CAJ | 학술논문

目的探讨漂白土洗胃联合清胰Ⅱ号导泻对口服百草枯中毒兔的治疗作用。方法成年健康日本大耳白兔30只，按照随机数字表法分为对照组、模型组、洗胃组（10%漂白土混悬液洗胃）、导泻组（清胰Ⅱ号导泻）、联合组（漂白土混悬液洗胃后10 min行清胰Ⅱ号导泻）5组，每组6只。一次性灌胃百草枯溶液100 mg/kg（用生理盐水稀释至5 mL）制备急性中毒模型；对照组灌胃等量生理盐水。各治疗组于灌胃1 h后进行相应治疗，连续3 d。观察动物存活情况；于中毒后1、2、4、8、24 h取耳缘静脉血，用紫外分光光度计检测血浆百草枯浓度；于中毒后8 d静脉注射空气处死动物取右肺下叶，苏木素-伊红（HE）染色，观察肺组织病理学改变。结果①存活情况：中毒后2 d各组兔存活数为联合组（6只）＞洗胃组（5只）＞导泻组（2只）＞模型组（0只），7 d存活数为联合组（5只）＞洗胃组（3只）＞导泻组（0只），差异均有统计学意义（P＜0.001和P＝0.003）。②血浆百草枯浓度：各组血浆百草枯浓度的吸收高峰在中毒后2 h，但洗胃组、导泻组、联合组血浆百草枯浓度均已明显低于模型组（mg/L：1.830±0.068、1.890±0.048、1.800±0.052比1.960±0.063，均P＜0.01）；随治疗时间延长，血浆百草枯血中浓度下降幅度为联合组＞洗胃组＞导泻组（均P＜0.01）；析因分析联合组4 h时洗胃和导泻出现交互作用〔F＝5.194，P＝0.034，百草枯浓度（mg/L）为0.670±0.057比1.010±0.018、1.210±0.052〕。③肺组织病理学改变：模型组、导泻组肺泡壁毛细血管明显扩张充血，肺泡间隔增宽，可见大量炎性细胞浸润；洗胃组、联合组肺损伤病理改变较模型组明显减轻，且联合组较洗胃组改善更明显。结论早期采用漂白土混悬液洗胃联合清胰Ⅱ号导泻能降低口服百草枯中毒兔血浆百草枯浓度，改善肺损伤程度，明显提高存活率，较单一洗胃、导泻治疗效果更好，对改善动物预后有协同作用。目的探討漂白土洗胃聯閤清胰Ⅱ號導瀉對口服百草枯中毒兔的治療作用。方法成年健康日本大耳白兔30隻，按照隨機數字錶法分為對照組、模型組、洗胃組（10%漂白土混懸液洗胃）、導瀉組（清胰Ⅱ號導瀉）、聯閤組（漂白土混懸液洗胃後10 min行清胰Ⅱ號導瀉）5組，每組6隻。一次性灌胃百草枯溶液100 mg/kg（用生理鹽水稀釋至5 mL）製備急性中毒模型；對照組灌胃等量生理鹽水。各治療組于灌胃1 h後進行相應治療，連續3 d。觀察動物存活情況；于中毒後1、2、4、8、24 h取耳緣靜脈血，用紫外分光光度計檢測血漿百草枯濃度；于中毒後8 d靜脈註射空氣處死動物取右肺下葉，囌木素-伊紅（HE）染色，觀察肺組織病理學改變。結果①存活情況：中毒後2 d各組兔存活數為聯閤組（6隻）＞洗胃組（5隻）＞導瀉組（2隻）＞模型組（0隻），7 d存活數為聯閤組（5隻）＞洗胃組（3隻）＞導瀉組（0隻），差異均有統計學意義（P＜0.001和P＝0.003）。②血漿百草枯濃度：各組血漿百草枯濃度的吸收高峰在中毒後2 h，但洗胃組、導瀉組、聯閤組血漿百草枯濃度均已明顯低于模型組（mg/L：1.830±0.068、1.890±0.048、1.800±0.052比1.960±0.063，均P＜0.01）；隨治療時間延長，血漿百草枯血中濃度下降幅度為聯閤組＞洗胃組＞導瀉組（均P＜0.01）；析因分析聯閤組4 h時洗胃和導瀉齣現交互作用〔F＝5.194，P＝0.034，百草枯濃度（mg/L）為0.670±0.057比1.010±0.018、1.210±0.052〕。③肺組織病理學改變：模型組、導瀉組肺泡壁毛細血管明顯擴張充血，肺泡間隔增寬，可見大量炎性細胞浸潤；洗胃組、聯閤組肺損傷病理改變較模型組明顯減輕，且聯閤組較洗胃組改善更明顯。結論早期採用漂白土混懸液洗胃聯閤清胰Ⅱ號導瀉能降低口服百草枯中毒兔血漿百草枯濃度，改善肺損傷程度，明顯提高存活率，較單一洗胃、導瀉治療效果更好，對改善動物預後有協同作用。
목적탐토표백토세위연합청이Ⅱ호도사대구복백초고중독토적치료작용。방법성년건강일본대이백토30지，안조수궤수자표법분위대조조、모형조、세위조（10%표백토혼현액세위）、도사조（청이Ⅱ호도사）、연합조（표백토혼현액세위후10 min행청이Ⅱ호도사）5조，매조6지。일차성관위백초고용액100 mg/kg（용생리염수희석지5 mL）제비급성중독모형；대조조관위등량생리염수。각치료조우관위1 h후진행상응치료，련속3 d。관찰동물존활정황；우중독후1、2、4、8、24 h취이연정맥혈，용자외분광광도계검측혈장백초고농도；우중독후8 d정맥주사공기처사동물취우폐하협，소목소-이홍（HE）염색，관찰폐조직병이학개변。결과①존활정황：중독후2 d각조토존활수위연합조（6지）＞세위조（5지）＞도사조（2지）＞모형조（0지），7 d존활수위연합조（5지）＞세위조（3지）＞도사조（0지），차이균유통계학의의（P＜0.001화P＝0.003）。②혈장백초고농도：각조혈장백초고농도적흡수고봉재중독후2 h，단세위조、도사조、연합조혈장백초고농도균이명현저우모형조（mg/L：1.830±0.068、1.890±0.048、1.800±0.052비1.960±0.063，균P＜0.01）；수치료시간연장，혈장백초고혈중농도하강폭도위연합조＞세위조＞도사조（균P＜0.01）；석인분석연합조4 h시세위화도사출현교호작용〔F＝5.194，P＝0.034，백초고농도（mg/L）위0.670±0.057비1.010±0.018、1.210±0.052〕。③폐조직병이학개변：모형조、도사조폐포벽모세혈관명현확장충혈，폐포간격증관，가견대량염성세포침윤；세위조、연합조폐손상병리개변교모형조명현감경，차연합조교세위조개선경명현。결론조기채용표백토혼현액세위연합청이Ⅱ호도사능강저구복백초고중독토혈장백초고농도，개선폐손상정도，명현제고존활솔，교단일세위、도사치료효과경호，대개선동물예후유협동작용。
