基于“肠-肝-脑轴”理论探讨生大黄与醋大黄保留灌肠治疗A型肝性脑病大鼠的作用及机制  

A Discussion on the Effects and Mechanisms of Retention Enema of Raw Rhubarb and Vinegared Rhubarb in the Treatment of Rats With Type A Hepatic Encephalopathy Based on the Theory of"Intestinal-Hepatic-Cerebral Axis"

作　　者：陈诚 陈斌[2] 朱凌琴 尹菁 李萃玲 CHEN Cheng;CHEN Bin;ZHU Lingqin;YIN Jing;LI Cuiling(Hunan University of Traditional Chinese Medicine,Changsha 410208,Hunan,China;The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha 410007,Hunan,China)

机构地区：[1]湖南中医药大学第一中医临床学院,湖南长沙410208 [2]湖南中医药大学第一附属医院,湖南长沙410007

出　　处：《实用中医内科杂志》2025年第4期107-111,I0022-I0027,共11页Journal of Practical Traditional Chinese Internal Medicine

基　　金：广西自然科学基金重点项目(桂科AB22035076)。

摘　　要：目的探讨生大黄与醋大黄保留灌肠对A型肝性脑病(HE)大鼠模型的疗效差异并分析其可能机制。方法按完全随机方法将50只雄性SPF级大鼠分为空白组(CON组)、模型组(MOD组)、乳果糖组(LT组)、生大黄煎剂组(RD1组)、醋大黄煎剂组(RD2组),每组各10只。CON组及MOD组大鼠用氯化钠溶液保留灌肠,2 mL/只,1次/d;LT组大鼠用乳果糖稀释液保留灌肠,2 mL/只,1次/d;RD1组和RD2组分别用生大黄煎剂及醋大黄煎剂保留灌肠,2 mL/只,1次/d。7 d给药治疗后,所有大鼠行Morris水迷宫实验,评估大鼠空间学习记忆能力及行为学状态;观察大鼠肝、肠、脑组织的病理变化;取大鼠血清,检测ALT、AST、IL-1β、IL-6、TNF-α和血氨水平;对结肠内容物进行pH值测定;对肠蠕动功能进行评估;qPCR法对结肠双歧杆菌及大肠杆菌进行定量检测;采用单因素方差分析进行多组间比较,根据方差齐性不同,进一步比较采用LSD-t检验或塔姆黑尼检验。结果与MOD组比较,LT组、RD2组穿台次数均增加(P<0.05),RD1组穿台次数与MOD组差异无统计学意义(P>0.05),LT组、RD1组、RD2组ALT、AST、IL-1β、IL-6、TNF-α、血氨水平、结肠内容物pH值均降低(P<0.05),RD1组、RD2组双歧杆菌数量明显增加(P<0.01),大肠杆菌数量明显减少(P<0.01),CON组及RD2组肠蠕动功能明显增加(P<0.01),LT组、RD1组、RD2组肝组织、肠组织及脑组织病理损伤均减轻,且RD2组综合治疗效果优于LT组和RD1组。结论生大黄煎剂及醋大黄煎剂保留灌肠对HE大鼠均具有较好的治疗作用,醋大黄煎剂可以通过更多的酸化肠道从而达到更佳的治疗效果。Objective To explore the differences in efficacy and possible mechanisms between raw rhubarb and vinegar rhubarb in the treatment of A-type hepatic encephalopathy(HE)rat model.Methods 50 male SD rats were divided into blank group(CON group),model group(MOD group),lactulose group(LT group),raw rhubarb decoction group(RD1 group),and vinegared rhubarb decoction group(RD2 group)according to complete randomization method,10 rats in each group.Among them,rats in the CON group and MOD group were treated with saline retention enema,2 mL/only,1 time/d;rats in the LT group were treated with lactulose dilution retention enema,2 mL/only,1 time/d;rats in the RD1 group and the RD2 group were treated with raw rhubarb decoction and vinegar rhubarb decoction retention enema,2 mL/only,1 time/d,respectively.After all rats were administered the drugs and treated for 7 d,the Morris water maze experiments were performed to analyze the spatial learning memory ability and behavioral status of rats;detecting serum ALT,AST,IL-1β,IL-6,TNF-αand blood ammonia levels of rats;detecting pH value of colon contents;testing intestinal peristalsis function;observing pathological changes in liver tissue,intestinal tissue and brain tissue of rats;and testing the number of bifidobacteria and Escherichia coli in the colon.The measurement data between multiple groups were compared using one-way ANOVA,and further two-by-two comparisons were made using LSD-t test or Tamheeni test according to the chi-square.Results Compared with the MOD group,the number of table crossings increased in the LT and RD2 groups(P<0.05),and there was no statistically significant difference between the number of table crossings in the RD1 group and that in the MOD group(P>0.05),and the number of ALT,AST,IL-1β,IL-6,TNF-α,blood ammonia level,and pH value of colon contents decreased in the LT,RD1,and RD2 groups(P<0.05),and the number of bifidobacteria and E.coli counts in the RD1 and RD2 groups decreased(P<0.05).The number of bifidobacteria in RD1 and RD2 groups was significant

关 键 词：肝性脑病 大黄煎剂 生大黄 醋大黄 结肠pH值 

分 类 号：R285.5[医药卫生—中药学]