健胃冲剂治疗大鼠反流性食管炎的机制研究

Mechanism of Action of Jianwei Granules in Treatment of Reflux Esophagitis in Rats

目的探究健胃冲剂治疗大鼠反流性食管炎的机制。方法复制反流性食管炎大鼠模型,将术后恢复较好的大鼠随机分为模型组,阳性对照组(雷贝拉唑钠肠溶片),健胃冲剂高、中、低剂量组,另设正常对照组,每组10只大鼠。各组末次给药24h后,立即自胃食管交界上0.5cm处向咽喉部截取长约1.5cm的食管组织,测定其pH值,并观察各组大鼠食管黏膜病理形态变化。结果与正常组比较,模型组大鼠食管下段黏膜pH值显著降低(P<0.01),食管下段大体标本肉眼病理评分显著升高(P<0.01),显微镜下病理评分(反向评分)显著降低(P<0.01)。与模型组比较,阳性对照组,健胃冲剂高、中、低剂量组pH值显著升高(P<0.05),大体标本肉眼病理评分显著降低(P<0.01),显微镜下病理评分显著升高(P<0.05,或P<0.01)。健胃冲剂高剂量组在升高pH值和食管黏膜显微镜下病理评分方面优于阳性对照组(P<0.05)。光镜下正常组大鼠食管黏膜组织结构正常;模型组大鼠黏膜上皮细胞层内出现较多炎性细胞浸润,鳞状上皮增生,严重者出现黏膜糜烂;健胃冲剂高、中、低剂量组较模型组均明显改善;雷贝拉唑组改变与健胃冲剂低剂量组基本相同。结论健胃冲剂能改善反流性食管炎大鼠的组织病理形态,其作用机制与降低模型大鼠食管下段黏膜的酸度有关。

Objective To investigate the mechanism of the action of Jianwei Granules in the treatment of reflux esophagitis in rats. Methods A rat model of reflux esophagitis was induced. The rats with good recovery after operation were randomly divided into model group （n= 10） , positive control group （n 10） , which was treated with enteric-coated tablets of rabeprazole sodium, and high-dose, middle-dose, and low dose Jianwei Granule treatment groups （n 10 for each group）. In addition, 10 normal rats were assigned to normal group （n=10）. A piece of esophageal tissue （about 1.5 cm in length）, which extended from the point 0.5 cm above gastroesophageal junction toward the throat, was collected from each rat at 24 h after last administration. The esophageal tissue was subjected to pH measurement and pathological observation of mucosa. Results Compared with the normal group, the model group showed significantly decreased mucosa pH value （P^0. 01）, significantly increased scores on macroscopic pathological changes （P〈 0.01）, and significantly decreased scores （reverse score） on microscopic pathological changes （P〈0.01）. Compared with the model group, the positive control group and high dose, middle-dose, and low-dose Jianwei Granule treatment groups showed significantly increased mucosa pH value （P〈0.05）, significantly decreased scores on macroscopic pathological changes （P〈0.01）, and significantly increased scores on microscopic pathological changes （P〈0.05 or P〈0.01）. The high-dose Jianwei Granule treatment group had significantly higher mucosa pH value and scores on microscopic pathological changes than the positive control group （P〈0.05）. Under the light microscope, the esophageal mucosae in normal group demonstrated normal tissue structure, while those in model group demonstrated severe inflammatory cell infiltra tion in epithelial layer, squamous hyperplasia, and even erosion. But significant improvement in pathologi- cal changes was seen in the high-dose, middle-dose, and low-dose Jianwei Granule treatment groups, and the positive control group showed approximately the same improvement as the low-dose Jianwei Granule treatment group. Conclusion Jianwei Granules can improve the pathological morphology in rats with reflux esophagitis, which is associated with decreasing the acidity of lower esophageal mucosa.