中药大承气汤改良方对术后肠梗阻小鼠胃肠功能的影响及机制研究  

Effect of traditional Chinese medicine Da-Cheng-Qi-Tang on gastrointes⁃tinal function in mice with postoperative ileus

作　　者：李敏 林思思[3] 刘胜远[4] 徐晓娟 李琨[3] 李永渝[3] 刘晓红[1] LI Min;LIN Si-si;LIU Sheng-yuan;Xu Xiao-juan;LI Kun;LI Yong-yu;LIU Xiao-hong(Department of Physiology,Zunyi Medical University,Zunyi Medical and Pharmeceutical College,Zunyi 563000,China;Department of Physiology,Zunyi Medical and Pharmeceutical College,Zunyi 563000,China;Department of Pathophysiology,Tongji University School of Medicine,Shanghai 200092,China;Department of Surgery,Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China)

机构地区：[1]遵义医科大学基础医学院生理教研室,贵州遵义563000 [2]遵义医药高等专科学校生理教研室,贵州遵义563000 [3]同济大学医学院病理生理教研室,上海200092 [4]遵义医科大学附属医院外科,贵州遵义563000

出　　处：《中国病理生理杂志》2021年第3期466-474,共9页Chinese Journal of Pathophysiology

基　　金：国家自然科学基金资助项目(No.31571181)。

摘　　要：目的:探讨中药大承气汤改良方(Da-Cheng-Qi-Tang,DCQT)对实验性术后肠梗阻(postoperative ileus,POI)小鼠胃肠功能的影响及机制。方法:实验设24 h和48 h两个观测时点,用成年C57BL/6小鼠各24只,雌雄不拘,随机均分成4组:对照(control)组(n=6)、假手术(sham)组(n=6)、POI组(n=6)和POI+DCQT组(n=6)。通过经典小肠干扰术诱导POI模型。术后以饮用水(control、sham和POI组)或DCQT(POI+DCQT组)灌胃,每天2次。术后24 h和48 h观测小鼠胃肠运动功能、肠道组织结构、局部神经递质及血清胃肠肽水平;用16S rRNA高通量测序检测肠黏膜菌群结构及其多样性,用高通量液体芯片检测血清促炎细胞因子的水平。结果:与control组或sham组比较,POI组小鼠胃肠排推运动减慢,肠黏膜充血水肿,肠道细菌结构和多样性发生改变,这些变化在DCQT处理后有不同程度减轻。在POI组,无论术后24 h或48 h,血清促炎细胞因子白细胞介素1α(interleukin-1α,IL-1α)、IL-6和肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)水平均较control组或sham组显著升高(P<0.05或P<0.01),单核细胞趋化蛋白1(monocyte chemoattractant protein-1,MCP-1)和IL-17水平在24 h显著升高(P<0.05);同时,POI组小鼠血清血管活性肠肽(vasoactive inestinal peptide,VIP)水平显著升高,胃动素(motilin,MTL)水平显著降低,回肠和结肠组织中5-羟色胺(5-hydroxytryptamine,5-HT)水平显著降低,组胺(histamine,HIS)水平显著升高(P<0.05或P<0.01);用DCQT处理后上述变化均有不同程度逆转(P<0.05或P<0.01)。结论:DCQT可有效改善POI小鼠的胃肠道运动功能,减轻炎症反应,调节肠道黏膜细菌的变化和胃肠肽的失衡。AIM:to investigate the effects of modified Da-Cheng-Qi-Tang(DCQT)on gastrointestinal functions in mice with postoperative ileus(POI).METHODS:Two observation time points,24 h and 48 h after operation,were set,and 24 adult C57BL/6 mice were used for the observation at each time point.The animals were randomly divided into control group(n=6),sham group(n=6),POI group(n=6)and POI+DCQT group(n=6).The POI model was induced by standardized small intestinal manipulation.Postoperative gavage of drinking water(control,sham and POI groups)or DCQT(POI+DCQT group)was given twice a day.After surgery for 24 h and 48 h,gastrointestinal motional function,intestinal tissue morphological changes,local neurotransmitters and serum levels of gastrointestinal peptides were observed.The structure and diversity of intestinal mucosal flora were detected by 16S rRNA high-throughput se‐quencing,and serum pro-inflammatory cytokines were detected by high-throughput liquid microarray.RESULTS:Compared with control group or sham group,the POI mice showed a reduction of gastrointestinal expulsion,congestion and edema in intestinal mucosa,and changes in intestinal bacterial structure and diversity,which were alleviated to different extents after DCQT treatment.The serum levels of pro-inflammatory cytokines,such as interleukin-1α(IL-1α),IL-6 and tumor necrosis factor-α(TNF-α),were significantly higher in POI group at 24 h and 48 h after surgery than those in control group or sham group(P<0.05 or P<0.01),while the levels of monocyte chemoattractant protein-1(MCP-1)and IL-17 were increased significantly in POI group at 24 h(P<0.05).At the same time,increased serum level of vasoactive intestinal peptide(VIP),decreased serum level of motilin(MTL),and decreased 5-hydroxytryptamine(5-HT)and increased histamine(HIS)levels in ileum and colon tissues of POI mice were observed,which were significantly different from those in control group or sham group(P<0.05 or P<0.01).These abnomalies were also reversed after DCQT treatment(P<0.05 or P<0.01).CONCLUSI

关 键 词：大承气汤 术后肠梗阻 肠道菌群 胃肠运动 胃肠肽 

分 类 号：R363.2[医药卫生—病理学] R656[医药卫生—基础医学]