调胃承气汤对肠源性脓毒症大鼠免疫功能的影响  

Influence of Tiaowei Chengqi Decoction on the immunologic function of rats with gut-derived sepsis

作　　者：赵锋利[1] 王澍欣[2] 罗苑苑[1] 郑述铭[1] 陈静 赵馥[1] 冼绍祥[3] ZHAO Fengli;WANG Shuxin;LUO Yuanyuan;ZHENG Shuming;CHEN Jing;ZHAO Fu;XIAN Shaoxiang(Intensive Care Unit, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Province, Guangzhou 510405, China;Acupuncture Department, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Province, Guangzhou 510405, China;the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Province, Guangzhou 510405, China)

机构地区：[1]广州中医药大学第一附属医院重症医学科,广东广州510405 [2]广州中医药大学第一附属医院针灸科,广东广州510405 [3]广州中医药大学第一附属医院,广东广州510405

出　　处：《中国医药导报》2019年第17期18-22,共5页China Medical Herald

基　　金：广东省科技计划项目(2016ZC0101)

摘　　要：目的观察调胃承气汤(TWCQ)对肠源性脓毒症大鼠免疫功能的影响。方法将60只SPF级雄性SD大鼠按体重随机分为假手术组、模型组、乌司他丁组(30 000 U/kg)、TWCQ灌胃组(9.45 g生药/kg)、TWCQ灌肠组(9.45 g生药/kg)和TWCQ灌肠+乌司他丁组(n = 8),在造模后2、10、24 h分别给药,乌司他丁经腹腔注射给药,TWCQ根据组别分别通过灌胃途径和灌肠途径给药,在24 h结束实验。用酶联免疫吸附测定法(ELISA)检测血清中白细胞介素10(IL-10)和肿瘤坏死因子α(TNF-α)水平,流式细胞仪检测小肠系膜中CD4+和CD8+T淋巴细胞水平,并在光镜下观察小肠HE染色结果。结果与假手术组比较,模型组大鼠小肠系膜中CD4+/CD8+T淋巴细胞数的比例明显下降(P < 0.05),血清IL-10水平降低,TNF-α水平升高(P < 0.05),小肠可见明显的病理性损伤;与模型组比较,TWCQ治疗组大鼠小肠系膜中CD4+/CD8+T淋巴细胞数的比例明显上升(P < 0.05),血清IL-10水平升高,TNF-α水平降低(P < 0.05),并且模型小肠的损伤程度明显改善;与TWCQ灌胃组比较,TWCQ灌肠组的治疗效果更为明显(P < 0.05)。结论 TWCQ具有改善肠源性脓毒症大鼠模型CD4+/CD8+T淋巴细胞比例、降低免疫炎症的功能,且灌肠疗法要优于灌胃疗法。Objective To observe the influence of Tiaowei Chengqi Decoction (TWCQ) on the immunologic function of rats with gut-derived sepsis. Methods Sixty SPF male SD rats were randomly divided into sham operation group, model group, Ulinastatin group (30 000 U/kg), TWCQ gavage group (9.45 g/kg), TWCQ enema group (9.45 g/kg) and TWCQ enema + Ulinastatine group according to their body weight (n = 8). After modeling for 2, 10, 24 h, Ulinastatine was administered by intraperitoneal injection, respectively. TWCQ was administered by gastric way and enema way respectively according to different groups, and the experiment was completed at 24 hours. The levels of serum interleukin 10 (IL-10) and tumor necrosis factor α(TNF-α) were detected by enzyme linked immunosorbent assay (ELISA), the levels of CD4+ and CD8+ T lymphocyte in mesentery of small intestine were detected by flow cytometry, and the results of HE staining in small intestine were observed under light microscope. Results Compared with sham operation group, the proportion of CD4+/CD8+ T lymphocyte in mesentery of small intestine in rats of model group was decreased significantly (P < 0.05), the level of IL-10 was reduced and TNF-α was improved significantly (P < 0.05), and the pathological damage of small intestine could be seen obviously. Compared with model group, the proportion of CD4+/CD8+ T lymphocyte in mesentery of small intestine in rats of TWCQ treatment group increased significantly (P < 0.05), the level of IL-10 was improved and TNF-α was reduced significantly (P < 0.05), and the damage degree of model small intestine was improved obviously. Compared with TWCQ gavage group, the therapeutic effect of TWCQ enema group was more obvious (P < 0.05). Conclusion TWCQ has the function of improving the proportion of CD4+/CD8+ T lymphocyte and reducing immunologic function in model rats with gut-derived sepsis, and enema therapy is superior to gavage therapy.

关 键 词：调胃承气汤 肠源性脓毒症 免疫功能 淋巴细胞 

分 类 号：R631.2[医药卫生—外科学]