清下解胰方及其拆方对重症急性胰腺炎大鼠血清淀粉酶的影响

Effects of Qingxia Jieyi Decoction and Its Disassembled Prescriptions on Serum Levels of Amylase in Rats with Severe Acute Pancreatitis

目的观察清下解胰方及其拆方对重症急性胰腺炎(severe acute pancreatitis,SAP)大鼠血清淀粉酶的影响。方法采用逆胆胰管注射牛黄胆酸钠的方法复制SAP大鼠模型。将大鼠随机分为假手术组、模型组、清下解胰汤全方组及其拆方组(包括通腑清热、活血化瘀、疏肝理气)。各中药干预组均于模型复制苏醒后即刻,模型复制后5、11 h分别经胃管注入中药,假手术组和模型组均于相同时间点经胃管注入等量生理盐水,观察清下解胰方及其拆方对大鼠胰腺组织病理形态学和血清淀粉酶的影响。结果①各治疗组(包括清下解胰汤全方组和各拆方组)和模型组大鼠胰腺组织均出现胰腺炎表现,病理学检查发现在胰腺水肿、炎性浸润、脂肪坏死、实质坏死等方面与假手术组比较,差异均有统计学意义(P<0.01);清下解胰汤全方组和活血化瘀组上述指标评分显著低于模型组(P<0.05,或P<0.01),通腑清热组胰腺水肿、脂肪坏死、实质坏死评分显著低于模型组(P<0.05,或P<0.01)。②模型组和各治疗组血清淀粉酶均显著高于假手术组(P<0.01),各治疗组血清淀粉酶与模型组比较,差异均无统计学意义(P>0.05)。结论清下解胰方及其拆方可能是通过其他途径而不是通过降低淀粉酶来减轻SAP大鼠的病理损害程度。

Objective To observe the effects of Qingxia Jieyi Decoction,a traditional Chinese prescription for clearing heat,purgation,activating blood circulation,and soothing the liver qi,and its disassembled prescriptions on the serum levels of amylase in rats with severe acute pancreatitis（SAP）.Methods The rat model of SAP was induced by retrograde injection of sodium taurocholate into the biliopancreatic duct.The rats were randomized into six groups,i.e.,sham operation group,model group,and Qingxia Jieyi Decoction and its disassembled prescriptions（including heat-clearing and purgation,promoting blood circulation and removing blood stasis,and soothing the liver-qi） treated groups.Qingxia Jieyi Decoction and its three disassembled prescriptions were administered to rats immediately after the SAP model was induced successfully,and 5 and 11 hours later,respectively;while the rats in the model group and the sham operation group were given the same volume of saline at the same intervals.The effects of Qingxia Jieyi Decoction and its disassembled prescriptions on the pathological changes of pancreas tissues and the serum levels of amylase were observed.Results（1）The pancreas tissues appeared inflammation in the treatment groups and model group.The pathological examination showed that there was significant differences in the degrees of pancreatic edema,inflammatory infiltration,adiponecrosis,and parenchyma necrosis between each treatment group and sham operation group,and between model group and sham operation group（P〈0.01）.The scores of above-mentioned indexes in Qingxia Jieyi Decoction treated group,and the group treated with therapy of promoting blood circulation andremoving blood stasis were significantly lower than those in the model group.The scores of pancreatic edema,adiponecrosis,and parenchyma necrosis in heat-clearing and purgation group were significantly lower than those in the model group.（2）The levels of amylase in each treatment group and model group were significantly higher than those in sham operation group（P〈0.01）.There was no significant difference in the levels of amylase between each treatment group and the model group（P〉0.05）.Conclusion Qingxia Jieyi Decoction and its disassembled prescription can alleviate the pathological changes by other pathways,not by decreasing the levels of amylase.