扶正透邪解毒化瘀方对多重耐药铜绿假单胞菌肺炎感染老年大鼠肺炎靶器官炎性损伤的修复机理初探  

Preliminarystudy on the repair mechanism of Fuzheng Touxie Jiedu Huayu Formula on target organ damage of MDRPA infected elderly rats with pneumonia

作　　者：王亚杰 徐红日 曹鸿云 张路遥 李雅莉 刘通 郝丹丹 刘凤仪 杨丽娟 WANG Yajie;XU Hongri;CAO Hongyun;ZHANG Luyao;LI Yali;LIU Tong;HAO Dandan;LIU Fengyi;YANG Lijuan(Emergency Department,The Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学第三附属医院急诊科,100029 [2]北京中医药大学东直门医院重症监护病房 [3]北京中医医院怀柔医院急诊科

出　　处：《环球中医药》2024年第11期2182-2192,共11页Global Traditional Chinese Medicine

基　　金：国家中医药管理局中医药创新团队及人才支持计划(ZYYCXTD-D-202208);北京市自然科学基金(7232285)。

摘　　要：目的通过观察促炎、抗炎因子的动态变化及肺组织超微结构电镜成像,探讨扶正透邪解毒化瘀方对多重耐药铜绿假单胞菌(multidrug-resistant pseudomonas aeruginosa,MDRPA)肺炎老年大鼠靶器官炎性损伤可能的修复机理。方法将老年大鼠随机分为空白组、模型组、西药组、中药组、中提组、中西组,每组48只,观察感染后不同时间点各组老年大鼠促炎与抗炎因子的动态变化及各组电镜下肺组织超微结构变化。结果与西药组比较,中西组可明显降低MDRPA感染所致老年大鼠肺炎模型靶器官肺组织中促炎性细胞因子白细胞介素(interleukin,IL)-6及高迁移率族蛋白1的过度表达、促进抗炎性细胞因子IL-10的表达(P<0.05,P<0.01),中提组在炎症反应早期可以升高靶器官肺组织中抗炎性细胞因子IL-10的表达(P<0.05,P<0.01),明显降低促炎性细胞因子IL-6、高迁移率族蛋白1的表达(P<0.05,P<0.01)。电镜下观察:模型组肺泡腔出现渗出,肺泡毛细血管扩张充血;西药组肺泡壁轻度纤维化,肺泡腔出现渗出;中药组见肺泡壁轻度增厚,肺泡腔未见明显渗出;中提组肺泡壁轻度增厚,肺泡腔内未见明显渗出。结论扶正透邪解毒化瘀方能够通过调节炎症因子的表达修复MDRPA感染早期老年大鼠肺组织的炎性损伤,该方联合头孢他啶对MDRPA感染后靶器官炎性损伤的修复作用最佳,该方提前给药能够对MDRPA感染后的炎性损伤起到一定的预防及治疗作用。Objective Based on the dynamic changes of anti-inflammatory and pro-inflammatory factors and observation under electron microscope to explore the mechanism of action of Fuzheng Touxie Jiedu Huayu Formula on MDRPA.Methods The experimental elderly rats were randomly divided into a blank control group,a model control group,a Western medicine control group,a Chinese medicine group,a Chinese medicine early administration group,and a combination of Chinese and Western medicine treatment group.The dynamic changes of anti-inflammatory and pro-inflammatory factors in each group of elderly rats at different time points were dynamically observed.Compare the ultrastructural changes of lung tissue under electron microscopy in different groups.Results The combination of traditional Chinese and Western medicine can significantly reduce the overexpression of pro-inflammatory cytokine interleukin-6(IL-6)and high mobility group protein 1 in the lung tissue of the target organ of an elderly rat pneumonia model caused by multidrug-resistant Pseudomonas aeruginosa infection,promote the expression of anti-inflammatory cytokine IL-10,and have a stronger effect than the Western medicine group(P<0.05,P<0.01).In the early stage of inflammatory response,the Zhongti group can increase the expression of anti-inflammatory cytokine IL-10 in target organ lung tissue(P<0.05,P<0.01),and significantly reduce the expression of pro-inflammatory cytokine IL-6 and high mobility group protein 1(P<0.05,P<0.01).Observation under electron microscope:In the model group,exudation appeared in the alveolar cavity,and the alveolar capillaries were dilated and congested;The Western medicine group showed mild fibrosis in the alveolar wall and exudation in the alveolar cavity;The traditional Chinese medicine group showed mild thickening of the alveolar wall and no obvious exudation in the alveolar cavity;The group receiving early administration of traditional Chinese medicine showed mild thickening of the alveolar wall and no significant exudation in the alveolar

关 键 词：扶正透邪解毒化瘀方 多重耐药铜绿假单胞菌 老年大鼠 靶器官 炎性损伤及修复 

分 类 号：R285.5[医药卫生—中药学]