大承气汤治疗重症急性胰腺炎肠功能障碍的机制研究  

Effect of Dachengqi Decoction on Intestinal Dysfunction in Rats with Severe Acute Pancreatitis

作　　者：沈燕萍[1] 唐晓月[1] 姜升阳[1] 王文远[1] 吴燕敏[1] 夏蓓蕾[1] 

机构地区：[1]无锡市第三人民医院,江苏无锡214041

出　　处：《中华中医药学刊》2017年第5期1138-1141,I0003,I0004,共6页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81200161)

摘　　要：目的:探讨大承气汤治疗大鼠重症急性胰腺炎(SAP)肠功能障碍的可能机制。方法:将54只雄性SD大鼠随机分为假手术组(SO组)、重症急性胰腺炎肠功能障碍组(SAP组)和大承气汤治疗组,每组18只。经胆胰管内加压注射3.5%牛磺胆酸钠0.1 m L/100 g体质量制备SAP肠功能障碍模型,治疗组在造模前给予10%的大承气汤剂(9.18 g/kg体质量)灌胃1次,SAP组和SO组则灌注等量0.9%氯化钠溶液。每组于造模后3、6、12 h各处死6只大鼠并立即心脏取血,检测血清淀粉酶、脂肪酶水平,酶联免疫吸附试验检测血清5-羟色胺(5-HT)、白介素6(IL-6)含量。同时检测6h时间点各组大鼠距屈氏韧带10 cm空肠、末端回肠及乙状结肠组织中5-HT7R的表达情况。结果:造模后SAP组和治疗组血清淀粉酶、脂肪酶及5-HT水平均明显高于SO组(P<0.05),且每个时间点治疗组均较SAP组显著降低(P<0.05)。与SO组相比,SAP组5-HT7R蛋白及阳性细胞面积表达水平在空肠、末端回肠及乙状结肠均明显增高(P<0.05);与SAP组比较,治疗组各部位5-HT7R蛋白及阳性细胞面积表达均减少(P<0.05)。结论:血清5-HT的增加过度激活5-HT7R可能是SAP发生肠功能障碍的原因之一,而大承气汤可能是通过减少5-HT7R的表达来促进肠功能恢复。Objective ： To investigate the effect of Dachengqi Decoction on intestinal dysfunction in rats with severe acute pancreatitis and its potential mechanism. Methods： Fifty -four SD rats were randomly divided into sham operation （SO） group, severe acute pancreatitis （SAP） group and Dachengqi Decoction group with 18 in each. The intestinal dysfunction in rats with SAP model was induced by retrograde injection of sodium taurocholate （0.1 mL/100 g） into bitiopancreatic duct. Before modeling,the rats in treatment group received 10% Dachengqi Decoction （9.18 g/kg） and the rats in other two groups received 0.9% NaC1 solution. The rats were sacrificed at 3,6 and 12 hours with 6 in each,and the blood samples were taken out for detecting the level of amylase, lipase and the contents of 5 - hydroxytlyptmnine （5 - HT）, interleukin -6 （IL -6 ） by enzyme -linked immunosorbent assay. The colonic tissues 10 cm apart from trans -liga- ment including jejunum, terminal ileum and sigmoid colon at the point of 6 h were collected for examining the expressions of 5 - HT7 receptor. Results ： The levels of serum amylase, lipase and 5 - HT in SAP group and treatment group were sig- nificantly higher than those in sham operation group （ P 〈 0. 05 ）, but they were lower in treatment group than in SAP group at each time points （P 〈 0. 05 ）. The expressions of 5 -HT7R proteins were significantly increased in the jejunum, terminal ileum and sigmoid colon in SAP group compared with SO group （ P 〈 0. 05 ）, as well as the area of 5 - HT7 posi- tive cell. Whereas the expressions of 5 - HT7R protein and the area of 5 - HT7 positive cell were decreased in the treat- ment group in comparison with SAP group （P 〈0. 05）. Conclusion： The increase of serum 5 - HT can activate 5 - HT7R excessively,which may induce intestinal dysfunction. Dachengqi Decoction decreasing the expression of 5 -HT7R may be a choice for treatment of severe acute pancreatitis with intestinal dysfunction.

关 键 词：重症急性胰腺炎 大承气汤 5-羟色胺7受体 肠功能障碍 

分 类 号：R576[医药卫生—消化系统]