CAJ | 학술논문

背景：急进高原缺氧引起的胃肠道运动功能紊乱发病率较高，目前其发生机制仍不明确，相关干预研究较少。目的：探讨高原缺氧对大鼠小肠运动的影响及其可能机制以及生白术的干预作用。方法：70只 Wistar 大鼠随机分为7组，分别为对照组、3500 m 和5000 m 海拔模型组以及相应海拔曲美布汀、生白术干预组。6组造模大鼠置于相应海拔低压低氧舱中并予相应药物溶液或0.9％ NaCl 溶液灌胃3 d。3 d 后所有大鼠于墨汁灌胃后30 min 处死，测量墨汁小肠推进率，观察小肠组织病理学变化，免疫组化法检测5-HT4受体表达。结果：与对照组相比，海拔3500 m 模型组小肠推进率减缓，5-HT4受体免疫阳性面积减少，海拔5000 m 模型组小肠推进率加快，5-HT4受体免疫阳性面积增加（P 均﹤0.05），两组小肠黏膜表现为中-重度损伤。生白术干预能有效纠正海拔 3500 m 和5000 m 引起的小肠推进率和5-HT4受体数量异常（P 均﹤0.05），使之接近对照组水平，并减轻小肠黏膜损伤，效果优于阳性对照药物曲美布汀。结论：急进高原缺氧引起的小肠运动功能紊乱与海拔高度密切相关，临床表现各异。生白术可能通过调节5-HT4受体有效改善此种运动功能紊乱，对小肠黏膜损伤亦有一定修复作用。
배경：급진고원결양인기적위장도운동공능문란발병솔교고，목전기발생궤제잉불명학，상관간예연구교소。목적：탐토고원결양대대서소장운동적영향급기가능궤제이급생백술적간예작용。방법：70지 Wistar 대서수궤분위7조，분별위대조조、3500 m 화5000 m 해발모형조이급상응해발곡미포정、생백술간예조。6조조모대서치우상응해발저압저양창중병여상응약물용액혹0.9％ NaCl 용액관위3 d。3 d 후소유대서우묵즙관위후30 min 처사，측량묵즙소장추진솔，관찰소장조직병이학변화，면역조화법검측5-HT4수체표체。결과：여대조조상비，해발3500 m 모형조소장추진솔감완，5-HT4수체면역양성면적감소，해발5000 m 모형조소장추진솔가쾌，5-HT4수체면역양성면적증가（P 균﹤0.05），량조소장점막표현위중-중도손상。생백술간예능유효규정해발 3500 m 화5000 m 인기적소장추진솔화5-HT4수체수량이상（P 균﹤0.05），사지접근대조조수평，병감경소장점막손상，효과우우양성대조약물곡미포정。결론：급진고원결양인기적소장운동공능문란여해발고도밀절상관，림상표현각이。생백술가능통과조절5-HT4수체유효개선차충운동공능문란，대소장점막손상역유일정수복작용。
Background:Gastrointestinal dysmotility is commonly seen in individuals exposed to acute plateau hypoxia. Its pathogenic mechanism is still not clear and intervention study is rarely performed. Aims:To investigate the influence of plateau hypoxia on small intestinal motility of rats,its possible mechanism,and the intervention effect of raw Atractylodes macrocephala. Methods:Seventy Wistar rats were randomly divided into 7 groups:control group,two high altitude model groups(3 500 m and 5 000 m),trimebutine and raw Atractylodes macrocephala groups at 3 500 m or 5 000 m altitude. Rats in six experiment groups were placed in a hypobaric chamber mimicking 3 500 m or 5 000 m altitude and given trimebutine/ raw Atractylodes macrocephala/ saline intragastrically for 3 days. Then all the rats were lavaged with 2 mL ink and sacrificed 30 minutes later. The propulsion rate of ink in small intestine was measured,the pathological changes of small intestine tissue were examined,and the expression of 5-HT4 receptor was determined by immunohistochemistry. Results:Compared with control group,the propulsion rate of small intestine and immunopositive area of 5-HT4 receptor were reduced in model group at 3 500 m altitude,while those in model group at 5 000 m altitude were increased(P ﹤0. 05). Moderate-to-severe mucosal injury was observed in two model groups. In model rats treated with raw Atractylodes macrocephala,the abnormalities in small intestine propulsion and 5-HT4 receptor induced by high altitude(3 500 m and 5 000 m)returned to the control level(P ﹤ 0. 05),and the mucosal injury ameliorated simultaneously. Efficacy of raw Atractylodes macrocephala was prior to trimebutine,a positive control. Conclusions:Acute plateau hypoxia may induce small intestine dysmotility with diverse manifestations,and altitude is a crucial determinant in this process. Raw Atractylodes macrocephala can exert therapeutic effect on this dysmotility by modulating 5-HT4 receptor,and it is also effective in repairing mucosal injury.