大黄附子汤对急性坏死性胰腺炎大鼠小肠黏膜屏障功能的保护作用  

Protective effects of Dahuangfuzi decoction on the intestine barrier functional of acute necrotizing pancreatitis in rats

作　　者：路小光[1] 战丽彬[2] 康新[1] 刘国辉[3] 董云[1] 范治伟[1] 白黎智[1] 刘莉[1] 纪春阳[1] 王小周[1] 

机构地区：[1]大连大学附属中山医院急诊科,大连116001 [2]大连医科大学附属二院中医科 [3]吉林大学附属第一医院急诊科

出　　处：《中华胰腺病杂志》2011年第2期113-116,共4页Chinese Journal of Pancreatology

基　　金：国家自然科学基金项目（30672767、30971626）;辽宁省科技厅（2007225005）

摘　　要：目的 探讨大黄附子汤对急性坏死性胰腺炎（ANP）大鼠小肠黏膜屏障功能的影响及意义.方法 将60只SD大鼠按数字表法随机分为假手术组（19只）、ANP组（21只）和大黄附子汤治疗组（20只）.经胰胆管逆行注入4%牛磺且酸钠1 ml/kg体重建立ANP模型,同时行空肠造瘘.治疗组于制模后0.5 h经空肠造瘘管注入大黄附子汤2 ml,隔4、8 h再注入2 ml;其他两组注入等容积生理盐水.术后24 h经腹主动脉取血,测定血淀粉酶、内毒素、D-乳酸含量及二胺氧化酶（DAO）活性.取胰腺、小肠组织行病理学检查,测定肠上皮损伤指数,观察小肠黏膜超微结构改变.结果 假手术组大鼠血淀粉酶、内毒素、D-乳酸含量及DAO活性分别为（152±32）U/L、（6.95±2.10）pg/L、（3.96±1.08）μg/ml和（14.26±2.67）μg/ml,ANP组分别为（1549±93）U/L、（40.48±3.41）pg/L、（12.34±1.23）μg/ml和（80.28±3.54）μg/ml,治疗组分别为（655±49）U/L、（19.55±2.50）pg/L、（6.75±1.36）μg/ml和（20.69±7.53）μg/ml,ANP组较假手术组明显升高,而治疗组较ANP组显著降低,但仍高于假手术组（P＜0.05或＜0.01）.ANP组小肠黏膜厚度、绒毛高度分别为（389.44±29.87）μm、（16.52±3.73）μm,显著低于治疗组的（501.95±45.38）μm、（27.82±5.17）μm,更显著低于假手术组的（658.72±57.49）μm和（35.49±6.43）μm;而肠上皮损伤指数为3.72±0.65,显著高于治疗组的2.12±0.37和假手术组的0.85±0.24.同时,大黄附子汤治疗后小肠黏膜组织学和超微结构改变亦均较ANP组明显减轻.结论 大黄附子汤可明显减轻ANP大鼠小肠黏膜屏障功能损害的程度.Objective To observe the effects of Dahuangfuzi decoction on the intestine barrier functional of acute necrotizing pancreatitis in rats. Methods The 60 rats were randomly divided into sham operation group （ n = 19 ）, ANP group （ n = 21 ）, and Dahuangfuzi treatment group （ n = 20）. The rats of ANP group were induced by injecting 1 ml/kg of 4% sodium taurocholate into the pancreatiobiliary duct, and jejunal fistula was esablished. The rats of treatment group received Dahuangfuzi decoction （2 ml, repeated at 4 and 8 h）through jejunum distal stoma tube 0. 5 h after ANP induction. The other 2 groups received same amount of normal saline. Blood sample was collected through abdominal aorta, 24 h after ANP induction, and the serum amylase, endotoxin, D-lactate, plasma diamine oxidase （DAO） were detected. Pancreas, small intestine tissue was harvested for pathologic examination, index of intestinal epithelial damage was measured and ultrastructural changes in small intestinal mucosa was observed. Results The expression of serum amylase, endotoxin,D-lactate, DAO in sham operation group was （ 152 ± 32 ） U/L, （6.95 ± 2.10） pg/L, （ 3.96 ± 1.08 ） μg/mland （ 14.26 ± 2.67 ） μg/ml, while the corresponding values were （ 1549 ± 93 ） U/L, （40.48 ± 3.41 ） pg/L,（ 12.34 ± 1.23 ） μg/ml and （ 80.28 ± 3.54） μg/ml in ANP group, and they were （655 ± 49 ） U/L, （ 19.55 ±2.50） pg/L, （6.75 ± 1.36 ） μg/mland （ 20.69 ± 7.53 ） μg/ml in treatment group. The values in ANP group were significantly higher than those in sham operation group. The values in treatment group were significantly lower than those in ANP group, but significantly higher than those in sham operation group （ P ＜ 0.05 or P ＜0. 01 ）. The thickness and height of intestinal mucosa in ANP group were （ 389.44 ± 29.87 ）μm and （ 16.52 ±3.73） μm, which were significantly lower than those in treatment group [（501.95 ± 45.38 ）μm, （27.82 ±5.17）] μm, and in sham operation grou

关 键 词：胰腺炎 急性坏死性 大黄附子汤 内毒素类 二胺氧化酶 肠道屏障功能障碍 

分 类 号：R576[医药卫生—消化系统]