ObjectiveTo observe the therapeutic effects of gastric lavage with fuller earth combined with QingyiⅡ catharsis in treatment of oral paraquat poisoning in rabbits.Methods Thirty healthy adult Japanese white rabbits were randomly divided into five groups: namely control group, model group, gastric lavage group (lavage of 10%fuller earth suspension), catharsis group (QingyiⅡ catharsis), and combination group (10 minutes after gastric lavage of fuller earth suspension liquid, giving QingyiⅡ for catharsis), with 6 rabbits in each group. All groups were challenged with paraquat (100 mg/kg) diluted to 5 mL with normal saline by lavage to reproduce the model of acute poisoning, while the control group was given 5 mL of normal saline instead. Each treatment group was treated accordingly at 1 hour after gavages of paraquat, and treatment continued for 3 days. The animal survival rate was observed. Venous blood samples were collected from ear marginal vein to determine the plasma concentration of paraquat by ultraviolet spectrophotometer at 1, 2, 4, 8 and 24 hours after the poisoning. The animals were sacrificed by intravenous air injection on the 8th day after the poisoning, and the right lower lobe of lung was harvested to observe the lung tissue pathological changes with hematoxylin-eosin (HE) staining.Results① Survival rate: the surviving rate of the combination group (6 rabbits) was higher than that of gastric lavage group (5 rabbits), catharsis group (2 rabbits) and model group (0 rabbit) on the 2nd day with statistically significant difference (P< 0.001). The survival rate on the 7th day in combination group (5 rabbits) was higher than that of gastric lavage group (3 rabbits), and catharsis group (0 rabbit) with statistically significant difference (P = 0.003).② Plasma concentrations of paraquat: plasma paraquat concentration in all groups peaked at 2 hours after intoxication, and its levels in the gastric lavage, catharsis and combination groups were significantly lower than that of the model group (mg/L: 1.830±0.068, 1.890±0.048, 1.800±0.052 vs. 1.960±0.063, allP< 0.01). As the time prolonged, the plasma concentration of paraquat was lowest in combination group than that of gastric lavage group and catharsis group (allP< 0.01). Gastric lavage and catharsis had interaction at 4 hours in combination group [F = 5.194,P = 0.034; the concentrations of paraquat (mg/L) was 0.670±0.057 vs. 1.010±0.018, 1.210±0.052].③ Lung histopathology: obvious expansion and hyperemia of the alveolar capillary, widened alveolar septum, a large number of inflammatory cell infiltrations were observed in model group and catharsis group. Lung histopathology was more improved in combination group and gastric lavage group, and it was improved more obviously in combination group than that in gastric lavage group.Conclusions Early start of gastric lavage with fuller earth combined with QingyiⅡ catharsis, can reduce the animal plasma concentrations of paraquat in oral paraquat poisoning rabbits. At the same time, it can alleviate the degree of lung injury and significantly improve survival rates compared with the single gastric lavage or catharsis alone. Gastric lavage with fuller earth combined with QingyiⅡ catharsis can improve the prognosis of animal synergistically.