丁香降气方对反流性食管炎大鼠胃排空及Cajal间质细胞影响的实验研究

目的：从胃动力角度探讨丁香降气方治疗反流性食管炎的作用机制。方法：采用贲门肌切开加幽门半结扎术制作酸反流性食管炎大鼠模型；中药组予丁香降气方颗粒剂混悬液灌胃，西药组予吗丁啉混悬液灌胃，模型组和假手术组予以等量的生理盐水灌胃．半固体排空检测法测定胃排空，免疫组化法观察胃体、胃窦C—kit阳性CajalN质细胞（ICC）的变化。结果：①胃内残留率：模型组较假手术组高（P〈0．01）；中药组和西药组较模型组降低（P〈0．05，P〈0.01），中药组低于西药组（P〈0.05）。②胃体、胃寞平滑肌层间、肌层内ICC计数：模型组较假手术组减少（P〈0．01）；中药组和西药组较模型组增多（P〈0．05，P〈0．01）；中药组胃体平滑肌层间ICC计数多于西药组（P〈0．01）。结论：①反流性食管炎大鼠存在胃排空延迟，胃体、胃窦平滑肌层间和肌层内ICC数量减少，可能是引起胃节律性电活动异常，胃动力下降，胃排空延迟的重要机制。②丁香降气方通过增加胃体、胃窦平滑肌层间、肌层内的ICC数量，能促进胃排空，改善胃动力，治疗反流性食管炎。

Effect of Dingxiang Jiangqi Recipe on Gastric Emptying and Cajal Interstitial Cells in Reflux Esophagitis Rats

Objective:To investigate the possible mechanism of Dingxiang Jiangqi Recipe for reflux esophagitis by studying the gastric motility.Methods:Acid reflux esophagitis models were induced by cardiomyotomy and pylorus semi-ligation.One week after modeling,suspension of Dingxiang Jiangqi Recipe granule was given to rats in the treatment group by intragastric administration,and Domperidone suspension was given to the positive control group,while saline was given to the sham operation group and model group.Semisolid paste method was used to measure the gastric emptying,while C-kit-positive interstitial cells of Cajal(ICC)in the corpus ventriculi and sinus ventriculi were quantitatively measured by immunohistochemical assay.Results:(1)Gastric remnant rate in the model group was significantly higher than the sham operation group(P<0.01),but in the treatment group and the positive control group,the rate was lower than that in the model group,and it was obviously lower in the treatment group than that in the positive control group.(2)The count of C-kit-positive cells of myenteric plexus ICC (ICC-MY),intramuscular ICC(ICC-IM)in the corpus ventriculi and sinus ventriculi was less in the model group than that in the sham operation group(P<0.01),but and more in the treatment group and the positive control group than that in the model group.The count of ICC-MY in corpus ventriculi of the treatment group was more than that in the positive control group(P<0.01),while there was no obvious difference between the two groups in the count of ICC-IM in corpus ventriculi and sinus ventriculi.Conclusion:(1)Delayed gastric emptying exists in the rats of reflux esophagatitis.The decreased number of ICC-Y and ICC-IM in corpus ventriculi and sinus ventriculi may induce the abnormality of gastric rhythmic electric activity,which lead to the lowering of gastric motility and the delay of gastric emptying.(2)Dingxiang Jiangqi Recipe can accelerate the gastric emptying and improve the gastric motility.The possible mechanism might be related with the increase of the number of ICC-MY and ICC-IM in corpus ventriculi and sinus ventriculi.