基于门静脉高压探讨鼓胀退水贴治疗肝硬化腹水的作用机制  

Study on the mechanism of Guzhangtuishui patch in the treatment of cirrhotic ascites based on portal hypertension

作　　者：傅琪琳 黄甫 唐颖慧 李粉萍[1] 薛敬东[1] 乔园 赵林涛[1] FU Qilin;HUANG Fu;TANG Yinghui;LI Fenping;XUE Jingdong;QIAO Yuan;ZHAO Lintao(Shaanxi Provincial Hospital of Chinese Medicine/Shaanxi Academy of Traditional Chinese Medicine,Xi'an 710003,China)

机构地区：[1]陕西省中医医院/陕西省中医药研究院,陕西西安710003

出　　处：《临床医学研究与实践》2023年第3期1-4,15,共5页Clinical Research and Practice

基　　金：陕西省自然科学基础研究计划项目(No.2019JQ-981);国家中医药管理局区域中医(肝病)诊疗中心培育单位建设项目(国中医药办医政函〔2017〕39号)。

摘　　要：目的分析鼓胀退水贴治疗肝硬化腹水的效果,并探讨其相关机制。方法将50只大鼠随机分为正常组、模型组和高、中、低剂量组,各10只。运用改良的CCl4-酒精综合法对模型组和高、中、低剂量组大鼠进行肝硬化腹水造模,高、中、低剂量组大鼠给予不同剂量鼓胀退水贴神阙穴外敷。治疗过程中,模型组2只大鼠死亡,中剂量组3只大鼠死亡。比较各组大鼠的腹水量、腹围、肝功能指标[总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、白蛋白(ALB)]水平。观察各组大鼠HE染色的肝脏组织病理学显微图。比较各组大鼠的肝组织血管内皮生长因子(VEGF)表达情况。比较各组大鼠的一氧化氮(NO)、内皮素-1(ET-1)水平。结果高、中剂量组的腹水量明显少于模型组(P<0.05);高、中、低剂量组的腹围明显小于模型组(P<0.05)。模型组和高、中、低剂量组的TBIL、ALT、AST、ALB水平比较,差异无统计学意义(P>0.05)。经HE染色发现,高、中、低剂量组肝组织炎症及纤维化程度明显减轻。高、中、低剂量组的VEGF免疫组化评分明显低于模型组(P<0.05)。高剂量组的NO水平明显低于模型组(P<0.05);高、中剂量组的ET-1水平明显低于模型组(P<0.05)。结论鼓胀退水贴治疗肝硬化腹水的效果显著,其机制可能在于降低血管活性物质NO和ET-1水平,下调肝组织VEGF表达,从而改善门静脉高压。Objective To analyze the effect of Guzhangtuishui patch in the treatment of cirrhotic ascites,and to explore its related mechanism.Methods Fifty rats were randomly divided into normal group,model group and high,medium and low dose group,with 10 rats in each group.The rats in the model group and the high,medium and low dose group were modeled with cirrhotic ascites by the improved CCl4-alcohol comprehensive method;the rats in the high,medium and low dose group were given different doses of Guzhangtuishui patch for external application at Shenque point.During the treatment,2 rats in the model group died,and 3 rats in the medium dose group died.The ascites volume,abdominal circumference,liver function indexes[total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),albumin(ALB)]levels of rats in each group were compared.Pathological micrographs of liver tissue stained with HE of rats in each group was observed.The expression of vascular endothelial growth factor(VEGF)in liver tissue of rats in each group was compared.The nitric oxide(NO)and endothelin-1(ET-1)levels of rats in each group were compared.Results The ascites volume in the high and medium dose group was significantly less than that in the model group(P<0.05);the abdominal circumference in the high,medium and low dose group was significantly smaller than that in the model group(P<0.05).There were no significant differences in TBIL,ALT,AST and ALB levels between the model group and the high,medium and low dose group(P>0.05).HE staining showed that the inflammation and fibrosis of liver tissue in the high,medium and low dose group significantly reduced.The VEGF immunohistochemical score in the high,medium and low dose group was significantly lower than that in the model group(P<0.05).The level of NO in the high dose group was significantly lower than that in the model group(P<0.05);the level of ET-1 in the high and medium dose group was significantly lower than that in the model group(P<0.05).Conclusion Guzhangtuishui patch in the

关 键 词：鼓胀退水贴 肝硬化腹水 门静脉高压 一氧化氮 内皮素-1 血管内皮生长因子 

分 类 号：R285.6[医药卫生—中药学]