中药抗休克合剂对严重烫伤大鼠早期肠损伤的影响  

Effect of Chinese Medicine Anti⁃shock Mixture on Early Intestinal Injury of Rats with Severe Scalds

作　　者：高欣 王沁澄 赵杰 胡万萱 李兴照[1] 胡德林[1] 孙业祥[1] GAO Xin;WANG Qincheng;ZHAO Jie;HU Wanxuan;LI Xingzhao;HU Delin;SUN Yexiang(Department of Burns,The First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,China;Department of TCM,The First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,China;Department of Plastics and Repair Surgery,Hefei Second People’s Hospital,Hefei,Anhui 230012,China)

机构地区：[1]安徽医科大学第一附属医院烧伤科,安徽合肥230022 [2]安徽医科大学第一附属医院中医科,安徽合肥230022 [3]合肥市第二人民医院整形与修复外科,安徽合肥230012

出　　处：《中国烧伤创疡杂志》2024年第3期190-195,共6页The Chinese Journal of Burns Wounds & Surface Ulcers

基　　金：国家自然科学基金(81272092);安徽医科大学第一附属医院临床研究重点基金(LCYJ2021ZD005)。

摘　　要：目的观察在高渗盐溶液(HS)补液基础上应用中药抗休克合剂对严重烫伤大鼠早期肠损伤的影响。方法选取32只8周龄SD大鼠,按照随机数表法将其随机分为假伤组、LR组、HS600组、HS600+中药组,每组8只。假伤组大鼠建立假伤模型以及LR组、HS600组、HS600+中药组大鼠建立烫伤模型后,LR组大鼠采用乳酸钠林格注射液(LR)补液,HS600组大鼠采用600 mmol/L HS补液,HS600+中药组大鼠采用600 mmol/L HS补液+中药抗休克合剂灌胃。对比观察模型建立24 h后各组大鼠血Na^(+)浓度,血清炎症因子水平以及小肠组织氧化应激水平与p38丝裂原活化蛋白激酶(p38MAPK)通路活化程度。结果LR组大鼠血Na^(+)浓度明显低于假伤组、HS600组及HS600+中药组(q=14910、32211、30010,P均<0001),且HS600组与HS600+中药组无明显差异(q=2198,P=0130)。LR组、HS600组及HS600+中药组大鼠血清肿瘤坏死因子-α、白细胞介素-10、白细胞介素-18水平以及小肠组织中丙二醛水平和磷酸化p38MAPK与p38MAPK比值均明显高于假伤组(肿瘤坏死因子-α:q=16070、10810、7579,P均<0001;白细胞介素-10:q=15920、20210、23850,P均<0001;白细胞介素-18:q=12750、7562、3897,P<0001、P<0001、P=0049;丙二醛:q=28450、20320、10160,P均<0001;磷酸化p38MAPK与p38MAPK比值:q=54310、15090、9196,P均<0001),且HS600+中药组大鼠血清肿瘤坏死因子-α与白细胞介素-18水平以及小肠组织中丙二醛水平和磷酸化p38MAPK与p38MAPK比值均明显低于LR组与HS600组、白细胞介素-10水平明显高于LR组与HS600组(肿瘤坏死因子-α:q=8494、3932,P<0001、P=0048;白细胞介素-18:q=9357、4165,P<0001、P=0031;丙二醛:q=18290、10160,P均<0001;磷酸化p38MAPK与p38MAPK比值:q=45110、5899,P<0001、P=0001;白细胞介素-10:q=7929、3939,P<0001、P=0047)。LR组、HS600组及HS600+中药组大鼠小肠组织中超氧化物歧化酶水平均明显低于假伤组(q=20880、14120、11110,P均<0001),且HS600+中药组明显高于LR�Objective To observe the effect of Chinese medicine anti-shock mixture on early intestinal injury of rats with severe scalds on the basis of fluid replacement with hypertonic salt solution(HS).Methods Thirty-two 8-week SD rats were divided,using the random number table,into the sham group(n=8),the LR group(n=8),the HS600 group(n=8),and the HS600+Chinese medicine group(n=8).Rats in the sham group were made sham scald model,and rats in the LR group,the HS600 group,and the HS600+Chinese medicine group were made scald model.And then,the rats in the LR group were given fluid replacement with sodium lactate Ringer’s injection(LR),and rats in the HS600 group were given fluid replacement with 600 mmol/L HS,while rats in the HS600+Chinese medicine group were given fluid replacement with 600 mmol/L HS plus intragastric injection of Chinese medicine anti-shock mixture.The blood Na^(+)concentration,the levels of serum inflammatory factors,oxidative stress levels in small intestine tissues,and the activation of p38 mitogen-activated protein kinase(p38MAPK)pathway were compared among the four groups 24 hours after model establishment.Results The blood Na^(+)concentration was significantly lower in the LR group respectively compared with the sham group,the HS600 group,and the HS600+Chinese medicine group(q=14910,32211 and 30010,all P<0001),and there was no significant difference between the HS600 group and the HS600+Chinese medicine group in this regard(q=2198,P=0130).The levels of serum tumor necrosis factor-α(TNF-α),interleukin-10(IL-10),and interleukin-18(IL-18),malondialdehyde(MDA)levels in small intestinal tissues and phosphorylated-p38MAPK(p-p38MAPK)/p38MAPK ratio were all obviously higher in the LR group,the HS600 group and the HS600+Chinese medicine group compared with the sham group(TNF-α:q=16070,10810 and 7579,all P<0001;IL-10:q=15920,20210 and 23850,all P<0001;IL-18:q=12750,7562 and 3897,P<0001,P<0001,P=0049;MDA:q=28450,20320 and 10160,all P<0001;p-p38MAPK/p38MAPK ratio:q=54310,15090 and 9196,all P<0001).Moreove

关 键 词：烧伤 烫伤 休克 液体复苏 肠损伤 中药抗休克合剂 作用机制 

分 类 号：R285.5[医药卫生—中药学]