芍药甙与生长抑素及其类似物对犬重症急性胰腺炎Oddi括约肌影响的比较研究

Effects of Paeoniflorin, Somatostatin and its Analogue on Sphincter of Oddi in Canine with Severe Acute Pancreatitis: A Comparative Study

背景:传统医学应用白芍作为松弛平滑肌的药物之一,芍药甙为白芍的主要有效成分,对重症急性胰腺炎(SAP)时的Oddi括约肌功能障碍可能具有潜在治疗作用。目的:比较芍药甙与生长抑素及其类似物对实验性SAP犬Oddi括约肌的影响。方法:将20条犬随机分为SAP非治疗组、芍药甙治疗组、奥曲肽治疗组和生长抑素治疗组,以注射5%牛磺酸钠和自身胆汁混合液制备SAP模型。分别于造模前后以及给药后5、10、30、60、120和180min测定Oddi括约肌基础压和时相收缩幅度(PCA)。结果:造模后,SAP非治疗组的Oddi括约肌基础压显著升高(P=0.0001)。芍药甙、奥曲肽和生长抑素均能显著降低SAP时的Oddi括约肌基础压(P<0.05);生长抑素还能显著降低SAP时的Oddi括约肌PCA(P=0.0003),芍药甙和奥曲肽则无明显作用(P>0.05)。比较给药后Oddi括约肌基础压降低的差值,结果显示生长抑素在给药初期(给药后5min和10min)表现出较为明显的降压作用(P<0.05),以后各时间点三者的作用无统计学差异(P>0.05)。结论:Oddi括约肌压力异常是SAP发展以及影响其严重程度的重要因素,芍药甙通过降低Oddi括约肌基础压而对SAP具有潜在治疗作用,且该作用在一定程度上与生长抑素及其类似物相当。

Background： Radix Paeoniae Alba is one of the traditional Chinese medicine used to relax the smooth muscle and paeoniflorin is known as its main active constituent, which may have the potential therapeutic effect on sphincter of Oddi （SO） dysfunction in patients with severe acute panereatitis （SAP）. Aims： To compare the effects of paeoniflorin, somatostatin and its analogue on SO in experimental SAP canine. Methods： Twenty canines were randomly allocated into 4 groups： SAP untreated group, paeoniflorin-, octreotide-, and somatostatin-treated group. The experimental SAP model was constructed by duetal injection of a mixture of 5% sodium taurocholate and autologous bile. The manometric parameters including basal pressure and phasic eontraction amplitude （PCA） of SO were measured before and after model construction. 5, 10, 30, 60, 120 and 180 rain, respectively after drug administration. Results： In SAP untreated group, the basal pressure of SO increased significantly after model construction （P=0.000 1）. After administration of paeoniflorin, octreotide or somatostatin, the basal pressure of SO deereased markedly in SAP canines （P〈0.05）. Somatostatin was shown to have significant inhibito%, effect on PCA of SO （P=0.000 3） in addition but not the paeoniflorin and octreotide （P〉0.05）. Based on comparison uf the difference in decreased SO basal pressure among the three treated groups, the tension decreasing effect of somatostatin was more significant in the initial 5 and 10 rain （P〈0.05）, but no statistical difference was found in the following time points （P〉0.05）. Conclusions： The abnornal SO pressure is an important factor in the development of SAP and may influence its severity. Paeoniflorin may have potential therapeutic effeet on SAP by decreasing the basal pressure of SO. The effect of paeoniflorin is equivalent to a certain degree to that of somatostatin and its analogue.