大黄及肺炎Ⅲ号对急性感染内毒素血症的影响

本研究说明急性肺炎患者中有1/3可以出现内毒素血症(ETM),并测得入院24小时血浆内毒素浓度,口服生大黄煎剂加抗生素治疗组低于抗生素对照组(P<0.05)。实验性肺炎球菌感染家兔 ETM 的阳性率为60%。感染后48小时内生大黄组的 ETM 阳性率及血浆内毒素浓度均低于水对照组(P<0.05)。肺炎Ⅲ号对急性惑染的 ETM 也有一定的影响。以上结果表明,急性感染中可以出现内源性的 ETM,应用大黄可以抑制并减轻 ETM 的发生。

英文摘要:

The authors have improved the method of limulus lysate test with chromogenic substrate for quantitative determination of plasma endotoxin.Peripheral plasma endotoxin levels in 27 normal volunteers were≤0.075 EU/ml when E coll.O₁₁₁B₄ endotoxin was used as reference.Acute pneumo- nia as representative disease was studied.Blood samples from 10 of 29 cases of acute pneumonia showed endotoxin>0.075 EU/ml.Positive rate of endotoxemia（ETM）was 34.5%.Rhubarb（Rheum Officinale）decoction could lower ETM in comparison with the control（P<0.05）. Further experimental study was carried out in rabbits.The plasma endotoxin levels in 60 normal rabbits were≤0.075 EU/ml before experiment.The infectious model of rabbits was produced by means of subcutaneous innoculation of pneumococci.9 out of 15 rabbits had ETM>0.075 EU/ml after the infection.Rhubarb Decoction and Anti-Pneumonia Mixture Ⅲ（Polygonum cuspidatum, Scutellaria barbata,Patrinia scabiosaefolia and Herba taraxaci）were given orally to the experiment groups respectively（n=14,n=15）and boiled war to the controls（n=15）at the beginning of infection and 12 hours after infection.The result showed that in rabbits given Rubarb,both the positive rate of ETM and plasma endotoxin were lower than that in those given boiled water（P< 0.05）.The above data indicate that ETM may present in acute infections,which come from the dysfunction of intestinal flora,and that Rhubarb can reduce the degree of ETM.

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