小承气汤对重型颅脑损伤大鼠急性期脑水肿及炎性因子的影响  

Effects of Xiao-Cheng-Qi decoction on brain edema and inflammatory factors in rats with severe traumatic brain injury

作　　者：彭玲玲 王景博[2] 潘宇政 杜宜衡[1] 黄贵华 Peng Lingling;Wang Jingbo;Pan Yuzheng;Du Yiheng;Huang Guihua(Guangxi University of Chinese Medicine,Nanning 530200,Guangxi Zhuang Autonomous Region,China;Department of Traditional Chinese Medicine,First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]广西中医药大学,南宁530200 [2]广西医科大学第一附属医院中医科,南宁530021

出　　处：《中华危重病急救医学》2021年第11期1347-1352,共6页Chinese Critical Care Medicine

基　　金：国家自然科学基金(81460687);国家重点临床专科(中医专业)建设项目(2013-239);广西壮族自治区中医药科技专项(GZLC14-29);广西中医药重点学科建设项目(2020-14);广西名中医传承工作室项目(2017-2);广西中医药大学博士研究生科研创新项目(bs004)。

摘　　要：目的探讨中药复方小承气汤(XCQD)对重型颅脑损伤(sTBI)大鼠急性期脑水肿和炎性因子的影响。方法将108只雄性SD大鼠按随机数字表法分为正常组、假手术组、sTBI模型组以及XCQD低、中、高剂量组,每组18只。参照改良Freeney法制备sTBI大鼠模型。伤后6 h XCQD低、中、高剂量组分别给予XCQD 1.80、2.78、4.59 g/kg灌胃,其他3组给予等量生理盐水,均每日1次,连续3 d。各组干预3 d后观察改良神经功能缺损评分(mNSS)并处死,苏木素-伊红(HE)染色后光镜下观察脑组织病理学改变,干湿比重法测量脑组织含水量,蛋白质免疫印迹试验(Western blotting)检测脑组织水通道蛋白4(AQP4)、肿瘤坏死因子-α(TNF-α)和白细胞介素-1β(IL-1β)蛋白表达,酶联免疫吸附试验(ELISA)检测血清TNF-α和IL-1β含量。结果与正常组比较,sTBI后大鼠mNSS评分明显升高,脑组织结构紊乱,出现炎症、水肿、神经细胞核固缩等病理改变,脑组织含水量、AQP4、TNF-α和IL-1β蛋白表达及血清TNF-α、IL-1β含量均显著升高;经XCQD干预后上述指标均明显改善。与sTBI模型组比较,XCQD中、高剂量组mNSS评分明显下降(分:6.94±1.16、6.88±1.02比8.61±1.09,均P<0.05),脑组织水肿、炎症等病理改变减轻;XCQD低、中、高剂量组脑组织含水量、AQP4蛋白表达及血清TNF-α、IL-1β含量均较sTBI模型组明显下降〔脑组织含水量:(78.25±0.71)%、(77.62±0.44)%、(76.70±0.74)%比(80.08±0.66)%,脑AQP4蛋白表达(AQP4/β-actin):0.86±0.13、0.84±0.22、0.65±0.13比1.08±0.14,血清TNF-α(ng/L):106.34±15.07、95.75±17.26、89.00±17.36比141.96±29.47,血清IL-1β(ng/L):90.41±12.88、72.82±13.51、71.32±16.79比128.57±22.56,均P<0.05〕;XCQD中、高剂量组脑组织TNF-α、IL-1β蛋白表达与sTBI模型组比较也明显下降〔TNF-α蛋白表达(TNF-α/β-actin):0.90±0.24、0.79±0.35比1.17±0.15,IL-1β蛋白表达(IL-1β/β-actin):0.91±0.21、0.68±0.28比1.23±0.08,均P<0.05〕。�Objective To observe the effects of the Chinese medicine prescription Xiao-Cheng-Qi decoction(XCQD)on acute brain edema and inflammatory factors in rats with severe traumatic brain injury(sTBI).Methods A total of 108 male Sprague-Dawley(SD)rats were divided into control group,sham operation group,sTBI model group,and XCQD low,medium,high dose groups by random number table method,with 18 rats in each group.sTBI rat model was prepared according to the modified Freeney method.At 6 hours after injury,the XCQD low,medium,and high dose groups were given XCQD 1.80,2.78,and 4.59 g/kg by gavage,respectively,and the other three groups were given the same amount of normal saline,once a day for 3 days.After 3 days of injury,rats in each group were sacrificed after the modified neurologic severity score(mNSS)assessed.Pathological changes of brain tissue were observed under light microscope after hematoxylin eosin(HE)staining,water content of brain tissue was measured by dry-wet specific gravity method,and the expressions of aquaporin 4(AQP4),tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)in brain tissue were detected by Western blotting.Serum TNF-αand IL-1βlevels were detected by enzyme linked immunosorbent assay(ELISA).Results Compared with the normal group,the mNSS score of rats increased significantly,the structure of brain tissue was disordered,and pathological changes appeared such as inflammation,edema,pyknosis of nerve nuclei,water content,the protein expressions of AQP4,TNF-αand IL-1βin brain tissue,and the contents of TNF-α,IL-1βin serum were significantly increased.After XCQD intervention,the above indexes were significantly improved.Compared with sTBI model group,the mNSS score of XCQD medium and high dose groups significantly decreased(6.94±1.16,6.88±1.02 vs.8.61±1.09,both P<0.05),and the pathological changes such as brain edema and inflammation were alleviated.Brain tissue water content,AQP4 protein expression and contents of serum TNF-α,IL-1βin XCQD low,medium,and high dose groups signific

关 键 词：小承气汤 重型颅脑损伤 脑水肿 水通道蛋白 炎性因子 

分 类 号：R285.5[医药卫生—中药学]