重症急性胰腺炎大鼠促炎抗炎细胞因子的动态变化及大承气汤的调节作用

目的：研究重症急性胰腺炎（SAP）大鼠促炎抗炎细胞因子TNF-α、IL-1、IL-10不同时间点的动态变化及大黄复方的调节作用,探讨大承气汤治疗SAP的作用机制。方法：采用胰胆管逆行注射5%牛磺胆酸钠法建立大鼠SAP模型。将SD大鼠随机分为假手术组、SAP模型组和大承气汤治疗组,观察各组不同时间点血清淀粉酶、TNF-α、IL-1、IL-10水平。结果：SAP模型组与假手术组比较,血清淀粉酶、TNF-α、IL-1水平均明显升高（P〈0.01）,IL-10水平降低（P〈0.01）,TNF-α/IL-10比值降低;大承气汤治疗组与SAP比较,血清淀粉酶、TNF-α、IL-1水平明显降低（P〈0.01）,IL-10水平不同程度上升（P〈0.05,P〈0.01）,TNF-α/IL-10比值回复接近假手术组水平。结论：大承气汤治疗SAP的作用机制可能通过下调IL-1、TNF-α等促炎细胞因子的释放,并一定程度提高抗炎细胞因子IL-10水平,重建促炎和抗炎细胞因子的平衡,进而减轻组织损伤,阻止SAP的进一步发展。

Dynamic Changes of Pro-and Anti-Inflammatory Cytokine of Sever Acute Pancreatitis Rats and Regulative Effection of Da-Cheng-Qi Decoction

Objective：To observe the dynamic levels of pro-and anti-inflammatory cytokine such as tumor necrosis factor（TNF-α）,interleukin-1（IL-1）,interleukin-10（IL-10） of severe acute pancreatitis（SAP）rats in different intervals and regulated by Da-Cheng-Qi Decoction.Methods：Seventy five SD rats were randomly divided into sham operation group,SAP group and Da-Cheng-Qi group.SAP was induced by retrograde injection of 5% sodium taurocholate.Da-Cheng-Qi group was given 43.2% Da-Cheng-Qi Decoction 2ml/100g by forced feeding at 3hours after induction of pancreatitis.The levels of amylase,TNF-α,IL-1 and IL-10 were detected at different intervals.Results：Compared with the sham operation group,the levels of amylase,TNF-α and IL-1 in serum in SAP group were increased significantly（all P〈0.01）,the level of IL-10 and ratio of TNF-α/IL-10 were decreased significantly（P〈0.01）.After the treatment with Da-Cheng-Qi Decoction,the levels of amylase,TNF-α and IL-1 in serum in Da-Cheng-Qi group were decreased significantly（all P〈0.01）,the level of IL-10 increased in different degree（P〈0.05 or P〈0.01）,and the ratio of TNF-α/IL-10 was reversed near the level of sham operation group.Conclusion：Da-Cheng-Qi Decoction has treatment effection on SAP by down-regulating the levels of TNF-α and IL-1,up regulating the level of IL-10,re-establishing the balance of pro-and anti-inflammatory cytokine,and ameliorating the inflammatory response of SAP.