扶正祛瘀通下法对多器官功能障碍综合征大鼠肠屏障功能的干预作用及其机制研究  

Intervention and mechanism of nourishing vital Qi and resolving blood stasis and purging method on intestinal barrier function in rats with multiple organ dysfunction syndrome

作　　者：赵娜 朱仕兵[2] 隋向前[3] 陈志明[1] 潘振亚 邓旻[1] Zhao Na;Zhu Shibing;Sui Xiangqian;Chen Zhiming;Pan Zhenya;Deng Min(Department of Emergency,Zhejiang Hospital of Traditional Chinese and Western Medicine,Hangzhou 310003,China;Department of Traditional Chinese Medicine,Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine,Hangzhou 310003,China;Department of Cardiology,Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine,Hangzhou 310003,China)

机构地区：[1]浙江省中西医结合医院急诊科,杭州310003 [2]浙江省中西医结合医院中医科,杭州310003 [3]浙江省中西医结合医院心内科,杭州310003

出　　处：《中国医药》2021年第11期1718-1722,共5页China Medicine

基　　金：杭州市科技发展计划(20180533B75)。

摘　　要：目的研究扶正祛瘀通下法对多器官功能障碍综合征(MODS)大鼠肠屏障功能的干预作用及其机制。方法30只清洁级Wistar大鼠完全随机分成对照组、MODS组、中药组,各10只,造模前3 d对照组、MODS组予0.9%氯化钠注射液灌胃,中药组予参附桃红承气汤灌胃,MODS组、中药组腹腔注射脂多糖建立MODS模型,对照组灌胃3 d后、MODS组及中药组造模后处死大鼠,取肠系膜淋巴结测定T淋巴细胞阳性表达,经腹主动脉取血测定内毒素、炎性细胞因子水平,分析盲肠内容物菌群变化。结果免疫组织化学染色结果显示,MODS组与中药组CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)T淋巴细胞较对照组的细胞数量明显增加,且中药组CD_(3)^(+)、CD_(4)^(+)T淋巴细胞多于MODS组。中药组和MODS组血浆内毒素、血清肿瘤坏死因子α、白细胞介素17(IL-17)、IL-23水平均高于对照组,但中药组均低于MODS组[(43.770±16.610)k EU/L比(70.330±7.520)k EU/L、(6.49±0.37)ng/L比(11.65±0.77)ng/L、(2.57±0.06)ng/L比(3.11±0.09)ng/L、(39±5)ng/L比(41±14)ng/L],MODS组血清IL-1β、IL-6水平均高于对照组和中药组,差异均有统计学意义(均P<0.01)。中药组和MODS组微生物数量及微生物种类均低于对照组,但中药组均高于MODS组,差异均有统计学意义(均P<0.01)。结论扶正祛瘀通下法可有效增加MODS大鼠CD_(3)^(+)、CD_(4)^(+)T淋巴细胞数量,下调炎性细胞因子水平,增加肠道微生态多样性,保护肠生物屏障完整性。Objective To study intervention and mechanism of nourishing vital Qi and resolving blood stasis and purging method on intestinal barrier function in rats with multiple organ dysfunction syndrome(MODS).Method Thirty clean Wistar rats were randomly divided into control group,MODS group and Chinese medicine group,with 10 rats in each group.Three days before modeling,control group and MODS group were given 0.9%sodium chloride injection for intragastic administration and Chinese medicine group was given Shenfu Taohong Chengqi decoction for intragastic administration.MODS group and Chinese medicine group were established MODS model with lipopolysaccharide intraperitoneal injection.Rats executed in control group 3 d after intragastic administration,and in MODS group and Chinese medicine group after MODS estabished,mesenteric lymph nodes were collected to detect positive expression of T lymphocytes,and blood through abdominal aorta was collected to detect endotoxin and inflammatory cytokines levels.The change of bacterial flora in cecal contents was analyzed.Results Immunohistochemical staining showed that the number of CD_(3)^(+),CD_(4)^(+)and CD_(8)^(+)T lymphocytes in MODS group and Chinese medicine group were higher than that in control group,and the number of CD_(3)^(+)and CD_(4)^(+)T lymphocytes in Chinese medicine group was higher than that in MODS group.Levels of plasma endotoxin,serum tumor necrosis factor-α,interleukin-17(IL-17)and IL-23 in Chinese medicine group and MODS group were higher than those in control group,and those in Chinese group were lower than those in MODS group[(43.770±16.610)k EU/L vs(70.330±7.520)k EU/L,(6.49±0.37)ng/L vs(11.65±0.77)ng/L,(2.57±0.06)ng/L vs(3.11±0.09)ng/L,(39±5)ng/L vs(41±14)ng/L];levels of IL-1βand IL-6 in MODS group were higher than those in control group and Chinese medicine group(all P<0.01).Microbial quantity and microbial species in Chinese medicine group and MODS group were lower than those in control group but those in Chinese medicine group were higher than

关 键 词：多器官功能障碍综合征 扶正祛瘀通下法/参附桃红承气汤 肠屏障 肠道菌群 

分 类 号：R259[医药卫生—中西医结合]