大承气汤对急性胰腺炎致急性肺损伤-腹内高压的作用

The Influnence of Dachengqi Tang on Acute Lung Injury and Intra Abdominal Hypertension in Rats with Acute Pancreatits

目的通过研究大承气汤(Dachengqi tang,DCQT)在实验性急性胰腺炎治疗腹内高压以缓解急性肺损伤的机理,初步阐释"肺与大肠"相表里的现代科学研究依据及科学内涵。方法将30只SD雄性大鼠随机分成:假手术模型组(sham operation,SO组),坏死性胰腺炎组(acute necrosis pancreatitis,ANP组)和大承气汤组(DCQT组),每组10只。术前检测大鼠腹内压,麻醉大鼠后胆胰管内逆行泵入5%牛磺胆酸钠溶液制备急性坏死性胰腺炎模型。术后2 h前二组灌喂生理盐水,DCQT组灌喂大承气汤1次;造模后24 h采集动脉血、胰腺组织,肺组织,计算肠推进率;取胰腺、肺组织做病理切片并分别按病理学评分标准进行评分,计算干湿重比,ELISA法检测髓过氧化物酶(MPO)。结果 DCQT组治疗后腹内压力、胰腺及肺组织病理评分、胰腺与肺组织MPO、胰腺与肺组织含水量均较ANP组降低(P<0.05)。DCQT组肠推进率、氧分压高于ANP组(P<0.05)。DCQT组存活率高于ANP组,但差异无统计学意义(P>0.05)。结论大承气汤能通过降低腹内压以减轻重症急性胰腺炎肺损伤程度。

Objective To test the hypothesis ＂lung and large intestine are interior exteriorly related＂ through investgating into the effect of Dacheng qi tang（DCQT） on intra abdominal hypertension（IAH） and acute lung injury（ALI） in rats with acute pancreatitis.Methods Male SD rats were randomly divided into three groups with ten rats for each group： rats with sham-operations（SO）;rats with acute necrosis pancreatitis（ANP）;rats with ANP plus DCQT treatment.ANP was induced by retrograde infusion of 5% taurocholic acid into pancreatic duct.Two hours after operations,10 mL/kg of normal saline was orally adminstered to the rats in both SO and ANP groups,whereas 10 mL/kg DCQT was adminstered to the rats in the treatment group.Aterial blood,pancreas and lung tissues were collected for biomarkers and histopathology 24 hours after operations.Intra-abdominal pressure and intestinal propulsion rate were also measured.Results DCQT treatment reduced intra-abdominal pressure and improved intestinal propulsion rate compared with those treated with saline（P0.05）.The ANP rats treated with DCQT had lower wet to dry weight ratio,and milder myeloperoxidase activity and histopathology changes in pancreas and lung than those treated with saline（P0.05）. Higher pressure of oxygen（PO2） was found in the rats treated with DCQT,while no difference in PCO2 was found between the DCQT and ANP groups（P0.05）.Only two rats in the ANP group died.Conclusion DCQT can effectively relieve IAH and cure ALI at the same time in rats with acute pancreatitis.The result provides evidence to support the hypothesis ＂lung and large intestine are interior exteriorly related＂.