攻下清热活血方对重症急性胰腺炎大鼠血清相关炎性因子及肠黏膜屏障功能的影响研究*

目的:探讨攻下清热活血方对重症急性胰腺炎(SAP)大鼠血清相关炎性因子及肠黏膜屏障功能的影响。方法:将90只SD大鼠随机分为正常对照组与造模组,雌雄各占50%,其中正常对照组大鼠10只,造模组大鼠80只。采用牛磺胆酸钠于胰胆管逆行注射构建SAP大鼠模型,模型组大鼠40只,奥曲肽治疗组大鼠20只,攻下清热活血中药治疗组大鼠20只。待造模过程完成之后开始给药,奥曲肽组于皮下注射16.0 μg/kg的奥曲肽; 中药组以8.33 g/kg的量灌胃。正常对照组与模型组均给予等剂量的生理盐水进行灌胃,上述操作每次间隔为8 h,共3次。比较各组大鼠血清TNF-α、IL-1β水平、MUC2免疫组化评分。结果:奥曲肽组大鼠24 h存活率为40.00%(8/20),中药组大鼠24 h存活率为45.00%(9/20),模型组存活率为25.00%(10/40)。两治疗组大鼠存活率均分别显著高于模型组,奥曲肽组与中药组差异无统计学意义; 模型组、奥曲肽组大鼠血清TNF-α及IL-1β水平均分别显著高于正常对照组(P<0.05),奥曲肽组大鼠血清TNF-α及IL-1β水平均分别显著小于模型组(P<0.05),中药组大鼠血清TNF-α及IL-1β水平均分别显著低于模型组、奥曲肽组(P<0.05),但中药组与正常对照组大鼠血清大鼠血清TNF-α及IL-1β水平差异无统计学意义(P>0.05); 采用免疫组化法对各组大鼠MUC2表达情况进行观察,结果表明:正常对照组MUC2阳性细胞表达率较高,模型组与正常对照组相比,MUC2阳性细胞表达率较低,染色程度相对较低,免疫组化评分显著低于正常对照组(P<0.05); 奥曲肽组MUC2阳性细胞表达率显著高于模型组,中药组MUC2阳性细胞表达率显著高于奥曲肽组(P<0.05)。结论:攻下清热活血中药可对SAP大鼠具有理想的治疗作用,可通过降低血清TNF-α及IL-1β水平来实现,此外其还能对SAP大鼠肠黏膜具有保护效果,加快肠黏膜屏障功能地恢复。

Gongxia Qingre Huoxue herb of TCM on serum inflammatory factors and intestinal mucosal barrier function in rats with severe pancreatitis

Objective:To explore the effects of Gongxia Qingre Huoxue herb of TCM on serum inflammatory factors and intestinal mucosal barrier function in rats with severe pancreatitis.Methods:Ninety SD rats were randomly divided into normal control group and model group,in which male and female rats were half-and-half.Of the rats,there was 10 rats in the normal control group and 80 rats in the model group.After pancreaticobiliary puncture,3.5% sodium taurocholate was used for retrograde injection of pancreaticobiliary tract at a speed of 1 ml/kg and constant pressure by micro-pump,and then the abdomen was closed and sutured.There were 40 rats determined in the model group,including 20 in the octreotide treatment group,and 20 in the treatment group of Chinese herb of Gongxia Qingre Huoxue.After the modeling process was completed,rats in the octreotide group were subcutaneously injected with 16.0 μg/kg octreotide; and those in the traditional Chinese medicine group were intragastrically administered at a dose of 8.33 g/kg.Rats in both the normal control group and the model group were given the same dose of normal saline for intragastric administration.The interval of the above operation was 8 hours each time,in a total of 3 times.The serum TNF-α and IL-1β levels as well as MUC2 immunohistochemical scores of rats in each group were compared.Results:The 24 h survival rate of rats in the octreotide group was 40.00%(8/20),that in the traditional Chinese medicine group was 45.00%(9/20),and the survival rate of the model group was 25.00%(10/40).The survival rates of rats in the two treatment groups were significantly higher than those in the model group.There was no statistically significant difference between the octreotide group and the traditional Chinese medicine group; The levels of serum TNF-α and IL-1β were significantly higher in rats of the model group and octreotide group than those of the normal control group(P<0.05).The levels of serum TNF-α and IL-1β of octreotide group were significantly lower than that of the model group(P<0.05).Besides,the levels of serum TNF-α and IL-1β in the traditional Chinese medicine group were significantly lower than those in the model group and octreotide group(P<0.05).But there was no statistically significant difference in the levels of serum TNF-α and IL-1β between the traditional Chinese medicine group and the normal control group(P>0.05).The expression of MUC2 in each group of rats was observed by immunohistochemistry.The results showed that the positive expression rate of MUC2 in the normal control group was higher.Compared with the normal control group,the model group had a lower positive expression rate of MUC2 and a relatively low degree of staining,and the immunohistochemical score was significantly lower than that of the normal control group(P<0.05).Meanwhile,the positive expression rate of MUC2 in the octreotide group was significant higher than the model group,and that of the traditional Chinese medicine group was significantly higher than that of octreotide group(P<0.05).Conclusion:The Chinese herb of Gongxia Qingre Huoxue may have an ideal therapeutic effect on rats with severe pancreatitis,which can be achieved by reducing the levels of serum TNF-α and IL-1β.In addition,it can also protect the intestinal mucosa of rats with severe pancreatitis and accelerate the recovery of intestinal mucosa barrier function.