通腑颗粒改善犬缺血再灌注状态下实施肠内营养时的小肠功能

Improvement effect of Tongfu particles on gut function in the process of enteral nutrition following intestinal ischemia and reperfusion in dogs

目的:研究通腑颗粒(TF)对肠缺血-再灌注(I/ R)状态下实施早期肠内营养(EN)时小肠功能的影响.方法:(?)杂种犬32只随机平均分为EN组、I/R组、I/R+EN组和I/R+EN+TF组,夹闭肠系膜上动脉(SMA)1h后恢复灌流造成肠I/R损伤,复流后4h实施EN.检测小肠腔内压(ICP)、血浆D-木糖含量和二胺氧化酶(DAO)活性评价小肠动力、吸收和屏障功能.结果:肠I/R各组与单纯EN组比较ICP和DAO显著升高(ICP:17.5±1.1kPa,17.6±1.3kPa,17.3±1.5kPa vs 12.3±0.9kPa,均P<0.01;DAO:1.19±0.15U,1.14±0.13U,1.18±0.15U vs 0.68±0.23U,均P<0.01),血浆D-木糖明显降低(2.28±0.23mmol/L,2.31±0.14 mmol/L,2.33±0.10mmol/L vs 3.68±1.05 mmol/L,均P<0.01).肠I/R+EN组上述变化最重,肠道不能耐受发生率显著高于I/R组和EN组(87.5% vs 12.5%,0%,P<0.01).EN后1h,通腑颗粒治疗组与I/R+EN组相比,血浆ICP和DAO显著降低(ICP:17.1±1.3kPa vs 27.5±1.1kPa,P<0.01;DAO:1.19±0.24 U vs 1.94±0.27U,P<0.01).D-木糖明显升高(2.97±0.21 mmol/L vs 1.07±0.15 mmol/L,P<0.01);肠道不能耐受发生率也显著降低.结论:通腑颗粒能显著改善肠道吸收、动力和屏障功能指标,提高犬I/R时小肠对早期肠内营养的耐受能力.

AIM： To investigate the effect of Tongfu particles （TF） on gut function during the administration of enteral nutrition （EN） following intestinal ischemia and reperfusion （I/R）. METHODS： Thirty-two male dogs were randomly and averagely divided into group A, B, C and D, received single EN, single I/R, I/R plus EN, and I/R plus EN plus TF, respectively. The intestinal I/R were achieved by clipping superior mesenteric artery （SMA） for 1 hours. EN was performed 4 hours after reperfusion. Gut intolerance was assessed by monitoring the symptoms of diarrhea and vomiting. Intestinal cavity pressure （ICP）, plasma D-xylose absorption and diamine oxidase （DAO） activities were measured to determine intestinal function. RESULTS： The value of ICP and the activities of DAO were significantly increased （ICP： 17.5 ± 1.1 kPa, 17.6 ± 1.3 kPa, 17.3 ± 1.5 kPa vs 12.3 ± 0.9 kPa, all P 〈 0.01; DAO： 1.19 ± 0.15 U, 1.14 ± 0.13 U, 1.18 ± 0.15 U vs 0.68 ± 0.23 U, all P 〈 0.01）, but the plasma D-xylose absorption was decreased （2.28 ± 0.23 retool/L, 2.31 ± 0.14 mmol/L, 2.33 ± 0.10 mmol/L vs 3.68 ± 1.05 mmol/L, all P 〈 0.01） in group B, C and D as compared with those in group A. The most significant changes were found in group C, with a higher intolerance than that group B and A （87.5% vs 12.5%, 0%, both P 〈 0.01）. Tongfu particles caused significant decreases of plasma ICP and DAO （ICP： 17.1 ± 1.3 kPa vs 27.5 ± 1.1 kPa, P 〈 0.01; DAO： 1.19 ± 0.24 U vs 1.94 ± 0.27 U, P 〈 0.01） and increases of D-xylose absorption （2.97 ± 0.21 mmol/L vs 1.07 ± 0.15 mmol/L, P 〈 0.01） I hour after EN, and the gut tolerance to EN was also down-regulated. CONCLUSION： Tongfu particles have obvious improvement effect on gut tolerance to EN by attenuating gut dysfunction in dogs with I/R injury.