茵陈胆道汤对急性胆管炎血浆纤维连结蛋白、胆汁血栓素A2和前列环素的影响

目的：探讨菌陈胆道汤治疗急性胆管炎的作用机制。方法：24急性胆管炎患者和36例胆管结石患者分别随机分为服药组和对照组，均经手术治疗，服药组手术后3天开始服用菌陈胆道汤，连服7天。观察服药前后血浆纤维连结蛋白（FN）和胆汁中血栓素A2（TXA2）及前列腺环素（PGI2）含量的变化。同时将兔制成急性胆管炎模型并设实验对照组，两组兔分别随机分为服药组和对照组，观察服药前后FN和胆汁中TXA2、PGI2含量的变化。结果：胆管炎患者术前FN明显低于胆管结石组（P<0.01），术后服药组则明显上升，与对照组比较差异有显著性（P<0.01）；胆管结石组也有类似变化。胆管炎组患者胆汁中TXA2和PGI2含量均明显高于胆管结石组（P<0.01,P<0.05）；服药后均显著下降（P<0.01）。胆管炎兔服药组FN显著升高(P<0.01）；胆管炎兔胆汁TXA2和PGI2含量显著高于对照组（P<0.01）。结论：菌陈胆道汤能升高FN和降低胆汁中TXA2和PGI2水平，这可能是其治疗急性胆管炎的作用机理之一。

Effect of Yinchen Dandao Decoction on Plasma Fibronectin, Biliary Thromboxane A2 and Prostaglandin I2 in Human and Animal Suffering from Acute Cholangitis

OBJECTIVE: To study the therapeutic mechanism of Yinchen Dandao decoction (YCDDD) in treating acute cholangitis. METHODS: Twenty-four patients with acute cholangitis and 36 cholangiolithiasis patients were randomly classified into the treated group and the control group, and all of these patients had undergone surgical operation. The treated group were given orally YCDDD 3 days after operation for 1 week, and plasma fibronectin (FN), biliary thromboxane A2(TXA2) and prostaglandin I2(PGI2) were measured and compared before and after oral administration of the drug. The models of cholangitis were established in rabbits, which were also randomly grouped into the treated group and the control group, and the same parameters (FN, TXA2, PGI2) were observed as in rabbits. RESULTS: The level of FN was significantly lower in cholangitis patients than that in the cholangiolithiasis patients before operation (P < 0.01), and compared to the control group, it obviously raised after YCDDD treatment (P < 0.01), the same happened in the cholangiolithiasis patients. The value of TXA2 and PGI2 in the bile was obviously higher (P < 0.01, P < 0.05) in cholangitis patients than those in chlangiolithiasis, and obviously reduced after YCDDD administration (P < 0.01). The level of FN in the treated group and the level of biliary TXA2 and PGI2 in rabbits with cholangitis were significantly higher than those in the control group (P < 0.01). CONCLUSION: YCDDD caused the increase of FN and decrease of biliary TXA2 and PGI2, which might be one of the mechanisms of the drug carried out in cholangitis patients.