织病理学等检测，评价消痔丸治疗效果及作用机制。结果 与模型组比较，消痔丸组大鼠肛周肿胀、黏液溢出、便秘等症状明显减轻，肛肠指数和血管通透性均显著降低（P<0.001），肛门直肠组织鳞状上皮细胞缺失、炎性细胞浸润、水肿等现象明显减少；血中白细胞数量及中性粒细胞、单核细胞比例显著降低（P<0.01、0.001），淋巴细胞比例显著升高（P<0.05）；血清及肛门直肠组织中白细胞介素-6（interleukin-6，IL-6）、IL-1β、肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）、前列腺素E₂（prostaglandin E₂，PGE₂）、γ-干扰素（interferon-γ，IFN-γ）、一氧化氮（nitric oxide，NO）水平显著降低（P<0.05、0.01、0.001）；肛门直肠组织中IL-6、IL-1β、TNF-α、环氧合酶-2（cyclooxygenase-2，COX-2）、IFN-γ、诱导型一氧化氮合酶（inducible nitric oxide synthase，iNOS）基因表达显著降低（P<0.05、0.01、0.001）。结论 消痔丸对巴豆油诱导的急性痔疮模型治疗作用显著，其对于痔疮引起的肛门肿胀、炎症反应、直肠血管通透性增加等均有很好的治疗效果。

Objective To explore the pharmacodynamic effect and mechanism of Xiaozhi Pills (消痔丸) on croton oil preparation induced hemorrhoidal rats model. Methods Male SD rats were randomly grouped into control group, model group, Xiaozhi Pills low-, medium-, high-dose (0.81, 1.62, 3.24 g/kg) groups, Citrus Bioflavonoids Tablets (柑橘黄酮片, 0.27 g/kg) group and Zhiyanxiao Tablets (痔炎消片, 0.86 g/kg) group, with 20 rats in each group. Rats were continuous ig administration for 7 d, on 4th day of administration, croton oil preparation was applied to the anal canal to induce anal swelling for 72 h. The treatment effect of each treatment group was preliminarily evaluated by measuring the area of anal swelling; Blood and anorectal tissues of rats were collected for biochemical indicators and histopathology tests to evaluate the therapeutic effect and mechanism of Xiaozhi Pills. Results Compared with model group, the symptoms of perianal swelling, mucus overflow and constipation in Xiaozhi Pills group were significantly reduced, anorectal index and vascular permeability were significantly decreased (P < 0.001); The absence of squamous epithelial cells, inflammatory cell infiltration and edema in anal and rectal tissues were significantly reduced. The number of white blood cells and proportion of neutrophils and monocytes in blood were significantly decreased (P < 0.01, 0.001), while the proportion of lymphocytes was significantly increased (P < 0.05). Levels of interleukin-6 (IL-6), IL-1β, tumor necrosis factor-α (TNF-α), prostaglandin E₂ (PGE₂), interferon-γ (IFN-γ) and nitric oxide (NO) in serum and anorectal tissue were significantly reduced (P < 0.05, 0.01, 0.001); IL-6, IL-1β, TNF-α, cyclooxygenase-2 (COX-2), IFN-γ and inducible nitric oxide synthase (iNOS) gene expressions in anal and rectal tissues were significantly reduced (P < 0.05, 0.01, 0.001). Conclusion Xiaozhi Pills has a significant therapeutic effect on croton oil preparation induced acute hemorrhoids model, and it has a good therapeutic effect on anal swelling, inflammatory reaction, rectal vascular permeability increase caused by hemorrhoids.

R285.5

国家自然科学基金重点项目（U21A20406）；兰州市人才创新创业项目（2022-RC-2）