中药合剂AA-3保护实验性急性胰腺炎大鼠肠粘膜屏障的研究

Study on protecting intestinal mucosa barrier of AA3 mixture in experimental pancreatitis in rats

目的：观察中药合剂ＡＡ３在治疗重症胰腺炎（ＳＡＰ）肠粘膜屏障缺血性损害及对抗肠源性感染导致的二次打击中的机制。方法：ＳＤ大鼠随机分假手术组（ＳＯ）、ＳＡＰ组和ＡＡ３组。改良式激活剂胰被膜均匀浸润法制模；中药ＡＡ３以生大黄、丹参、生山栀为主。用ＦＩＴＣ标记大肠杆菌ＡＴＣＣ；检出肠系膜淋巴结、胰腺、肾脏、脾脏、肝脏标记菌；观察空肠细胞超微结构；进行回肠组织病理学检查。结果：各组间各被检脏器标记菌检出经统计学比较差异显著（ＳＡＰ组比ＳＯ组，Ｐ＜０．００１；ＳＡＰ组比ＡＡ３组，Ｐ＜０．０５）。ＳＡＰ组空肠上皮亚细胞结构损害，ＡＡ３组亚细胞结构基本完整、损害减轻。ＳＡＰ组回肠粘膜严重破坏，ＡＡ３组病理损害程度较ＳＡＰ组明显减轻。结论：“通里攻下、活血化瘀和清热解毒”治则治疗ＳＡＰ和降低死亡率的机制部分是通过保护肠粘膜屏障功能和减轻小肠缺血性损伤来实现的。

Objective:To investigate the protecting effect of AA3 mixture on the intestinal mucosa barrier of experimental pancreatitis in severely acute pancreatitis(SAP)rats.Methods:SD rats were randomly divided into three groups Sham operation(SO),SAP,AA3 .The model of severely acute pancreatitis was induced by infiltrative infusion of 5% sodium taurocholate into the pancreatic sheath.E.coli ATCC25922 was labeled by FITC.The parameter included the detection of label bacteria in mesenteric lymph node(MLN),pancreas,kidney,liver and spleen,and the observation of jejunal cell substrcture and the examination of ilum histopathology.Results:It was showed that there were significantly statistical difference in the label bacteria tested in each organ among different groups (SAP vs.SO, P <0 001;SAP vs.AA3, P <0 05),the substructure of jejunal cell was injured and the ileum mucosa was destroyed in the SAP group.The degree of the injury and destroy abovementioned were decreased in the AA3 group.Conclusions:It was suggested that the mechanisms of principle of “Tongli Gongxia,Huoxue Huayu,Qingre Jiedu”(通里攻下,活血化瘀,清热解毒) to treat SAP and reduce mortality be related to the protection of intestinal mucosa barrier and the reduction of intestine ischemia injury,indicating that the management of integrated traditional Chinese and western medicine can block the process of SAP to become more severe.