清热解毒方对脓毒症大鼠的治疗作用  

Mechanism of Qing Re Jie Du(清热解毒) Formula in Septic Rat Model

作　　者：刘洪斌[1] 吴咸中[1] 李东华[1] 王倩[2] 杨秀竹[2] 薛小平[2] 张艳萍[2] 

机构地区：[1]天津医科大学南开临床学院,天津300100 [2]天津市中西医结合急腹症研究所

出　　处：《中国中西医结合外科杂志》2008年第6期580-584,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：天津市科技攻关计划重大科技项目(O5YFGDSF02600)

摘　　要：目的:观察不同剂量清热解毒方对脓毒症模型大鼠的治疗效果,并探讨其作用机制。方法:采用盲肠结扎穿孔法制作大鼠脓毒症模型,给予不同剂量清热解毒方(流浸膏)进行治疗,连续3d,观察动物死亡率,测定多种生化指标,同时测定血中C-反应蛋白、内毒素、脂多糖结合蛋白、单核细胞趋化因子-1水平,进行主要脏器病理组织学观察。结果:脓毒症模型大鼠72h死亡率为65%,多项血清生化指标明显异常;血清C-反应蛋白、内毒素、脂多糖结合蛋白及单核细胞趋化因子-1水平显著升高,主要脏器的病理组织学呈现明显损害;清热解毒方大剂量(24g/kg体重)组死亡率显著降低,血清生化指标明显改善,血清C-反应蛋白、内毒素、脂多糖结合蛋白及单核细胞趋化因子-1水平显著降低,主要脏器的病理组织学改变明显减轻。中、小剂量的各项检查虽均有明显改善,但72h动物死亡率并未显著降低。结论:清热解毒方可通过清热解毒和通里攻下的双重作用机制,拮抗和降低内毒素的致炎作用,降低脂多糖结合蛋白和单核细胞趋化因子-1水平,从而减轻脓毒症时主要脏器损害,降低死亡率。Objective To study the mechanism of Qing Re Jie Du（清热解毒） Formula in treating a cecal ligation and puncture（CLP） rat septic model.Methods Using a sepsis model induced by CLP,the septic rats were treated with 3 different doses of liquid extract of Qing Re Jie Du Formula for 72 h. The serum biochemical parameters, sermn exdotoxin, lipopolysaccharide binding protein （LBP） and monocyte chemotactic protein I （MCP- 1 ） were examined. Histopathological changes of the intestine, liver and lung were observed with light microscopy. Also, the mortalities of different groups were determined. Results The 72h mortality of the model group is 65 % and the multiple serum bio- chemical parameters, serum endotoxin, LBP and MCP - 1 of the model group were all increased significantly compared with the sham operation group. Histopathological changes were obvious in model group. The high dose of Qing Re Jie Du formula decreased the 72h mortality to 10%, significantly lower than that of the model group and all the parameters were decreased in high dose group. Although the parameters of median and low dose groups were reduced, their mortalities remained not different from the model group. Conclusion The Qing Re Jie Du Formula has therapeutic effects on septic model by double mechanisms, one is purgation and the other is clearing heat and dispelling toxin. It can antagonize the effect of endotoxin and inflammatory effects, decrease the LBP and MCP- 1 levels and alleviated the organ damage, thus reducing the mortality.

关 键 词：清热解毒方 脓毒症 内毒素 脂多糖结合蛋白 单核细胞趋化因子-1 

分 类 号：Q95-33[生物学—动物学] R285.5[医药卫生—中药学]