凉膈散对脓毒症大鼠炎症介质的表达及肝肾功能的影响

Effect of Liangge powder on expression of inflammatory mediators and hepatic and renal function in rats with sepsis

目的观察凉膈散对脓毒症大鼠血清炎症介质的表达和肝肾脏器功能的影响，并进行初步分析。方法将195只Wistar大鼠按随机数字表法分为假手术组（15只），模型组（90只）和治疗组（90只），模型组和治疗组根据造模术后时间点24、48和72 h分成3个亚组，每组30只。通过盲肠结扎穿孔术（CLP）复制脓毒症大鼠模型，采用固相夹心酶联免疫吸附试验（ELISA）检测CLP术后24、48和72 h脓毒症大鼠白细胞介素-10（IL-10）、IL-1、IL-4和脂多糖（LPS）的表达；应用全自动生化分析仪检测丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、尿素（BUN）和肌酐（Cr）。结果与假手术组比较，模型组CLP术后24、48、72 h血清IL-1、IL-4、IL-10、LPS、BUN、Cr、AST、ALT升高，差异均有统计学意义（P〈0.05）；与模型组比较，治疗组CLP术后24、48、72 h血清IL-1下降，24、48 h血清IL-4升高，24、72 h血清IL-10升高，LPS下降,差异有统计学意义（P〈0.05）。与模型组比较，治疗组CLP术后24 h ALT下降，48 h BUN下降，Cr下降，72 h AST下降，差异均有统计学意义（P〈0.05）。结论在脓毒症早期，促炎与抗炎失衡的同时伴随着免疫功能抑制，这可能是导致脓毒症大鼠肝肾功能损伤的原因之一，中药凉膈散可调节脓毒症大鼠的炎症反应，恢复促炎与抗炎失衡和改善肝肾功能。

ObjectiveTo investigate the effect of Liangge powder on the expression of inflammatory mediators and hepatic and renal function in rats with sepsis via a preliminary analysis.MethodsA total of 195 Wistar rats were randomly divided into sham-operation group （15 rats） , model group （90 rats） , and treatment group （90 rats） using a random number table, and according to the time point after modeling, the model group and the treatment group were further divided into 24, 48, and 72 hour subgroups, with 30 rats in each subgroup. Cecal ligation and puncture （CLP） was performed to establish a rat model of sepsis, and solid-phase sandwich enzyme-linked immunosorbent assay was used to measure the expression of interleukin-10 （IL-10） , interleukin-1 （IL-1） , interleukin-4 （IL-4） , and lipopolysaccharide （LPS） at 24, 48, and 72 hours after CLP. An automatic biochemical analyzer was used to measure the levels of alanine aminotransferase （ALT） , aspartate aminotransferase （AST） , blood urea nitrogen （BUN） , and creatinine （Cr） .ResultsCompared with the sham-operation group, the model group had significant increases in the serum levels of IL-1, IL-4, IL-10, LPS, BUN, Cr, AST, and ALT at 24, 48, and 72 hours after CLP （P〈0.05） . Compared with the model group, the treatment group had a significant reduction in the serum level of IL-1 at 24, 48, and 72 hours after CLP, a significant increase in the serum level of IL-4 at 24 and 48 hours after CLP, and a significant increase in the serum level of IL-10 and a significant reduction in the serum level of LPS at 24 and 72 hours after CLP （P〈0.05） . Compared with the model group, the treatment group had a significant reduction in ALT at 24 hours after CLP, significant reductions in BUN and Cr at 48 hours after CLP, and a significant reduction in AST at 72 hours after CLP （P〈0.05） .ConclusionIn the early stage of sepsis, imbalance between pro-inflammation and anti-inflammation and immunosuppression may cause hepatic and renal impairment in rats with sepsis. The traditional Chinese medicine Liangge powder can regulate inflammatory response, restore the balance between pro-inflammation and anti-inflammation, and improve hepatic and renal function in rats with sepsis.