加味四君子汤对烫伤肠黏膜及炎症因子的影响  

Effect of modified sijunzi decoction on intestinal mucosa and inflammatory factors in scald

作　　者：许志俊 罗锦花[1] 詹剑华[1] 程兴 黄凯[1] XU Zhijun;LUO Jinhua;ZHAN Jianhua(Departmeat Scald,First Affiliated Hospital of Nanchang,University,330006,China)

机构地区：[1]南昌大学第一附属医院烧伤科,南昌330006

出　　处：《江西医药》2022年第2期103-106,114,共5页Jiangxi Medical Journal

基　　金：江西省科技计划项目,编号20171BBG70061。

摘　　要：目的探讨不同剂量加味四君子汤对严重烫伤肠道屏障功能的保护作用。方法取90只大耳兔,随机分5组,18只/组。对照组A:饮水;烫伤组B:烫伤后,0.9%NaCl注胃,10 mL/次tid;低剂量组C:烫伤后,予四君子汤注胃0.2 g/mL,10 mL/次tid;中剂量组D:烫伤后,给1.0 g/mL四君子汤注胃,10 mL/次,tid;高剂量组E:烫伤后,给5.0 g/mL四君子汤注胃,10 mL/次tid,喂药后在第1 d、第3 d、第7 d,沿着兔子耳缘静脉注射空气安乐死,将部分回肠组织HE染色,观察不同组兔肠黏膜病理学形态变化,行酶联免疫(ELSIA)法,检测不同组黏膜中的TNF-α、IL-1、IL-10的水平。结果HE染色结果可知,A组的回肠黏膜正常无改变,而B组随着时间进展,兔回肠黏膜病理学形态下可见炎性细胞大量弥散在烫伤的组织附近,绒毛结构全部被破坏,周围组织明显肿胀及渗出。在C、D、E组给药组疗效与时间和浓度正相关,且在D组中第7 d回肠黏膜明显恢复,与A组形态结构基本一致。与A组对比,B组中肠黏膜内炎症因子TNF-α和IL-1β显著升高,反而IL-10显著降低。在D和E组中TNF-α和IL-1β逐步下降,第7 d降到最低;IL-10逐步升高,第7 d达到峰值,D组效果更佳。结论严重烫伤后回肠黏膜在7 d内黏膜的损伤及炎症标记物水平逐步加重,加味四君子汤在促进回肠黏膜功能恢复均有一定疗效,最好疗效浓度为1.0 g/mL,作用时间为7 d。Objective To observe the changes of intestinal mucosa after severe scald and explore the protective effect of different doses of modified Sijunzi Decoction on intestinal barrier function after severe scald.Methods Ninety rabbits with big ears were randomly divided into 5 groups and 18 rabbits in each group.Control group A:drinking water;Scald group B:after scald,0.9%NaCl was injected into stomach,10 mL/time tid;Low dose group C:after scald,0.2 g/mL Sijunzi Decoction;was injected into stomach,10 mL/time tid.Middle dose group D:after scald,1.0 g/mL Sijunzi Decoction was injected into stomach,10 mL/time,tid.High dose group E:after scald,5.0 g/mL Sijunzi Decoction was injected into stomach,10 mL/time tid,air euthanasia was injected along the ear vein of rabbits on the 1st,3rd and 7th day.Some ileal tissues were stained with HE to observe the pathological morphological changes of intestinal mucosa in different groups.Enzyme-linked immunosorbent assay(ELSIA)was used to detect the levels of TNF-α,IL-1 and IL-10 in different groups.Results The results of HE staining showed that the ileal mucosa in group A was normal,but in group B,with the progress of time,a large number of inflammatory cells were scattered near the scalded tissue,the villous structure was destroyed,and the surrounding tissue was obviously swollen and exudated.The curative effect was positively correlated with time and concentration in group C,D and E,and the ileal mucosa recovered obviously on the 7th day in group D,which was basically consistent with the morphological structure of group A.Compared with group A,the inflammatory TNF-αand IL-1βin mucosa of group B increased significantly,while IL-10 decreased significantly.In group D and E,TNF-αand IL-1βdecreased gradually and reached the lowest on the 7th day,while IL-10 increased gradually and reached the peak on the 7th day,and the effect of group D was better.Conclusion The injury of ileal mucosa and the level of inflammatory markers are gradually aggravated within 7 days after severe scald.Modif

关 键 词：四君子汤 严重烧伤 多器官功能障碍综合症 肠道屏障 

分 类 号：R285.5[医药卫生—中药学]