早期肠内营养合中药干预对胃大部切除术后肠屏障功能的影响

目的探讨早期肠内营养合中药干预对胃大部切除大鼠肠黏膜屏障功能的影响及机制。方法将60只雄性SD大鼠建立胃大部切除模型,随机分成对照组,普通肠内营养组,肠内营养加四君子汤组。从术后第1天起连续营养支持7 d,各组等氮、等热卡。观察术前1 d、术后1 d、3 d和术后7 d的免疫指标(肠壁CD4 、CD8 、CD4 /CD8 ),肠黏膜通透性指标(D-乳酸)以及肠道细菌易位情况(血中细菌DNA检测)的变化。结果四君子汤组术后3 d后CD4 、CD8 、CD4 /CD8 水平显著高于对照组和肠内营养组(P<0.05),D-乳酸浓度、血中细菌DNA阳性率显著低于对照组和肠内营养组(P<0.05)。结论早期肠内营养合中药(四君子汤)干预可提高术后大鼠的免疫机能,降低肠黏膜通透性,明显改善肠黏膜屏障功能,减少肠道细菌易位的发生。

Effect of Early Enteral Nutrition plus "Sijunzi Decoction" on Intestinal Mucosal Barrier Function after Subtotal Gastrectomy

Objective To evaluate the influence of early enteral nutrition plus "Sijunzi Decoction" on intestinal mucosal barrier function after subtotal gastrectomy and explore the possible mechanism.Methods Subtotal gastrectomy was performed in sixty male Sprague-Dawley rats,and then the rats were divided randomly into three groups with twenty animals in each group: control group(C group),enteral nutrition group(EN group) and treatment group(EN SJZD group).The rats received isocaloric and isonitrogenous nutrition support for seven days.The gut immunity indexes including CD4 ,CD8 ,CD4 /CD8 ,plasma levels of D-lactic acid,and bacterial DNA in serum the day before operation and day 1,day 3 and day 7 after operation were measured.Results The levels of CD4 ,CD8 ,CD4 /CD8 ,D-lactic acid,and bacterial DNA in EN SJZD group were higher than those in other groups,P<0.05,and there were significantly lower D-lactic acid value and bacterial translocation positive rate in the study group,P<0.05.Conclusion Early enteral nutrition combined with "Sijunzi Decoction" may effectively improve the immunity and decrease the intestinal mucosal permeability of the subtotal gastrectomy rats,also may obviously decrease the bacterial translocation positive rate through protecting the intestinal mucosal barrier function.