参麦注射液对重症急性胰腺炎大鼠多器官保护作用的实验研究

Protective effect of Shenmai injection on multiple organs of rats with severe acute pancreatitis ： an in vivo study

目的观察参麦注射液对重症急性胰腺炎（SAP）大鼠多器官的保护作用，初步探讨其相关机制。方法将30只雄性SD大鼠按随机数字表法分为对照组、SAP组和参麦组，每组10只。采用逆行胰管内注射牛磺胆酸钠1mL／kg法复制SAP大鼠模型；对照组仅开腹翻动十二指肠并触摸胰腺数次关腹。制模后30min对照组和SAP组均经尾静脉注射生理盐水5mL／kg；参麦组同时注射参麦注射液5mL／kg。观察制模后24h胰腺、肺脏、肾脏组织病理学改变，检测血清血红素加氧酶-1（HO-1）、肿瘤坏死因子-α（TNF-α）、白细胞介素-10（IL-10）含量及胰腺、肺脏和肾脏组织中HO-1、TNF-α及IL-10的基因表达水平。结果组织病理学观察显示，参麦组大鼠胰腺、肺脏、肾脏组织病理损伤较SAP组明显减轻；参麦组大鼠血清HO-1、和IL-10含量均较SAP组显著升高[HO-1（μg／L）：1．76±0．16比0．86±0．09），IL-10（ng／L）：106．43±12．15比79．17±3．68，均P〈0．05]，而TNF-α含量较SAP组显著降低（ng／L：27．54±3．72比51．24±6．34，P〈0．05）；参麦组大鼠胰腺、肺脏、肾脏组织中HO-1[胰腺（2^-△△Cr）：166．27±22．16比116．21±11．43；肺脏（2^-△△Cr）：175．29±25．54比127．45±21．38；肾脏（2^-△△Cr）：164．63±16．92比101．47±20．17]的基因表达和胰腺、肺脏组织中IL-10[胰腺（2^-△△Cr）：67．15±7．76比36．63±3．39；肺脏（2^-△△Cr：60．55±10．16比26．65±5．76]的基因表达均较SAP组显著升高（P〈0．05），而胰腺、肺脏、肾脏组织中TNF—α[胰腺（2^-△△Cr）：24．54±3．29比32．69±4．11：肺脏（2^-△△Cr）：15．22±4．01比24．29±2．91；肾脏（2^-△△Cr）：13．75±3．81比23．49±5．67]的基因表达较SAP组显著降低（均Jp〈0．05）。结论参麦注射液对SAP大鼠胰腺、肺脏、肾脏具有保护作用，并且可能通过诱导HO-1及提高IL-10和抑制TNF-α的表达从而起到调控炎症反应的作用。

Objective To investigate the protective effect of Shenmai injection on muhiple organs of rats with severe acute pancreatitis （SAP） and preliminarily explore its related mechanism. Methods A total of 30 male Sprague-Dawley （SD） rats were randomly divided into three groups： control group, SAP group and Shenmai group, 10 rats in each group. The SAP model was reproduced by retrograde injection of 1 mL/kg sodium tauroeholate through pancreatic duct. The rat in control group, only was the duodenum flipped and pancreas touched for several times, and then the abdomen incision was closed. In control group and SAP group, normal saline （NS） 5 mL/kg was injected through a tail vein at 30 minutes after model establishment; at the same time, in Shenmai group, Shenmai injection 5 mL/kg was injected via a tail vein. After SAP model establishment for 24 hours, the histopathological changes of pancreas, lung and kidney were observed; the serum heme oxygenase-1 （HO-1）, tumor necrosis factor-α （TNF-α） and interleukin-10 （IL-10） levels were detected, and the levels of HO-1, TNF-α and IL-10 gene expressions of pancreas, lung and kidney tissues were assayed. Results Compared to the SAP group, the pathological changes of pancreas, lung and kidney were significantly milder in the rats of Shenmai group. The serum HO-1 and IL-10 levels in Shenmai group were significantly higher than those in the SAP group [HO-1 （ μg/L）： 1.76 ± 0.16 vs. 0.86± 0.09, IL-10 （ng/L）： 106.43 ± 12.15 vs. 79.17 ±3.68, both P 〈 0.05], while the serum TNF- α level in Shenmai group was significantly lower than that in SAP group （ng/L： 27.54 ±3.72 vs. 51.24 ±6.34, P 〈 0.05）. Compared to the SAP group, the HO-1 gene expressions of pancreas, lung and kidney tissues in rats of Shenmai injection group [pancreas （2^-△△Cr）： 166.27 ± 22.16 vs. 116.21 ± 11.43; lung （2^-△△Cr）： 175.29±25.54 vs. 127.45 ±21.38; kidney （2^-△△Cr）： 164.63 ±16.92 vs. 101.47± 20.17] were significantly elevated （both P 〈 0.05 ）, and the IL-10 expressions of pancreas, lung [pancreas （2 ^-△△Cr）： 67.15 ± 7.76 vs. 36.63 ± 3.39; lung （2^-△△Cr）： 60.55±10.16 vs. 26.65 ± 5.76] were also obviously elevated （both P 〈 0.05）, while the levels of TNF-ctexpressions in pancreas, lung and kidney tissues were significantly decreased [pancreas （2^-△△Cr）： 24.54± 3.29 vs. 32.69 ± 4.11; lung （2^-△△Cr）： 15.22 ± 4.01 vs. 24.29 ±2.91; kidney （2^-△△Cr）： 13.75 ± 3.81 vs. 23.49± 5.67]. Conclusions Shenmai injection has a protective effect on pancreas, lung and kidney of SAP rats. The mechanism is possibly related to its inducing HO-1, elevating IL-10 and inhibiting TNF-α gene expressions to play a role in regulating the inflammatory response.