四君子汤联合快速康复外科干预肝脏缺血再灌注损伤的实验研究  

Intervention of hepatic ischemia-reperfusion injury by Sijunzi Tang combining fast-track surgery

作　　者：傅永清[1] 华晨[1] 陈炳荣[1] 傅天啸[1] 张军[1] 周剑[1] 

机构地区：[1]浙江中医药大学附属第一医院外科,浙江310006

出　　处：《北京中医药大学学报》2012年第11期757-760,F0003,共5页Journal of Beijing University of Traditional Chinese Medicine

基　　金：浙江省教育厅基金项目(No.Y201018053)

摘　　要：目的探究四君子汤联合快速康复外科(FTS)对肝脏缺血再灌注损伤的干预作用。方法健康SPF级SD大鼠60只,随机分为假手术组、非FTS组及FTS组,FTS组再分常规组及FTS中药组,每组各15只。所有大鼠均行胆管总结扎制备梗阻性黄疸模型,FTS组及非FTS组均进行肝脏缺血再灌注操作。FTS中药组加用中药(四君子汤)干预。24 h后检测血清天冬氨酸转氨酶(AST)、谷氨酸转氨酶(ALT),肝脏组织丙二醛(MDA)、超过氧化物歧化酶(SOD),HE染色观察大鼠肝脏形态学改变,TUNEL法检测肝组织细胞原位凋亡,并计算凋亡指数(AI)。结果各组间大鼠血清ALT、AST水平相互比较,假手术组与FTS组无明显差异(P>0.05),与非FTS组比较有差异(P<0.05),非FTS组与FTS组比较有差异(P<0.05),FTS中药组与FTS常规组比较有差异(P<0.05);各组间MDA比较无差异(P>0.05);假手术组与FTS常规组SOD无差异(P>0.05),其余各组相互比较均有差异(P<0.05);形态学观察:FTS组损伤情况轻于非FTS组;假手术组AI显著低于其他各组(P<0.01),非FTS组高于FTS组(P<0.05)。结论 FTS的因素干预能改善肝细胞的凋亡程度,降低黄疸大鼠缺血再灌注损伤后肝细胞和肝功能的损伤程度。Objective To investigate the intervention effect （FTS） on hepatic ischemia-reperfusion injury. Methods of Sijunzi Tang combining fast-track surgery divided into sham-operation group, non-FTS group and FTS Health SD rats （n = 60 ） were randomly group, and FTS group was divided further into routine group and Chinese medicinal group （FTS ＋ CM group, each n = 15 ）. The model of obstructive jaundice was established by common bile duct ligation in all rats, and FTS groups and non-FTS group were given the operation of hepatic ischemia-reperfusion. FFS ＋ CM group was additionally given Chinese medicinals （Sijunzi Tang）. After 24 hours, the levels of aspartate aminotransferase （ AST）, alanine aminotransferase （ ALT）, malondialdehyde （MDA） and superoxide dismutase （SOD） were detected. The morphological changes of liver were observed after HE staining. The in situ apoptosis of liver cells was detected by using TUNEL and apoptosis index （AI） was calculated. Results The comparison in the levels of ALT and AST showed that there was no significant difference between sham-operation group and FTS groups （P 〉 0.05 ） , there was a difference between sham-operation group and non-FTS group （ P 〈 0.05 ）, there was a difference between non-NFS group and FTS groups （ P 〈 0.05 ）, and there was a difference between routine group and FTS ＋ CM group （ P 〈 0.05 ）. The comparison in level of MDA showed there was no difference among all groups （P 〉 0.05 ）. The comparison in level of SOD showed that there was no difference between sham-operation group and routine group （ P 〉 0.05 ） , and there were differences in the comparison among other groups （P 〈 0. 05 ）. The morphological observation showed that the injury was milder in FTS groups than that in non-FFS group. AI was significantly lower in sham-operation group than that in other groups （P 〈 0.01 ）, and higher in non-FTS group than that in FTS groups （ P 〈 0.05 ）. Conclusion The intervention of FT

关 键 词：快速康复外科 肝脏缺血再灌注损伤 天冬氨酸转氨酶 谷氨酸转氨酶 丙二醛 超过氧化物歧化酶 细胞凋亡 大鼠 

分 类 号：R285.5[医药卫生—中药学]