疏肝和胃方对非糜烂性胃食管反流病发病中枢机制的影响

Effect of "Shugan Hewei Decoction" on Central Mechanism in Nonerosive Gastroesophageal Reflux Disease

目的:从内脏高敏感角度探讨疏肝和胃方治疗非糜烂性胃食管反流病的可能机制。方法:将60只SD大鼠随机分为空白对照组、生理盐水对照组、模型组、奥美拉唑组、疏肝和胃方组,每组12只。后3组均采用腹腔注射鸡卵清蛋白(OVA)基础致敏,并联合食管酸灌注的方法建立内脏高敏性大鼠模型;生理盐水对照组腹腔注射生理盐水,于第14天生理盐水灌注;疏肝和胃方组和奥美拉唑组分别予以疏肝和胃中药、奥美拉唑混悬液灌胃14 d,其他各组不予特殊处理。用免疫组化法观察各组大鼠脑、脊髓背角神经元型一氧化氮合成酶(ncNOS)及c-Fos蛋白表达情况。结果:模型组脑、脊髓背角ncNOS及c-Fos蛋白表达明显高于空白对照组和生理盐水对照组(P<0.05);疏肝和胃方组、奥美拉唑组脑、脊髓背角ncNOS及c-Fos蛋白表达均明显低于模型组(P<0.05),其中疏肝和胃方组ncNOS蛋白表达明显低于奥美拉唑组(P<0.05),而c-Fos蛋白表达两组无明显差异。结论:疏肝和胃方能够降低食道内脏高敏感性,这可能与降低脑、脊髓背角ncNOS及c-Fos蛋白表达有关。

Objective： To explore the mechanism of ＂ Shugan Hewei Decoction＂ in the treatment of nonerosive gastroesophageal reflux disease on the basis of visceral hypersensitivity. Methods： Sixty SD rats were randomized into blank control group, saline control group, model group, Omeprazole group and ＂Shugan Hewei Decoction＂ group, 12 rats in each group. Models of visceral hypersensitivity in rats were established by basal ovalbumin-sensitized combined intra-esophageal mucosal acid exposure in the last three groups ; rats in saline control group were intraperitoneal injected with saline, at thel4th day with normal saline perfusion; rats in ＂Shugan Hewei Decoction＂ group and Omeprazole group were treated by Chinese medicine and Omeprazole respectively for 14 days, and without any treatments for the other groups. Expressions of ncNOS and c-Fos protein were detected by immunohistochemistry. Results： Expressions of ncNOS and c-Fos in model group were higher than that of blank control group and saline control group （ P 〈 0.05 ） ; expressions of ncNOS and c-Fos in ＂ Shugan Hewei Decoction＂ group and Omeprazole group were lower than that of model group （ P 〈 0.05 ）, expression of ncNOS in ＂Shugan Hewei Decoction＂ group was lower than that of Omeprazole group significantly. （ P 〈 0.05 ）, and there was no significant difference in expression of c-Fos between ＂Shugan Hewei Decoction＂ group and Omeprazole group. Conclusion： ＂ Shugan Hewci Decoction＂ can reduce the viscera/hypersensitivity by reducing the expressions of neNOS and c-Fos.