清热利胆汤治疗奥狄括约肌功能障碍的实验研究  

Experimental study on the treatment of sphincter of Oddi dysfunction by Qingre Lidan Decoction

作　　者：梁易璇 林豪男 赵王强 曹君葳 王天麒 王长淼[2] Liang Yixuan;Lin Haonan;Zhao Wangqiang;Cao Junwei;Wang Tianqi;Wang Changmiao(Laboratory of Integrative Medicine,the First Affiliated Hospital of Dalian Medical University,Dalian 116000,China;Department of General Surgery 3,the First Affiliated Hospital of Dalian Medical University,Dalian 116000,China)

机构地区：[1]大连医科大学附属第一医院中西医结合临床国家重点学科实验室,大连116000 [2]大连医科大学附属第一医院普外三科,大连116000

出　　处：《中华肝胆外科杂志》2023年第11期857-861,共5页Chinese Journal of Hepatobiliary Surgery

基　　金：国家自然科学基金(81774082)。

摘　　要：目的研究双侧迷走神经干切断后兔奥狄括约肌压力的变化以及清热利胆汤的作用,为治疗奥狄括约肌功能障碍提供新方式。方法选取体重1.5~2.0 kg的新西兰大白兔24只,雌雄不限,分为对照组、模型组和干预组。对照组仅行幽门成形术;模型组和干预组行幽门成形术加膈肌水平双侧迷走神经干切断术,干预组行一个月清热利胆汤灌胃治疗。采用多通道生物信号采集系统记录各组兔子奥狄括约肌压力变化;酶联免疫吸附试验检测兔子血清中炎症因子白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的变化。结果模型组奥狄括约肌压力高于对照组[低压区:(51.95±0.35)mmHg(1 mmHg=0.133 kPa)比(21.60±1.13)mmHg;高压区:(60.75±0.49)mmHg比(20.70±0.85)mmHg],干预组奥狄括约肌压力低于模型组[低压区:(22.70±1.13)mmHg比(51.95±0.35)mmHg;高压区:(32.15±0.49)mmHg比(60.75±0.49)mmHg],差异均具有统计学意义(均P<0.05)。与对照组相比,干预组血清IL-6和TNF-α水平均明显升高;与模型组相比,治疗组IL-6和TNF-α水平均有所下降,差异均具有统计学意义(均P<0.05)。结论双侧迷走神经干切断后会导致奥狄括约肌障碍,清热利胆汤治疗可以改善奥狄括约肌功能障碍。Objective To study the changes in the sphincter of Oddi pressure in rabbits after bilateral vagus nerve trunk severance and the therapeutic effect of Qingre Lidan Decoction,to provide a new way for the treatment of sphincter of Oddi dysfunction.Methods Twenty-four 1.5~2.0 kg New Zealand Large White rabbits of either gender were randomly selected and divided into the control group,the model group,and the treatment group.In the control group,only pyloroplasty was performed;in the model group and the treatment group,pyloroplasty plus bilateral vagus nerve trunk dissection at the level of the diaphragm were performed,and in the treatment group,one month of gavage treatment with Qingre Lidan Decoction was carried out 7 days after the operation.Multi-channel bio-signal acquisition system was used to record the pressure changes of the sphincter of Oddi in rabbits of each group;ELISA was used to detect the changes of inflammatory factors IL-6 and tumor necrosis factor TNF-α in the serum of rabbits.Results The pressure of the sphincter of Oddi in the model group was significantly higher than those in the control group[low-pressure area:(51.95±0.35)mmHg(1 mmHg=0.133 kPa)vs(21.60±1.13)mmHg(P<0.05);High pressure area:(60.75±0.49)mmHg vs(20.70±0.85)mmHg(P<0.05)],the pressure of sphincter of Oddi in the treatment group of Qingre Lidan Decoction was lower than that of the model group[low-pressure area:(22.70±1.13)mmHg vs(51.95±0.35)mmHg(P<0.05);high-pressure area:(32.15±0.49)mmHg vs(60.75±0.49)mmHg(P<0.05)].Serum IL-6 and TNF-αwere significantly elevated in the model group compared to the control group;IL-6 and TNF-αlevels were decreased in the treatment group compared to the model group,and the differences were statistically significant(P<0.05).Conclusion Bilateral vagus nerve trunk severance leads to Oddi sphincter dysfunction,and treatment with Qingre Lidan Decoction could improve Oddi sphincter dysfunction.

关 键 词：奥狄括约肌 迷走神经 清热利胆汤 

分 类 号：R285.5[医药卫生—中药学]