大黄甘草汤对高原急性坏死性胰腺炎合并肠损伤大鼠的影响  

Effect of Dahuang Gancao decoction on intestinal injury caused by acute necrotizing pancreatitis at plateau

作　　者：张方信[1] 李文祥[3] 邓芝云[2] 张盼[1] 陈嘉屿[1] 邓尚新[1] 王秀锋[1] 贾红梅[1] 苟艳子[1] 

机构地区：[1]兰州军区兰州总医院消化科,兰州730050 [2]兰州大学第二临床医学院消化科 [3]兰州军区兰州总医院检验科,兰州730050

出　　处：《中华胰腺病杂志》2013年第6期390-394,共5页Chinese Journal of Pancreatology

基　　金：全军后勤科研计划（CLZ12J005）

摘　　要：目的 观察大黄甘草汤对高原急性坏死性胰腺炎（P-ANP）并发肠损伤大鼠的治疗效果.方法 54只Wistar大鼠,由兰州市运至马衔山（海拔3848米）适应性喂养1个月.按完全随机法分为假手术组、P-ANP组、大黄甘草汤组,每组18只.采用逆行胰胆管注射4％牛磺胆酸钠方法制备P-ANP模型.大黄甘草汤组于造模前2h、造模后每12 h给予大黄甘草汤0.6 ml/100 g体质量灌胃,假手术组和P-ANP组给予等容积生理盐水灌胃.术后6、12、24 h分批处死大鼠,取胰腺及小肠组织行组织病理学检查并评分,透射电镜观察肠黏膜超微结构变化.采用ELISA法检测小肠组织IL-10、TNF-α表达水平.结果 造模后12 h,假手术组、P-ANP组、大黄甘草汤组的胰腺病理评分为（0.33±0.52）、（8.33±0.52）、（6.17±2.13）分;肠组织病理评分为（0.17±0.41）、（3.83±1.17）、（2.17±1.17）分.P-ANP组和大黄甘草汤组胰腺、小肠病理评分均显著高于假手术组（P值均＜0.01）,大黄甘草汤组又均显著低于同时间点的P-ANP组（P值均＜0.05）,且大黄甘草汤组肠组织和胰腺组织病理学损伤呈正相关（r =0.796,P＜0.01）.P-ANP组大鼠肠黏膜超微结构损伤严重,而大黄甘草汤组较P-ANP组损伤明显减轻.造模后12 h,假手术组、P-ANP组、大黄甘草汤组小肠组织IL-10水平分别为（136.68±13.98）、（762.21 ±79.58）、（896.36±84.87） pg/g,TNF-α水平分别为（353.05±76.21）、（1913.87±259.33）、（1481.58±231.47）pg/g,P-ANP组和大黄甘草汤组IL-10、TNF-α水平均较假手术组显著增高,大黄甘草汤组IL-10水平又较P-ANP组显著增高（P＜0.05）,但TNF-α水平则较P-ANP组显著降低（P＜0.05）.结论 大黄甘草汤可迅速改善P-ANP大鼠并发的肠损伤.Objective To investigate the therapeutic effects of dahuang gancao decoction on intestinal injury caused by plateau acute necrotizing pancreatitis （ANP）.Methods Fifty-four Wistar rats were transported from Lanzhou to Maxianshan （altitude 3848 m） for 30 days adaptive feeding,then they were randomly divided into 3 groups （n =18 in each group）,namely sham-operated group （SO）,P-ANP group （P-ANP）,dahuang gancao decoction intervention group （DG）.P-ANP model was induced by retrograde injection of 4% sodium taurocholate into the biliary and pancreatic duct.Dahuang gancao decoction 0.6 ml/100 g weight was gavaged 2 h before and every 12 h after P-ANP model induction.The same volume of normal saline was gavaged in the SO and P-ANP group.After 6,12,24 h,all rats were sacrificed,and pancreas and intestine tissues were harvested to observe the pathological changes.The change of intestinal mucosal ultrastructure was observed under transmission electron microscope.The expression of IL-10,TNF-α in intestinal tissue was determined by ELISA.Results twelve hours after P-ANP induction,the pancreas pathological scores were 0.33 ± 0.52,8.33 ± 0.52,6.17 ± 2.13 ; the intestine pathological scores were 0.17 ±0.41,3.83 ± 1.17,2.17 ± 1.17 in SO group,P-ANP group and DG group.The values in P-ANP group and DG group were significantly higher than that in SO group （P 〈 0.01）,and the corresponding values in DG group were significantly lower than that in P-ANP group （P 〈0.05）,and there was a positive association between pancreas and intestine injuries （r =0.796,P 〈 0.01）.The injury of intestinal mucosal ultrastructure in P-ANP groups was severe; however,the injury was less severe in DG group.Twelve hours after ANP induction,the IL-10 levels in intestinal tissue were （136.68 ± 13.98）,（762.21 ± 79.58）,（896.36±84.87） pg/g; the TNF-α levels in intestinal tissue were （353.05± 76.21）,（1913.87± 259.33）,（1481.58 ± 231.47） pg/g in SO group,P-ANP group and DG group.The values

关 键 词：胰腺炎 急性坏死性 缺氧 肠黏膜 通透性 大黄甘草汤 

分 类 号：R285.5[医药卫生—中药学]