辛开苦降法对反流性食管炎模型大鼠食管黏膜细胞间隙的影响

目的观察辛开苦降法对反流性食管炎（reflux esophagitis,RE）模型大鼠食管黏膜细胞间隙的影响。方法 100只Wistar大鼠按照随机数字表法分为对照组、模型组、西药组、中药组,每组25只,共4组。对照组只行腹腔开关术,其余3组均采用改良部分贲门肌切开加外置幽门部分结扎术,制备RE大鼠模型。术后第3天西药组灌胃混合剂：吗丁啉片（3.2 mg/kg）＋奥美拉唑胶囊（4.3 mg/kg）＋铝碳酸镁片（161.4mg/kg）,中药组灌胃半夏泻心汤加减汤剂（5.7 g/kg）,1次约2.5 m L,1天2次,连续14天;同时对照组和模型组大鼠每天给予灌胃等量生理盐水。观察实验第7、14天各组模型食管下段p H值、黏膜大体标本、病理组织学变化,并测量各组食管黏膜上皮细胞间隙进行对照研究。结果与本组治疗第7天比较,西药组和中药组在第14天大鼠食管下段p H值均升高（P〈0.01）,食管黏膜肉眼积分均降低,上皮细胞间隙亦降低（P〈0.05）。与对照组同期比较,模型组大鼠食管下段p H值均降低（P〈0.01）,模型组大鼠食管黏膜肉眼积分升高,上皮细胞间隙亦升高（P〈0.01）。与模型组同期比较,中药组和西药组第7、14天大鼠食管下段p H值升高,食管黏膜肉眼积分降低（P〈0.01）,中药组和西药组第14天大鼠食管黏膜上皮细胞间隙亦降低（P〈0.01）。与西药组同期比较,中药组第7天大鼠食管下段p H值降低（P〈0.05）,中药组第14天大鼠食管黏膜肉眼积分和上皮细胞间隙均降低（P〈0.05）。结论辛开苦降法对RE动物模型有良好的治疗作用,并随疗程增加效果更加明显,其机制可能是通过对损伤黏膜良好的修复作用、增加下食管括约肌的压力及抑制胃酸实现的。

Effect of Pungent Dispersion Bitter Purgation Method on the Esophageal Mucosal Intercellular Space of Reflux Esophagitis Model Rats

Objective To observe the effect of pungent dispersion bitter purgation method（ PDBPM） on the esophageal mucosal intercellular space of reflux esophagitis（ RE） model rats. Methods Totally 100 Wistar rats were randomly divided into the control group,the model group,the Western medicine group（ WM）,the Chinese medicine group（ CM）,25 rats in each group. Rats in the control group only received switch operation. Rats in the rest three groups received modified partial cardia muscle incision combined pylorus ligation of external parts to prepare the RE rat model. Starting from the 3rd day after operation,WM mixture（ Motilium 3. 2 mg / kg ＋ Omeprazole Capsule 4. 3 mg / kg ＋ Hydrotalcite Tablet 161. 4 mg /kg） was administered by gastrogavage to rats in the WM group. Rats in the CM group was administered by gastrogavage with Modified Banxia Xiexin Decoction（ 5. 7 g / kg）,2. 5 m L each time,twice daily for 14 consecutive days. Equal volume ofnormal saline was administered by gastrogavage to rats in the control group and the model group. On day 7 and 14,the lower esophagus p H value,general specimen of mucosa and histopathologic changes were observed. Intercellular spaces of esophageal epithelium were measured for a control study. Results Compared with the same group at day 7,the lower esophagus p H value increased at day 14（ P 〈0. 01）; the naked eye integral of esophageal mucosa and intercellular spaces of esophageal epithelium also decreased at day 14 in the CM group and the WM group（ P 〈0. 05）. Compared with the control group at the same time point,the lower esophagus p H value decreased in the model group（ P 〈0. 01）. The naked eye integral of esophageal mucosa,and intercellular spaces of esophageal epithelium increased in the model group with increased intercellular spaces（ P 〈0. 01）. Compared with the model group at the same time point,the lower esophagus p H value increased and the naked eye integral of esophageal mucosa decreased in the CM group and the WM group at day