三黄泻心汤三味药联合抗生素对幽门螺杆菌的体外抑菌实验研究

目的探讨组成三黄泻心汤的大黄、黄连、黄芩对幽门螺杆菌(Hp)的抑制作用,研究三味中药两两联合、每味中药分别与克拉霉素(CLR)、左氧氟沙星(LEV)、甲硝唑(MTZ)联合对Hp的增敏效果。方法菌株ATCC43504做质控及实验菌株,以药敏纸片法探讨三味中药对Hp的抑制作用;琼脂二倍稀释法检测实验药物(大黄、黄连、黄芩、CLR、LEV、MTZ)单独及联合使用对Hp菌株ATCC43504的最小抑菌浓度(MIC),计算抑菌浓度指数(FICI),确定联合抑菌效果,判断联合用药时实验药物敏感性的变化。结果黄连、大黄、黄芩的抑菌环直径:22 mm、18 mm、10 mm;MIC值:0.625 mg/ml、1.25 mg/ml、5 mg/ml;黄连与黄芩、黄连与CLR、黄连与MTZ、黄芩与MTZ联合的FICI≤0.5,呈协同作用,其余组合为相加作用,未见拮抗作用。菌株ATCC43504为抗生素MTZ的耐药菌株,联合用药时MTZ的MIC大于耐药折点,菌株依然对MTZ耐药。结论中药联合较单药有更强的抑制Hp能力。中药大黄、黄连、黄芩与抗生素联合用药能一定程度上提高抗生素敏感性。三黄泻心汤组方及三味中药可以与抗生素联合应用于根除Hp。

In vitro antibacterial study of three ingredients in Sanhuang Xiexin Decoction combined with antibiotics on Helicobacter pylori

Objective To explore the effects of Rhubarb,Coptis,and Scutellaria in Sanhuang Xiexin Decoction on Helicobacter pylori(Hp)and to study the bacteriostatic effects of different combinations of these three traditional Chinese medicines and their combination with clarithromycin(CLR),levofloxacin(LEV),and metronidazole(MTZ).Methods Kirby-Bauer disk diffusion method was used to explore the inhibitory effects of Rhubarb,Coptis,and Scutellaria on Hp(strain ATCC43504)growth.The minimum inhibitory concentrations(MICs)of the drugs alone and in combination was determined using the agar double dilution method,and the fractional inhibitory concentration index(FICI)was calculated to find out the combined antibacterial effects,and to decide the changes in drug sensitivy when used in combination.Results The diameters of the inhibition zones were as follows:Coptis:22 mm,Rhubarb:18 mm,Scutellaria:10 mm.The MICs of Rhubarb,Coptis,and Scutellaria were 0.625 mg/ml,1.25 mg/ml,and 5 mg/ml,respectively.The FICIs of Coptis with Scutellaria,Coptis with C,Coptis with M,and Scutellaria with M were all no more than 0.5.These combinations displayed synergistic effects,while the other combinations displayed additive effects.The strain ATCC43504 was a resistant strain of antibiotic MTZ.The MIC of MTZ was greater than the resistance break point when used in combination,and the strain was still resistant to MTZ.Conclusion The combination of these traditional Chinese medicines inhibits Hp more strongly than any of the single use of medicines.Rhubarb,Coptis,and Scutellaria may increase antibiotic sensitivity when used in combination with antibiotics.Therefore,the Sanhuang Xiexin Decoction and the 3 ingredients in it can be used in combination with antibiotics for clinical eradication of Hp.