清胰Ⅱ号方对重症急性胰腺炎大鼠肠黏膜屏障功能的影响

作者	单位
蔡治方	遵义医学院第一临床学院肝胆胰外科
兑丹华	遵义医学院第一临床学院肝胆胰外科
王俊	遵义医学院第一临床学院肝胆胰外科
李继志	遵义医学院第一临床学院肝胆胰外科

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中文摘要:

目的探讨清胰Ⅱ号方对重症急性胰腺炎(severe acute pancreatitis,SAP)大鼠肠黏膜屏障功能的影响。方法选取48只SD大鼠制备SAP模型,造模后随机分为模型组及清胰Ⅱ号方治疗组(治疗组),每组24只。另选取8只大鼠作为假手术组。造模后麻醉苏醒即开始干预,治疗组给予清胰Ⅱ号方(1mL/100g)灌胃,假手术组及模型组给予等体积生理盐水灌胃,各组灌胃均6h/次,干预后6、12、24h每组取8只大鼠,开腹后测腹水量,测血清二胺氧化酶(diamine oxidase,DAO)及D-乳酸浓度;取胰腺及回肠做病理检查,并进行胰腺病理评分;取回肠做扫描电镜检查。结果假手术组无腹水,胰腺及回肠病理无明显异常。与假手术组比较,模型组6h时腹水量、DAO、D-乳酸、病理评分均升高,差异均有统计学意义(P<0.05)。模型组6～24h时DAO、D-乳酸、病理评分逐渐升高,差异均有统计学意义(P<0.05),镜下见组织结构紊乱、间质水肿、出血,大量中性粒细胞浸润,局部灶性或片状肠坏死。与本组12h比较,模型组24h腹水量增多,差异有统计学意义(P<0.05)。治疗组6～24h时D-乳酸、病理评分逐渐升高,差异均有统计学意义(P<0.05),与本组12h比较,治疗组24h腹水量增多,DAO升高,差异均有统计学意义(P<0.05)。与模型组同期比较,治疗组6～24h各指标均降低,差异均有统计学意义(P<0.05),镜下见肠黏膜组织水肿、充血,少量中性粒细胞浸润,程度较模型组轻。结论清胰Ⅱ号方对SAP大鼠肠黏膜屏障功能有保护作用。

英文摘要:

Objective To observe the effects of Qingyi Ⅱ Recipe(QR) on the intestinal barrier function(IBF) of severe acute pancreatitis(SAP) rats.Methods Forty-eight SD rats were selected to prepare SAP model.After modeling,they were randomly divided into the model group and the QR treatment group,24 in each group.Another 8 rats were selected as the sham-operation group.The intervention was started just when they came to resuscitation from anesthesia.Rats in the QR treatment group was administered with QR(1 mL/100 g) by gastrogavage,while an equal volume of normal saline was given to rats in the sham-operation group and the model group by gastrogavage.The gastrogavage was performed once every 6 h.Eight rats were selected from each group 6,12,and 24 h after intervention.The ascites amount was measured after opening abdomens.The concentrations of serum diamine oxidase(DAO) and D-lactate were measured.Pathological changes of pancreas and ileum were observed.The pathological scoring of the pancreas was performed.The ileum were scanned by electron microscope.Results There was no ascites in the sham-operation group.There was no obviously pathological abnormality in the pancreas or ileum.Compared with the sham-operation group,the ascites amount,serum DAO,D-lactate,and pathological scoring all increased at 6 h in the model group,showing statistical difference(P<0.05).In the model group,the serum DAO,D-lactate,and pathological scoring increased gradually at 6-24 h with statistical difference(P<0.05).Results under microscope showed disarranged structure,interstitial edema,hemorrhage,a large amount of neutrophil infiltration,local foci or lamellar intestinal necrosis.The 24-h ascites amount increased more at 24 h than at 12 h in the model group with statistical difference(P<0.05).The serum D-lactate and pathological scoring increased gradually at 6-24 h in the QR treatment group with statistical difference(P<0.05).The 24-h ascites amount and DAO increased more at 24 h than at 12 h in the model group with statistical difference(P<0.05).Compared with the model group at the same time point,each index decreased at 6-24 h in the QR treatment group with statistical difference(P<0.05).Results under microscope showed edema and congestion of the intestinal mucosa tissue,little amount of neutrophil infiltration.But the degrees were milder when compared with those of the model group.Conclusion QR protected IBF of SAP rats.

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