柴芍承气汤改善重症胰腺炎肠内微生态的作用

The role of Chaishao Chengqi decotion on intestinal microbiota and microbial metabolitesin severe acute pancreatitis

目的观察柴芍承气汤调节重症急性胰腺炎（SAP）肠道菌群微生态平衡及对肠黏膜损伤的作用。方法选择2010年至2011年四川省遂宁市中心医院感染管理科SAP患者46例，采用随机数字表法将患者随机分为两组。对照组给予常规治疗，治疗组加用柴芍承气汤，两组均连续治疗7d后检测患者血浆二胺氧化酶（DAO）、D-乳酸水平以及肠道菌群变化。结果治疗后7d，治疗组血浆DAO水平为（4．65±0．82）U／ml，较对照组（5．66±2．17）U／ml明显下降（P〈0．05）；乳酸为（10．65±5．24）mg／L，与同组治疗前（11．51±5．78）mg／L比较，差异无统计学意义（P〉0．05），但高于对照组的（5．42±2．13）mg／L，（P〈0．05）；治疗组肠道双歧杆菌、乳杆菌总数为（6．02±1．42）Irdg、（7．21±2．02）In／g，高于治疗前的（3．74±1．71）In／g、（4．03±1．79）In／g（P〈0．05），肠道菌群比例接近正常，对照组仍存在一定程度的菌群紊乱。结论柴芍承气汤具有减轻SAP肠黏膜损伤、调节肠道菌群微生态平衡、保护肠屏障功能的作用。

Objective To investigate the effects of Chaishao Chengqi Decotion on intestinal microbiota and intestinal mucosal lesion in severe acute pancreatitis （SAP）. Methods 46 Patients with SAP were randomized into two groups. Routine medical management was initiated in two groups. The treatment group received Chaishao Chengqi Decotion for 1 week. The plasma concentrations ofDiamine Oxidase （DAO）, D-lactate were detected and changes of microflora were evaluated by bacterial culture. Results The levels of DAO in the treatment group （4.65 ± 0.82）U/ml were significantly lower than those in the control group （5.66± 2.17） U/ml （P〈 0.05）7 days after treatment. The levels of D-lactate in the treatment group （10.65 ± 5.24）mg/L were significantly higher than those in the control group （5.42±2.13）mg/L （P〈0.05）. Bacterial culture revealed that the amount of bifidobaterium （6.02± 1.42）In/g and lactobacilli （7.21 ± 2.02） In/g were significantly increased when compared to those before treatment （3.74±l.71）In/g and （4.03±l.79）Irdg respectively, while there was imbalance of intestinal microflora to some extent in the control group. Conclusion Chaishao Chengqi Decotion exerted the protective effects on gut barrier function by alleviating the damage of intestinal mucosa and balancing the intestinal microbiota following severe acute pancreatitis.