大建中汤对术后肠梗阻大鼠胃肠功能的影响

Effect of Daikenchuto on gastrointestinal function of rats with postoperative ileus

目的观察大建中汤对术后肠梗阻大鼠胃肠功能及血清血管活性肽(VIP)、分泌型免疫球蛋白(sIgA)、白细胞介素-1β(IL-1β)的影响,探讨大建中汤的可能作用机制。方法将40只雄性SD大鼠随机为正常组、假手术组、术后肠梗阻组、大建中汤组,每组10只。术后肠梗阻组和大建中汤组大鼠通过Klaff小肠干扰术建立术后肠梗阻模型。造模成功后,大建中汤组分别在术后6 h、12 h、24 h灌胃0.486 g/mL大建中汤溶液,正常组、假手术组和术后肠梗阻组灌胃等量生理盐水。在处死前60 min,各组均灌胃2%蓝色葡聚糖2000,30 min后取小肠,肉眼观察肠道形态,测定小肠推进率,HE染色观察肠组织病理表现,ELISA法测定血清中VIP、sIgA、IL-1β水平。结果术后肠梗阻组大鼠肠管表面有少量渗血点,肠壁水肿,肠腔内有气液聚积,肠蠕动稍差,部分大鼠肠管明显粘连、扩张;小肠推进率明显低于正常组及假手术组(P均<0.05);HE染色显示肠黏膜损害明显,黏膜下充血水肿,绒毛萎缩变短、部分水肿变宽,间质可见炎性细胞浸润;血清VIP、IL-1β水平均明显高于正常组及假手术组(P均<0.05),血清sIgA水平明显低于正常组及假手术组(P均<0.05)。大建中汤组大鼠肠管充血水肿情况较术后肠梗阻组明显改善,无明显出血、溃疡,肠蠕动尚可;小肠推进率明显高于术后肠梗阻组(P<0.05);HE染色显示肠黏膜上皮排列较整齐,绒毛长短稍显不齐,间质轻度充血水肿,可见少量炎性细胞浸润;血清VIP、IL-1β水平均明显低于术后肠梗阻组(P均<0.05),血清sIgA水平明显高于术后肠梗阻组(P<0.05)。结论大建中汤能够有效改善术后肠梗阻大鼠的胃肠功能,机制可能与降低血清VIP水平促进胃肠运动,升高sIgA水平和下调IL-1β水平从而调控肠道炎症反应,保护肠黏膜屏障,维持肠道免疫功能有关。

Objective It is to observe the effect of Daikenchuto on gastrointestinal function and serum vasoactive intestinal peptide(VIP),secretory IgA(sIgA)and interleukin-1β(IL-1β)in rats with postoperative ileus(PI),and to investigate the possible action mechanism of this decoction.Methods Forty SPF male SD rats were randomly divided into normal group,sham operation group,PI group and Daikenchuto group,with 10 rats in each group.The rat models of PI were successfully established by Klaff small intestinal interference in the PI group and Daikenchuto group.After successful modeling,the rats of the Daikenchuto group were gavaged with Daikenchuto solution at 6 h,12 h and 24 h after operation,while the rats of the normal group,sham operation group and PI group were gavaged with normal saline.60 minutes before execution,the rats of each group were gavaged with 2%blue dextran 2000,and their small intestine was taken 30 min later,the intestinal morphology was observed by naked eye,the propulsion rate of the small intestine was determined,the pathological manifestations of intestinal histology were observed by HE staining,and the levels of VIP,sIgA,and IL-1βin serum were determined by ELISA.Results After modeling,there were a few bleeding on the intestinal surface of the rats in the PI group,with intestinal wall edema,gas and liquid accumulation in the intestinal lumen,slightly worse intestinal peristalsis,and some rats'intestinal tubes were obviously adhered and expanded,their small intestinal propulsion rate were significantly decreased(P<0.05);HE staining showed that the intestinal mucosal damage was obvious,with submucosal hyperemia and edema,villi atrophy and shortening,some edema became wider,and interstitial inflammatory cell infiltration was observed;the serum levels of VIP and IL-1βin the PI group were significantly higher than those in the normal group and sham operation group(all P<0.05),and the level of sIgA was significantly lower than those in the normal group and sham operation group(all P<0.05).The intestinal congestion and edema of the rats in the Daikenchuto group were significantly improved compared with the model group,without obvious bleeding and ulcer,and the intestinal peristalsis was OK,the small intestinal propulsion rate was higher than that of the PI group(P<0.05);HE staining showed that the mucosal epithelium of intestinal tissue was arranged neatly,the length of villi was slightly uneven,the interstitial hyperemia and edema were mild,and a small amount of inflammatory cell infiltration was observed;the serum levels of VIP and IL-1βin Daikenchuto group were significantly lower than those in the PI group(P<0.05),and the level of sIgA was significantly higher than that in the PI group(P<0.05).Conclusion Daikenchuto can effectively improve the gastrointestinal function of rats with postoperative ileus,the mechanism maybe related with reducing the level of serum VIP,promoting gastrointestinal motility,increasing the level of sIgA,down-regulating the level of IL-1βto regulate intestinal inflammation,protect intestinal mucosal barrier,and maintaining intestinal immune function.