桂枝去桂加茯苓白术汤对脓毒症性大鼠肾损伤的影响及机制  

Effects of Guizhi Qugui plus Fuling Baizhu decoction on renal injury in septic rats

作　　者：谷翠芝[1] 谢敏慧 唐余广[3] 曾凝[2] 刘仕[1] 覃源[2] 叶祖杨 李清初[2] GU Cuizhi;XIE Minhui;TANG Yuguang;Zeng Ning;LIU Shi;QIN Yuan;YE Zuyang;LI Qingchu(Guilin Medical College, Guilin 541004, China)

机构地区：[1]桂林医学院,广西桂林541004 [2]桂林医学院附属医院 [3]盐城市第三人民医院

出　　处：《山东医药》2018年第46期24-28,共5页Shandong Medical Journal

基　　金：国家自然科学基金资助项目(81860800);广西自然科学基金面上项目(2016JJA140396);广西高校科学技术研究项目(LX2014264)

摘　　要：目的探讨桂枝去桂加茯苓白术汤对脓毒症性大鼠急性肾损伤的影响及机制。方法选择SD大鼠32只,随机分为假手术组(S组)、盲肠结扎穿孔术模型组(CLP组)、桂枝去桂加茯苓白术汤高剂量组(G组)与桂枝去桂加茯苓白术汤低剂量组(D组),每组8只。CLP组、G组和D组采用盲肠结扎+穿孔法制作脓毒症大鼠模型,S组同法找到盲肠后不进行盲肠结扎+穿孔。术后1. 5、6、12 h时,G组、D组均分别给予高剂量(2. 22g/药汁1 mL)及低剂量(1. 27 g/药汁1 mL)桂枝去桂加茯苓白术汤灌胃,S组与CLP组均灌胃等剂量生理盐水。观察各组大鼠饮水、进食、呼吸、心率、眼角分泌物、精神状态、皮温等一般情况。术后24 h麻醉处死大鼠,解剖腹腔,观察腹腔气味、肠粘连、腹水、盲肠末端结扎部位坏死等情况。经心脏穿刺取血,全自动生化分析仪检测血清肌酐(Cr)、尿素氮(BUN)水平,采用酶联免疫吸附测定法检测血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)水平。取肾组织,采用HE染色观察各组肾组织病理改变,采用免疫组织化学法检测肾组织NF-κB、TNF-α蛋白表达。结果 S组术后15 min左右苏醒,表现正常; CLP组术后30 min左右苏醒,精神萎靡、嗜睡,眼角较多分泌物,呼吸急促,心率增快,死亡4只; G组与D组各项症状均较CLP组减轻。S组腹腔内结构正常;CLP组见较多血性腹水,可闻及恶臭味,充血水肿,严重粘连,盲肠末端结扎部发黑; G组和D组大鼠腹腔结构较清晰,病变较CLP组减轻。CLP组、G组、D组血清Cr、BUN及NGAL水平均高于S组,G组、D组血清Cr、BUN及NGAL水平均低于CLP组,G组血清Cr、BUN及NGAL水平均低于D组(P均<0. 05)。S组肾脏组织结构正常;CLP组部分肾小管结构破坏,大量肾小管上皮细胞水肿、空泡样变性、胞核固缩边集,间质有较多炎性细胞浸润;G组与D组肾脏组织损害较CLP组减轻。CLP组肾组织NF-κB、TNF-α蛋白表达均高于Objective To investigate the effects and mechanism of Guizhi Qugui plus Fuling Baizhu decoction on sepsis-induced acute kidney injury(SAKI)in rats.Methods:Thirty-two SD rats were randomly divided into the sham-operated group(group S),cecal ligating and perforating model group(CLP group),high-dose Guizhi Qugui plus Fuling Baizhu decoction group(group G)and low-dose group(group D),with8in each group.In the CLP group,group G,and group D,we used cecal ligation+perforation method to make sepsis rat models.In the group S,we did not perform cecal ligation+perforation after finding the cecum by the same method.At1.5,6and12h after operation,rats in the group G and group D were given high-dose(2.22g/juice1mL)and low-dose(1.27g/juice1mL)Guizhi Qugui plus Fuling Baizhu decoction by gavage,respectively,while rats in the group S and CLP group were given the same dose of saline by gavage.The general conditions of drinking water,eating,breathing,heart rate,eye corner secretion,mental state,and skin temperature of rats in each group were observed.After24hours of operation,rats were anaesthetized and killed.The abdominal cavity was dissected.The odor of abdominal cavity,intestinal adhesion,ascites and necrosis of the ligation site at the end of cecum were observed.Blood samples were taken by heart puncture.The levels of Cr and BUN were detected by automatic biochemical analyzer,and serum NGAL was detected by enzyme-linked immunosorbent assay.Kidney tissues were taken and the pathological changes were observed by HE staining.The expression levels of NF-κB and TNF-αin the kidney tissues were detected by immunohistochemistry.Results In the group S,the rats recovered at15minutes after operation and showed normal performance.In the CLP group,at30minutes after operation,the rats recovered,and they were mentally depressed,drowsy,had more secretions in the corners of the eyes,had shortness of breath and increased heart rate,and4rats died.The symptoms of group G and group D were less severe than those of group CLP.The intraperitoneal str

关 键 词：桂枝去桂加茯苓白术汤 脓毒症 急性肾损伤 核因子-ΚB 肿瘤坏死因子Α 

分 类 号：R631[医药卫生—外科学] R692.9[医药卫生—临床医学]