清胰汤对大鼠重症急性胰腺炎时急性肺损伤治疗作用的观察

目的 :探讨中药清胰汤在治疗重症急性胰腺炎 (SAP)时对急性肺损伤 (ALI)的保护机制 ,为临床用药提供确切的理论依据。 方法 :Wistar大鼠制备大鼠重症急性胰腺炎肺损伤模型 ,随机分成 3组 :假手术对照组 (SHAM) ,SAP模型组 (SAP) ,SAP +清胰汤治疗组 (QYT)。分别于造模后 2 4h测定动脉血气、血清淀粉酶的含量、血清内毒素及血清和肺组织匀浆中的TNF、IL - 6、MDA、SOD的含量、肺湿重 /干重比值以及肺组织病理学改变。 结果 :①SAP模型组内毒素、TNF、IL - 6、氧自由基、肺湿重 /干重比值均较SHAM组明显升高 (P <0 0 1)。动脉血气显示肺损伤严重 ,肺组织病理学形态改变加重。②QYT组各检测指标均较SAP组明显改善 (P <0 0 5 )。 结论 :清胰汤通过保护肠屏障 ,减少了细菌移位 ,降低血清中内毒素水平 ,防止过氧化损伤 ,纠正机体致炎和抗炎系统失衡等多方面机制而对肺脏起到全面保护作用。

Effect of Qingyi(清胰) Decoction on Rats with Acute Lung Injury Caused by Severe Acute Pancreatitls

Objective To observe the therapeutic mechanism of Qingyi decoction in the rats with acute lung injury(ALI)induced by severe acute pancreatitis(SAP) Methods Sodium deoxycholate 1.5% was injected retrograddy into the common biliopancretic duct in rats to make the model of ALI during SAP.The rats were divided into 3 groups randomly:(1)sham operated controls(n=10);(2)SAP model(n=20);(3)SAP+Qingyi decoction(n=20).All the rats were killed in 24 hours after operation and treatment.The levels of TNF,IL-6,MDA and SOD in serum and pulmonary homogenate were measured,compared and analyzed.Results 1.The serum level of endotoxin(ET),the levels of TNF,IL-6,SOD,MDA in serum and pulmonary homogenate of the model group were significantly higher than those of sham opera ted control group( P <0.01).The indices of blood gas analysis showed obvious pathologic changes in the model group and so did the pathologic examination of lung tissue.2.The indexes of SAP+Qingyi decoction group were better than the model group( P <0.05).Conclusion ET,TNF,IL-6,OFR,NO play an important role in ALI caused by SAP.Qingyi decoction protects the lungs from injury in many aspects,by preserving the damage of gut barrier function,reducing or eliminating endotoxemia derived from the gut,inhibiting the production and release of TNF,IL-6 and the translocation of bacteria.