大黄附子汤改善重症急性胰腺炎大鼠肠道动力障碍的机制研究  

Study on the mechanism of Dahuangfuzi decoction in improving intestinal motility disorder of rats with severe acute pancreatitis

作　　者：宋轶[1] 刘杰 路晓光[1] 战丽彬[3] 范治伟[1] 路童 康新[1] Song Yi;Liu Jie;Lu Xiaoguang;Zhan Libin;Fan Zhiwei;Lu Tong;Kang Xin(Department of Emergency Medicine,The Affiliated Zhongshan Hospital of Dalian University,Dalian 116001,China;Department of Hepatobiliary Surgery,The Second Affi liated Hospital of Xi'an Medical College,Xi'an 710038,China;School of Traditional Chinese Medicine and School of Integrated Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210023,China;Innovation Engineering and Technology Center of Traditional Chinese Medicine,Liaoning University of Traditional Chinese Medicine,Shenyang 110847,China)

机构地区：[1]大连大学附属中山医院急诊医学科,116001 [2]西安医学院第二附属医院肝胆外科,710038 [3]南京中医药大学中医学院·中西医结合学院,210023 [4]辽宁中医药大学中医药创新工程技术中心,沈阳110847

出　　处：《中华急诊医学杂志》2021年第8期954-959,共6页Chinese Journal of Emergency Medicine

基　　金：国家自然科学基金(81673801、81473512、81173397)。

摘　　要：目的通过观察大黄附子汤对重症急性胰腺炎(Severe acute pancreatitis,SAP)致肠道动力障碍大鼠血清胃动素、回肠Cajal间质细胞及胃动素受体的影响,探讨大黄附子汤改善肠道动力障碍的作用及机制。方法清洁级雄性Sprague-Dawley大鼠,18只,随机(随机数字法)分为对照组、SAP组及大黄附子汤治疗组(n=6)。采用逆行胰胆管注射4%牛磺胆酸钠制备SAP大鼠模型。对照组开腹后,找到胰腺轻微翻动数次后关腹;SAP组在造模后12、24 h分别给予2 mL生理盐水(37℃)灌肠;治疗组在造模后12、24 h分别给予2 mL大黄附子汤(37℃)灌肠。于造模48 h后,各组大鼠取腹主动脉血,测定血清内毒素及淀粉酶含量,使用酶联免疫吸附法测定血清胃动素水平;取胰腺、回肠组织行苏木精伊红染色观察病理变化;采用免疫组织化学法检测回肠平滑肌组织中Cajal间质细胞(interstitial cells of cajal,ICC)表达蛋白c-kit及胃动素受体(Motilin receptor,MTL-R)蛋白的表达。结果与对照组相比,SAP组大鼠血清内毒素、淀粉酶水平均显著增高[(504.98±88.81)pg/mL vs.(17.76±5.01)pg/mL;(532.28±66.53)vs(69.45±3.61)U/L,均P<0.05],而血清胃动素水平显著降低[(195.4±6.7)ng/L vs.(301±8.10)ng/L,P<0.05],ICC表达蛋白c-kit及MTL-R免疫组织化学评分降低(P<0.05);与SAP组相比,大黄附子汤治疗组大鼠血清内毒素、淀粉酶水平均显著降低[(189.9±38.23)pg/mL vs.(504.98±88.81)pg/mL;(294.23±25.66)vs.(532.28±66.53)U/L,均P<0.05],而血清胃动素水平显著升高[(264.2±8.3)ng/L vs.(195.4±6.7)ng/L,P<0.05],同时c-kit及MTL-R免疫组织化学评分升高(P<0.05)。结论大黄附子汤通过促进胃动素的分泌、提高ICC细胞的活性及MTL-R的表达而改善SAP大鼠肠道动力障碍。Objective To explore the mechanism of Dahuangfuzi decoction on intestinal motility disorder by observing its effect on serum motilin,Cajal interstitial cells and motilin receptor in rats with severe acute pancreatitis(SAP).Methods Eighteen clean male Sprague-Dawley rats were randomly divided into the control group,SAP group and Dahuangfuzi group(n=6 each group).The SAP rat model was prepared by retrogradely injected 4%sodium taurocholate into cholangiopancreatic duct.The rats in the SAP group were given 2 mL normal saline(37℃)enema at 12 and 24 h after operation.The rats in the Dahuangfuzi group was given 2 mL Dahuangfuzi decoction(37℃)enema at 12 and 24 h respectively.For the control group,the pancreas was exposed in the same way and then the abdomen was closed.Forty-eight h after operation,the abdominal aorta blood samples were taken for determination of serum endotoxin and amylase,and for detection of serum motilin by enzyme-linked immunosorbent assay(ELISA);the pathological changes of pancreas and ileum were observed by hematoxylin-eosin(HE)staining.The expression of c-kit and motilin receptor protein in ICC in ileum tissue was detected by immunohistochemistry.Results Compared with the control group,the levels of serum endotoxin and amylase in the SAP group were signifi cantly higher[(504.98±88.81)pg/mL vs.(17.76±5.01)pg/mL;(532.28±66.53)vs.(69.45±3.61)U/L,P<0.05],while the levels of serum motilin were significantly lower[(195.4±6.7)ng/L vs.(301±8.10)ng/L,P<0.05],and the scores of c-kit and motilin receptor protein were decreased(P<0.05);compared with the SAP group,the levels of serum endotoxin and amylase in the Dahuangfuzi group were signifi cantly reduced[(189.9±38.23)pg/mL vs.(504.98±88.81)pg/mL;(294.23±25.66)vs.(532.28±66.53)U/L,P<0.05],while the levels of serum motilin were signifi cantly increased[(264.2±8.3)ng/L vs.(195.4±6.7)ng/L,P<0.05],and the scores of c-kit and motilin receptor protein were increased(P<0.05).Conclusions Dahuangfuzi decoction can improve the intestinal motility of

关 键 词：重症急性胰腺炎 CAJAL间质细胞 胃动素 胃动素受体 肠道动力障碍 

分 类 号：R285.5[医药卫生—中药学]