大黄附子汤对重症急性胰腺炎肺损伤大鼠肺泡上皮屏障功能的影响
대황부자탕대중증급성이선염폐손상대서폐포상피병장공능적영향
Effect of Dahuang Fuzi decoction on alveolaur epithelial barrier in rats with lung injury with severe acute pancreatitis
  • 万方数据
    中华急诊医学杂志 중화급진의학잡지
    CHINESE JOURNAL OF EMERGENCY MEDICINE
    2011年 2期 151-155 ,共5页

    路小光%康新%战丽彬%宫殿博%刘莉%范治伟%白黎智%庞宏刚%康利民%纪春阳%王小周

    로소광%강신%전려빈%궁전박%류리%범치위%백려지%방굉강%강이민%기춘양%왕소주

    重症急性胰腺炎%急性肺损伤%肺泡上皮屏障%大黄附子汤%肺泡上皮通透性%肺泡内液体清除率%总肺水量%肺血管外肺水量 重癥急性胰腺炎%急性肺損傷%肺泡上皮屏障%大黃附子湯%肺泡上皮通透性%肺泡內液體清除率%總肺水量%肺血管外肺水量
    중증급성이선염%급성폐손상%폐포상피병장%대황부자탕%폐포상피통투성%폐포내액체청제솔%총폐수량%폐혈관외폐수량
    Severe acute pancreatitis%Acute lung injury%Alveolaur epithelial barrier%Dahuang fuzi decoction%Lung epithelial permeability%Alveolar liquid clearance rate%Total lung water content%Extravascular lung water content
    目的 探讨大黄附子汤对重症急性胰腺炎肺损伤大鼠肺上皮屏障功能的影响及意义.方法 96只SD大鼠随机分为假手术组、重症急性胰腺炎肺损伤组(SAP-ALI组)及大黄附子汤组三组,每组32只.各组再按3,6,12,24 h时间点分为四个亚组,每个亚组各8只.假手术组开腹后行空肠造瘘,翻动胰腺数次后关腹;SAP-ALI组在假手术组基础上经胰胆管逆行注入4%牛磺胆酸钠(1mL/kg),建立重症急性胰腺炎急性肺损伤模型;大黄附子汤组在SAP-ALI组基础上经空肠造瘘管注入大黄附子汤10 mL.各组按时间点分别于伤后3,6,12,24 h测定肺泡上皮通透性(AEP)、肺泡内液体清除率(ALCR)、总肺水量(TLW)和肺血管外肺水量(EVLW),同时测定血浆内毒素(ET)、血清淀粉酶含量,光镜下观察肺脏病理组织学变化.结果 与假手术组比较,SAP-ALI组大鼠术后3,6,12,24 h ALCR显著降低,TLW,EVLW及AEP呈明显升高趋势(P＜0.05或P＜0.01).与SAP-ALI组比较,大黄附子汤组对大鼠术后3,6,12,24 h ALCR均显著升高,TLW,EVLW及AEP呈明显降低趋势(P＜0.05或P＜0.01),且肺组织的水肿、出血、炎症程度及肺损伤学评分和肺湿/干重比均明显好转.结论 重症急性胰腺炎并急性肺损伤大鼠存在严重的肺泡上皮屏障功能障碍;大黄附子汤通过抑制内毒素过度释放,可降低炎症反应,改善肺泡上皮功能障碍,减轻肺损伤程度.
    목적 탐토대황부자탕대중증급성이선염폐손상대서폐상피병장공능적영향급의의.방법 96지SD대서수궤분위가수술조、중증급성이선염폐손상조(SAP-ALI조)급대황부자탕조삼조,매조32지.각조재안3,6,12,24 h시간점분위사개아조,매개아조각8지.가수술조개복후행공장조루,번동이선수차후관복;SAP-ALI조재가수술조기출상경이담관역행주입4%우광담산납(1mL/kg),건립중증급성이선염급성폐손상모형;대황부자탕조재SAP-ALI조기출상경공장조루관주입대황부자탕10 mL.각조안시간점분별우상후3,6,12,24 h측정폐포상피통투성(AEP)、폐포내액체청제솔(ALCR)、총폐수량(TLW)화폐혈관외폐수량(EVLW),동시측정혈장내독소(ET)、혈청정분매함량,광경하관찰폐장병리조직학변화.결과 여가수술조비교,SAP-ALI조대서술후3,6,12,24 h ALCR현저강저,TLW,EVLW급AEP정명현승고추세(P＜0.05혹P＜0.01).여SAP-ALI조비교,대황부자탕조대대서술후3,6,12,24 h ALCR균현저승고,TLW,EVLW급AEP정명현강저추세(P＜0.05혹P＜0.01),차폐조직적수종、출혈、염증정도급폐손상학평분화폐습/간중비균명현호전.결론 중증급성이선염병급성폐손상대서존재엄중적폐포상피병장공능장애;대황부자탕통과억제내독소과도석방,가강저염증반응,개선폐포상피공능장애,감경폐손상정도.
    Objective To investigate effect of Dahuang Fuzi decoction on alveolaur epithelial barrier in rats with lung injury with severe acute pancreatitis. Method Ninty-six health SD rats were randomly divided into three groups: sham operation group, SAP-ALI group, Dahuang Fuzi decoction group, and then according to the time point of sacrifice after operation, each group was subdivided into 3,6,12,24 hour subsets ( each, n = 8). After the belly of a rat in the sham operation group was cut open, the pancreas was flipped several times,and then a stoma was made in the jejunum to form its fistula. In the SAP-ALl group,1 mL/kg sodium taurocholate was reversely injected into the pancreatobile duct to establish the model of SAP, and then the jejimum fistula was performed. The SAP-ALI model in Dahuang Fuzi decoction group was treated by injection of 10ml of Dahuang Fuzi decoctionon into the fistula respectively. Blood was collected from heart to detect serum amvlase and endotoxin (ET) levels before the rat being executed. The lung histopathologic changes, pulmonary injury scores and wet/dry weight(W/D) ratios were observed after the rats were executed. The alveolar liquid clearance rate(ALCR), total lung water content (TLW), extravascular lung water content(EVLW) and alveolar epithelial permeability (AEP) were examined in 3,6, 12,24 h after injury.Results There was continuous increase of AEP,TLW and EVLW,as well as progressive reduction of ALCR compared with sham operation group at 3,6,12,24 h after operation. Compared with SAP-ALI group, there was continuous decrease of AEP,TLW and EVLW, and elevated of ALCR at 3,6,12,24 h after operation.Conclusions Dahuang Fuzi decoction can significantly reduce alveolaur epithelial barrier and degree of lung tissue of SAP-ALI rats by inhibiting the elevation of LPS and inflammation reaction.
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