ARDS“肺肠同病”的病理特征与通腑泻肺中药作用机制的实验研究

Experimental Study on the Pathological Features of ARDS“Lung and Large Intestine Concurrent Disease” and the Mechanism of Tongfu Xiefei Herbs

目的:在"肺与大肠相表里"理论指导下,观察ARDS"肺肠同病"的病理特征及通腑泻肺中药的作用机制,为"肺肠同病"的临床治疗提供实验依据。方法:健康wistar大鼠30只,随机分为3组,正常组、模型组和治疗组,采用尾静脉注射油酸加内毒素方法造成ARDS模型,治疗组给予通腑泻肺中药,于实验第7天检测分析各组大鼠肺功能、肺脏局部及全身炎症因子、肠黏膜屏障功能及肺肠组织黏膜免疫等指标。结果:1)与正常组比较,模型组大鼠肺顺应性显著降低、吸气和呼气阻力显著升高(P<0.01),治疗后肺顺应性、吸气阻力有所改善。2)模型组大鼠血浆D-乳酸、DAO含量较正常组明显升高(P<0.01)。治疗后二者含量显著降低(P<0.01)。3)模型组大鼠血清及BALF中TNF-α、IL-1β、IL-6、IL-10含量较正常组均明显升高(P<0.01)。治疗后血清TNF-α、IL-1β含量明显降低(P<0.01),BALF中TNF-α、IL-1β和IL-6含量明显降低(P<0.01)。4)模型组大鼠肺与肠组织SIgA含量较正常组明显升高(P<0.01),治疗后显著降低(P<0.05)。结论:1)肺通气功能障碍、肠黏膜屏障功能受损、全身及肺脏局部炎症反应水平明显升高、肺肠组织黏膜免疫的同步反应是ARDS"肺肠同病"的主要病理特征;2)通腑泻肺中药具有肯定的疗效,其作用机制在于改善肺通气和肠黏膜屏障功能、调节炎性因子表达及肺肠黏膜免疫应答。

Objective：According to the interior-exteriorly related theory of lung and the large intestine , to observe the pathological fea-tures of ARDS lung and large intestine concurrent disease , and investigate the mechanism of Tongfu Xiefei herbs in ARDS rats , then pro-vide experimental basis for clinical treatment .Methods：Thirty healthy Wistar rats were randomly divided into 3 groups, control group, model group , and treatment group .The ARDS rats were established by intravenous injecting oleic acid plus endotoxin in caudal vein , and rats in treatment group were treated with Tongfu Xiefei herbs .The lung function , inflammatory cytokines in the lung and serum , in-testinal barrier function and the indicators of lung and intestinal mucosal immunity in each group were observed after 7 days.Results：1） Compared with control group , the lung compliance of model group was obviously decreased;the aspiratory and expiratory resistance were obviously increased（P＆lt;0.01）.The lung function of treatment group improved .2）The D-Lactate, DAO of model group were significant-ly increased than those of control group （P＆lt;0.01）.Both of them decreased significantly after treatment （P＆lt;0.01）.3）The TNF-α,IL-1β,IL-6,IL-10 in BALF and serum of model group were obviously increased than those of control group （P＆lt;0.01）.After treatment, TNF-α, IL-1βin serum were significantly decreased （ P ＆lt;0.01 ） .TNF-α, IL-1βand IL-6 in BALF were significantly decreased （ P ＆lt;0.01）.4）The SIgA expression in lung and large intestine of model group were obviously increased than those of control group （P＆lt;0.01）,and it significantly decreased after treatment （P＆lt;0.05）.Conclusion：1）The pathological features of ARDS is lung and large in-testine concurrent disease, which mainly include ventilation dysfunction, intestine barrier functional disturbance, the body’s and lung’ s inflammation levels significant increase and the synchronous response in lung and intestinal mucosal immune .2 ） Tongfu Xiefei herbs shows positive curative effect , for they could improve the pulmonary ventilation and intestinal barrier function , regulate inflammatory cy-tokines expression and lung and intestinal mucosal immune response .