DAR疗法对重症急性胰腺炎大鼠血浆内毒素和TNF-α、IL-6水平的影响

Effect of DAR therapy on the levels of plasma endotoxin,TNF-α and IL-6 in severe acute pancreatitis model rats

目的探讨DAR疗法治疗重症急性胰腺炎(SAP)的机制。方法实验动物为160只SD大鼠。用5%牛黄胆酸钠逆行胰胆管注射法制备SAP模型,造模后随机分为6 h和12 h DAR组、对照组、单药给药组[D(地塞米松)组、A(山莨菪碱)组、R(生大黄)组]和联合给药组[DA(地塞米松+山莨菪碱)组、DR(地塞米松+生大黄)组、AR(山莨菪碱+生大黄)组],每组均10只。DAR组地塞米松(2 mg/kg)腹腔内注射,山莨菪碱(2 mg/kg)腹腔内注射,6 h后重复给药,生大黄粉混悬液(200mg/kg)灌胃。对照组用等量生理盐水替代地塞米松、山莨菪碱和大黄,用法同DAR组。单药给药组和联合给药组按DAR组相应药物的剂量和方法单独或联合给药。结果 DAR组较单药给药组和联合给药组可显著降低血浆内毒素水平;DAR组较单药给药组可显著降低血浆TNF-α和IL-6含量,并显著低于部分联合给药组中TNF-α和IL-6含量。结论 DAR疗法可能通过地塞米松、山莨菪碱和大黄三者分别作用于SAP病理生理进程的不同环节,功能上相互补充、加强,发挥对SAP的治疗作用。

Objective To investigate the mechanism of DAR（dexamethasone,anisodamine and rhubarb） therapy for severe acute pancreatitis（SAP）.Methods A total of 160 SD rats were randomly assigned into DAR group,control group,three single drug groups and three combination groups（DA group,DR group and AR group）.Each group had 20 SD rats.The 5% taurocholate was employed to develop the SAP model.In DAR group,dexamethasone（2 mg/kg） and anisodamine（2 mg/kg） were injected into peritoneal cavity,and rhubarb（200 mg/kg） was gavaged.The administration was repeated 6 h later.In control group,equal amount of normal saline was used in the same way as the above.In single drug groups and combination groups,the same drug was administered just as the same way in DAR group.At 6 h and 12 h,ten animals in each group were sacrificed,respectively,then abdominal aorta arterial blood samples were harvested for determining endotoxin,tumor necrosis factor-α（TNF-α） and interleukin-6（IL-6）.Results The contents of endotoxin in DAR group were significantly lower than those in the other groups.In DAR group,levels of TNF-α and IL-6 were decreased compared with three single drug groups,control group and combination groups.Conclusion DAR therapy exert its therapeutic effects on SAP probably through the synergetic effect of dexamethasone,anisodamine and rhubarb on some critical factors and key steps in the pathophysiologic process of SAP.