通腑颗粒对犬缺血/再灌注损伤小肠黏膜血液灌流和通透性的影响

Effects of Tongfu granules(通腑颗粒) on small intestinal mucosal hemoperfusion and permeability during gut ischemia/reperfusion injury in dogs

目的:观察通腑颗粒对肠缺血/再灌注(I/R)损伤小肠黏膜血液灌流及通透性的影响。方法:采用夹闭肠系膜上动脉1 h后恢复血液灌流造成肠I/R损伤犬动物模型。随机将动物分成I/R模型组和I/R治疗组,每组8只。缺血即刻经肠内营养通道分别滴注生理盐水或中药通腑颗粒溶液(0.3 g/kg)。于缺血前及缺血后1、6、8、12和24 h检测血浆二胺氧化酶(DAO)活性、D-乳酸含量、肠黏膜二氧化碳分压(P iCO2);于缺血后24 h活杀动物,取空肠组织,观察病理形态学改变。结果:两组缺血后P iCO2、血浆DAO和D-乳酸均较缺血前显著升高,但随缺血时间延长,各指标有所下降。I/R治疗组各指标均明显低于I/R模型组,且于缺血后24 h回落至缺血前水平。光镜下I/R模型组缺血早期小肠黏膜下血管明显增多,黏膜血管扩张、充血,并可见大量炎性细胞浸润;黏膜上皮细胞坏死、脱落,肠壁变薄。I/R治疗组肠组织病理损害较I/R模型组减轻。结论:通腑颗粒能显著改善肠组织血液灌流及功能指标,减轻肠黏膜病理损害,对I/R损伤小肠有显著的保护作用。

Objective： To observe the effects of Tongfu granules （通腑颗粒） on small intestinal mucosal hemoperfusion and permeability during gut ischemia/reperfusion （I/R） injury. Methods： Gut I/R model was established by blocking the superior mesenteric artery （SMA） for 1 hour, and followed by restoration of SMA blood flow. Dogs were randomly divided into I/R model group and I/R treatment group （each n 8）. Tongfu granules solution of Chinese medicine （0.3 g/kg） or 0.9% normal saline was given enterally to animals in the two groups respectively via a tonometric catheter immediately after blocking SMA. The diamine oxidase （DAO） activities, D- lactate contents and intestinal mucosal partial pressure of carbon dioxide （PiCO2） were detected at 1, 6, 8, 12 and 24 hours of ischemia. Animals were sacrificed at 24 hours after ischemia, and the jejunal tissue was taken for histopathological examination. Results： The levels of plasma DAO, D -lactate and PiCO2 were significantly elevated in both groups after isehemia than those before, and gradually declined as ischemia continued. The changes in intestinal parameters of hemoperfusion and permeability in Tongfu granules group were significantly lowered than those in I/R model group, and returned to the pre injury levels at 24 hours of ischemia. The pathological examination of the intestine showed that the blood vessels in the gut submucosa were increased, there were angiectasis, congestion and a large amount of inflammatory cell infiltration in the intestinal epithelium, the intestinal epithelial cells had apoptosis and detachment and the intestinal wall was thin at early stage of gut I/R. Less pathological injuries were found in animals with Tongfu granules than those without it. Conclusion： Tongfu granules have a protective effect on gut with 1/R injury by ameliorating hemoperfusion of intestinal tissues and function parameters, attenuating intestinal functional and pathological changes.