TNF在犬急性胰腺炎早期肺损伤中的作用及通里攻下法的影响

Role of Tumor Necrotizing Factor in Lung Injury of Early-Stage Acute Pancreatitis and Effect of“Tong Xia”Therapeutic Method

本实验旨在研究肿瘤坏死因子（ＴＮＦ）在急性坏死性胰腺炎早期变化规律及与肺损伤的关系，研究观察中药通里攻下法治疗能否阻抑ＴＮＦ的分泌及损伤效应。实验将１４只家犬随机分成三组。承气汤组（ｎ＝５）：ＡＮＰ模型＋大承气汤治疗；盐水组（ｎ＝５）：ＡＮＰ模型＋生理盐水治疗；假手术组（ｎ＝４）。术后测定血清及支气管肺泡灌洗液（ＢＡＬＦ）ＴＮＦ活性和肺损伤情况。结果显示：１ＡＮＰ时外周血及ＢＡＬＦ中ＴＮＦ活性升高，以后者升高更突出。２承气汤组术后６、１２小时血清及ＢＡＬＦ中ＴＮＦ活性低于盐水组（ｐ＜０．０１）。３承气汤组肺损伤程度轻于盐水组。结果表明，ＴＮＦ的过度分泌参与ＡＮＰ病理生理及肺损伤的发生。中药通里攻下法能够减轻ＴＮＦ介导的肺损伤程度。

This study is aimed at investigating the changes of tumor necrotizing factor (TNF)in the early stage of acute pancreatitis(AP)and its correlation to lung injury of AP,and evaluating the therapeutic effect of “Tong Xia”method in prohibiting or minimizing the severity of lung injury of AP.14 canines were randomly divided into 3 groups.The treatment group(n=5):experimental AP model treated with “Da Chen Qi”mixture;the saline control group(n=5):experimental AP model treated with normal saline;and the sham operative group(n=4).TNF activities in serum and in bronchi-alveolar larage fluid (BALF)were measured and degrees of lung injury were assessed.Results showed:(1).The activities of TNF were elevated in peripheral blood and BALF,especially prominent in the later.(2).The elevation of serum TNF activities at 6 and 12 hours and of BALF TNF activities at 12 hours in the treatment group were significantly lower than in the control (p<0.01).(3).The degrees of lung injury in the treatment group were significantly milder than in the control.The study shows that the Hypersecretion of TNF plays a role in the pathogenesis of lung injury in AP and “Tong Xia”therapeutic method is demonstrated to alleviate the degree of TNFmediated lung injury in AP.