摘要
目的探讨通肠清胰汤对重症急性胰腺炎(severe acute pancreatitis,SAP)大鼠肠道功能的影响。方法将36只雄性Wistar大鼠随机分为通肠清胰汤组、SAP组、假手术组,每组各12只,通肠清胰汤组和SAP组大鼠经胆胰管穿刺逆行注射法制备SAP模型,假手术组大鼠麻醉开腹后翻动十二指肠并触摸胰腺数次后缝合腹部。通肠清胰汤组予通肠清胰汤煎剂灌胃,SAP组和假手术组大鼠予以等体积生理盐水灌胃,每隔2h灌胃1次。术后6h各组大鼠以1.5ml亚甲蓝注射液灌胃,所有大鼠均于造模成功后7h取胰腺组织、小肠,计算小肠推进比,HE染色观察胰腺组织及回肠末端组织;取部分回肠标本以蛋白质印记法(Western blot)检测5-羟色胺受体1A(5-hydroxytryptamine receptor 1A,5HT1AR)的表达;取腹主动脉血,分离血清,检测血淀粉酶(amylase,AMS)、脂肪酶(lipase,LPS)、C反应蛋白(Creactive protein,CRP)、二胺氧化酶(diamine oxidase,DAO)、5-羟色胺(5-hydroxytryptamine,5-HT)的水平。结果与假手术组比较,SAP组、通肠清胰汤组的小肠推进率差异有统计学意义(P均<0.05);与SAP组比较,通肠清胰汤组的小肠推进率差异无统计学意义(P>0.05)。HE染色显示假手术组胰腺、回肠组织无明显病理损伤变化;SAP组胰腺腺泡细胞广泛坏死、小叶结构模糊、间质水肿出血、坏死胰腺周围浸润炎性细胞,回肠细胞肿胀、炎性细胞浸润、肠绒毛剥脱、局部出血坏死、黏膜腺体减少;通肠清胰汤组的胰腺、回肠病理损害较SAP组均减轻。与假手术组比较,SAP组、通肠清胰汤组血AMS、LPS、CRP、DAO、5-HT水平均显著升高(P<0.01);通肠清胰汤组血AMS、LPS、CRP、DAO、5-HT水平较SAP组均降低(P<0.01)。与假手术组比较,SAP组、通肠清胰汤组回肠黏膜5-HT1AR蛋白表达均降低(P均<0.01);通肠清胰汤组回肠黏膜5-HT1AR蛋白表达较SAP组升高(P<0.01)。结论通肠清胰汤能保护肠黏膜,其机理可能是通过恢复5-HT与其受体的亲和力,使5-HT与5-HT1AR的水平处于一个较为平衡的状态,从而收缩胃肠道平滑肌,改善肠道功能。
Objective To investigate the effect of Tongchang Qingyi decoction on intestinal function of rats with severe acute pancreatitis(SAP).Methods Thirty-six male Wistar rats were randomly divided into Tongchang Qingyi decoction group,SAP group and sham operation group,with 12rats in each group.The model of SAP was prepared by retrograde injection of biliary pancreatic duct puncture on Tongchang Qingyi decoction group and SAP group rats,while the rats in the sham operation group were anesthetized and given laparotomy,and then the duodenum was turned and the pancreas touched several times before the abdomen was sutured.The rats in Tongchang Qingyi decoction group was administered with Tongchang Qingyi decoction by gavage,and the rats in SAP group and the sham operation group were given an equal volume of normal saline by gavage,all of them were intragastrically administered once every 2hours.Pancreatic tissue and small intestine were taken from all rats 7hafter successful modeling,the small intestine propulsion ratio was calculated,and the pancreatic tissue and terminal ileum tissues were observed by HE staining.The expression of 5-hydroxytryptamine receptor 1A(5HT1AR)in ileal specimens were detected by Western blot.The level of amylase(AMS),lipase(LPS),C-reactive protein(CRP),diamine oxidase(DAO),5-hydroxytryptamine(5-HT)in abdominal aortic blood were detected.Results Compared with the sham operation group,the small intestine propulsion ratios of the SAP group and the Tongchang Qingyi decoction group were significantly different(all P<0.05);there was no significant difference in the small intestine propulsion ratio of the Tongchang Qingyi decoction group and the SAP group(P>0.05).HE staining showed no obvious pathological changes in the pancreas and ileum tissues of the sham operation group;in the SAP group,pancreatic acinar cells were extensively necrotic,lobular structure was fuzzy,interstitial edema and hemorrhage,inflammatory cells infiltrated along the necrotic pancreas,ileum cell swelling,inflammatory cell infiltration,intestinal villi exfoliation,local hemorrhage and necrosis and mucosal glands decreased;the pathological damage of the pancreas and ileum in the Tongchang Qingyi decoction group was reduced than that of the SAP group.Compared with the sham operation group,the levels of AMS,LPS,CRP,DAO,5-HT in the SAP group and Tongchang Qingyi decoction group were significantly increased(P<0.01).The levels of AMS,LPS,CRP,DAO and 5-HT in Tongchang Qingyi decoction group were lower than those in SAP group(P<0.01).Compared with the sham operation group,the expression of 5-HT1AR protein in the ileal mucosa of SAP group and Tongchang Qingyi decoction group were reduced(all P<0.01);the 5-HT1AR protein expression in ileal mucosa of Tongchang Qingyi decoction group was higher than that of SAP group(P<0.01).Conclusion Tongchang Qingyi decoction can protect the intestinal mucosa.The mechanism may be that the levels of 5-HT and 5-HT1AR are in a relatively balanced state by restoring the affinity of 5-HT and its receptor,thereby contracting smooth muscles of the gastrointestinal tract and improving intestinal function.
作者
章茜
刘斌斌
苏成霞
胡运莲
ZHANG Qian;LIU Binbin;SU Chengxia;HU Yunlian(Department of Spleen and Stomach,Hubei Provincial Hospital of Traditional Chinese Medicine,Wuhan Hubei 430061,China)
出处
《华南国防医学杂志》
CAS
2020年第5期301-305,共5页
Military Medical Journal of South China
基金
中国中医科学院中医基础理论研究所“院所协同创新”科研专项基金(YZ-1757)。
关键词
重症急性胰腺炎
通肠清胰汤
肠道功能
实验研究
Severe acute pancreatitis
Tongchang Qingyi decoction
Intestinal function
Experimental study
