大黄对胃肠道血流灌注影响的临床与实验研究

目的：研究大黄对有肠道血流灌注的影响。方法：采用胃肠粘膜内ＰＨ值评做危下患者胃肠粘膜物血流灌注情况。观察大黄的临床疗效并进行实验研究。结果：临床研究结果显示，脓毒症患者直肠粘膜内ＰＨ值明显低于对照组（Ｐ〈０．０１），大黄能显著提高胃肠粘膜内ＰＨ值（Ｐ〈０．０１），大黄对应激性胃肠粘膜为伴出务的有效率为７３．４％，动物实验结果显示，大黄可提高失血性休克大鼠胃、小肠粘膜和肠系膜的血流量（Ｐ〈０．０１）

Clinical and Experimental Study on Effect of Rhubarb on Gastrointestinal Blood Flow Perfusion

To study the effect of rhubarb on gastrointestinal (GI) pertusion in critical illness and hemorrhagic shocked rats. Methods: Clinical study: Sixty-four septic patients suffered from stress ulcer were treated with rhubarb at a dose of 25 mg/kg, 25 non-septic patients were taken as control. The GI perfusion was evaluated by intramural pH. Animal study: SD rats were anesthetized with intraperitoneal sodium pentobarbital at a dose of 20 mg/kg. Then the animals were blood-letting, the blood pressure reduced to 5. 32kPa and maintained for 120 minutes. They were resuscitated at the end of shock by reperfusing all the shed blood. The rats were divided into four groups: normal control, shock group, treated group (shocked rats were treated with 50 mg/kg rhubarb by the end of shock), and rhubarb group (normal rats were treated with rhubarb). Laser Doppler determination was applied to estimate the GI per fusion. Results: Clinical study: The pH in septic patients was much lower than that in the control, whereas rhubarb could obviously elevate GI' pH (P< 0. 01 ). In addition, rhubarb also had a good effect on gastric hemorrhage caused by stress ulcer, the effectiveness was 73.4%. Animal study: Although the shocked rats were resuscitated completely, their GI per fusion was much lower than that in the control. Rhubarb could significantly improve the mucous membrane of GI and mesenterium perfusion (P < 0. 01 ). Furthermore, rhubarb also increased the GI per fusion in normal rats. Conclusion: The rhubarb could improve the GI blood perfusion in critical illness and shocked rats.