胃黏膜保护剂及抑酸剂对乙醇性胃黏膜损伤的预防研究

Experimental studies on role of gastric mucosal protective drugs and acid inhibitors in prevention of gastric mucosal lesions induced by alcohol in rats

目的探讨胃黏膜保护剂——铝碳酸镁、瑞巴派特、H2受体拮抗剂,单种及联合用药对乙醇所致急性胃黏膜损伤的保护作用。方法将70只大鼠随机分为7组:正常对照组,损伤对照组,铝碳酸镁组,瑞巴派特组,法莫替丁组,铝碳酸镁+法莫替丁组,瑞巴派特+法莫替丁组,每组10只。预先给予以上药物,采用白酒诱发大鼠胃黏膜急性损伤的方法造模。比较各组损伤指数(UI)并观察胃黏膜的病理学改变。结果(1)损伤对照组大鼠胃黏膜损伤最严重,UI明显高于其他6组,差异具有统计学意义(P<0.05);后5组的UI均低于损伤对照组,但高于正常对照组,差异有统计学意义(P<0.05);后5组中,铝碳酸镁组,瑞巴派特组,法莫替丁组UI均高于铝碳酸镁+法莫替丁联合用药组,瑞巴派特+法莫替丁联合用药组,组间差异具有统计学意义(P<0.05)。(2)胃黏膜HE染色镜下观,损伤对照组绝大部分为Ⅲ～Ⅳ级损伤。铝碳酸镁组,瑞巴派特组,法莫替丁组绝大部分为Ⅰ～Ⅱ级的损伤,与损伤对照组相比有统计学意义(P<0.05)。联合用药组绝大部分损伤仅为Ⅰ级,无Ⅲ级以上的损伤,与损伤对照组及单种用药组相比有统计学意义(P<0.05)。结论铝碳酸镁、瑞巴派特、法莫替丁单种用药均能预防乙醇导致的急性胃黏膜损伤;胃黏膜保护剂与抑酸剂联合用药的预防作用优于单种用药。

Objective This study was designed to determine the protective effect of gastric mucosal protective drugs （hydro-talcite or rebamipide）, acid inhibitors（famotidine）, single and co-administration on gastric mucosal lesions induced by alcohol administration in rats. Methods 70 SD rats were employed in the study and divided into 7 groups： normal control group,injury model group, hydrotalcid group, rebamipide group, famotidine group, hydrotalcid ＋ famotidine co-treatment group,rebamipide ＋ famotidine co-treatment group. After model of the acute gastric injury in rats induced by alcohol was set up. The index of gastric mucosal injury was evaluated macroscopically. Gastric mucosa structural change were observed under the microscope. Results The pathological change of gastric mucosa which exposed to alcohol were significant. Erosion, bleeding and necrosis of gastric mucosa were observed. The rats in injury model group were found with the most severe gastric mucosal injury, then in the single treatment group a less mucosal injury, in co-treatment group the least mucosal injury ,the mildest gastric mucosal injury was not found in normal control group, there had statistical significance between each group （P〈0.05）. Pathologic change with HE dyeing： no histological damage was observed in the gastric mucosa of normal group, exfoliation and necrosis of superficial cells, structural alterations on the glandular pits, and bleeding erosions developed in all experimental stomachs. The architecture of the crypts was distorted, and the infiltration consisting of polymorphonuclear leukocytes and lymphocytes was observed. Pretreatment with gastric mucosal protective drugs or （and） acid inhibitors reduced exfoliation of superficial cells and lessened the haemorrhage in different degree. It was also well observed that the cooperation between gastric mucosal protective drugs and acid inhibitors protected gastric mucosal. Conclusions Gastric mucosal protective drugs and acid inhibitors play an important protective role in the gastric mucosa in rats. Co-treatment with gastric mucosal protective drugs and acid inhibitors seem to contribute significantly to the gastric protection in this experimental model.