温阳败毒饮对脓毒症大鼠心肌肌钙蛋白Ⅰ及肺表面活性蛋白A水平的影响

Effect of Wenyang Baidu Yin on myocardiac troponin I and pulmonary surfactant protein A levels in sepsis rats

目的 观察温阳败毒饮对脓毒症大鼠血清心肌肌钙蛋白I（cTnI）和支气管肺泡灌洗液（BALF）中肺表面活性蛋白A（SP-A）水平的影响.方法 选择120只健康SD大鼠,按随机数字表法分为正常组、模型组、西药治疗组、中药治疗组、联合用药组,每组24只.采用腹腔注射大肠杆菌内毒素的方法制备脓毒症大鼠模型.正常组、模型组术后给予生理盐水灌胃;西药治疗组给予地塞米松2.5 mg/kg灌胃;中药治疗组给予温阳败毒饮（金银花30 g、蒲公英30 g、附子30 g,水煎液浓缩制成膏备用,使用时用温水溶化）8 g/kg灌胃;联合用药组给予温阳败毒饮联合地塞米松灌胃,用药方法同前.观察制模后24、48、72 h各组大鼠血清cTnI及BALF中SP-A水平的变化.结果 模型组制模后24、48、72 h cTnI水平均较正常组明显增加（μg/L：24 h为6.95±3.52比0.83±0.32,48 h为7.42±5.01比0.64±0.21,72 h为10.52±4.15比0.91±0.36,均P〈0.05）,SP-A均较正常组明显降低（μg/L：24 h为4.36±2.71比72.83±7.35,48 h为3.15±0.53比81.45±5.01,72 h为0.47±0.21比78.52±4.47,均P〈0.05）.西药治疗组、中药治疗组、联合用药组用药后cTnI均较模型组明显减少,SP-A较模型组明显增加;联合用药组制模后48 h开始与西药治疗组、中药治疗组比较出现统计学差异,持续到72 h〔cTnI（μg/L）：48 h为3.68±0.52比4.23±0.53、5.15±1.18,72 h为1.38±0.02比2.51±0.24、1.95±0.32,SP-A（μg/L）：48 h为58.19±3.46比49.61±5.22、47.05±3.97,72 h为67.83±6.14比60.48±2.71、55.17±3.26,均P〈0.05〕.结论 温阳败毒饮可有效降低大肠杆菌内毒素诱导的脓毒症大鼠血清cTnI及BALF中SP-A水平.

Objective - To observe the effect of Wenyang Baidu Yin on serum myocardiac troponin I （cTnI） level and pulmonary surfactant protein A （SP-A） mRNA expression level in bronchoalveolar lavage fluid （BALF） in rats with sepsis. Methods One hundred and twenty healthy male Sprague-Dawley （SD） rats were randomly divided into normal group, model group, western medicine group, traditional Chinese medicine （TCM） group and combined drug group, with 24 rats in each group. The sepsis rat model was made by intra-peritoneal injection of E.coli endotoxin. After operation, the normal group and model group were given normal saline, and the western medicine group was given dexamethasone 2.5 mg/kg by intragastric adminstration; the TCM group was given Wenyang Baidu Yin （the ingredients consisted of lonicera japonica 30 g, dandelion 30 g, aconite 30 g, mixed with water and boiled to form decoction and then concentrated to prepare an ointment for reserve, whenever it was applied, using warm water to dilute it to form decoction） 8 g/kg taken by gastric lavage; the combined drug group was given the same methods as above mentioned Wenyang Baidu Yin and dexamethasone by gastric lavage. The level changes of serum cTnI and SP-A in BALF were observed at different time points 24, 48 and 72 hours after modeling. Results The levels of cTnI at 24, 48 and 72 hours after modeling in model group were significantly higher than those in normal group （μg/L： 24 hours was 6.95 ± 3.52 vs. 0.83±0.32, 48 hours was 7.42 ± 5.01 vs. 0.64 ± 0.21, 72 hours was 10.52± 4.15 vs. 0.91 ±0.36, all P 〈 0.05）, and SP-A mRNA was significantly lower than those in normal group （μg/L： 24 hours was 4.36 ±2.71 vs. 72.83 ± 7.35, 48 hours was 3.15 ± 0.53 vs. 81.45 ± 5.01, 72 hours was 0.47 ± 0.21 vs. 78.52 ± 4.47, all P 〈 0.05）, with the extension of time after modeling, the tendency of increase of cTnI and the decrease of SP-A were more obvious. The levels of cTnI of the western medicine group, TCM group and the combined drug group were significantly lower than those of the model group, and the SP-A was obviously higher than that of the model group; since 48 hours after modeling, there were statistical significant differences in levels of cTnI and SP-A between the combined group and the western medicine group, also between the combined drug group and TCM group [cTnI（μg/L）： 48 hours was 3.68 ±0.52 vs. 4.23 ±0.53, 5.15 ± 1.18, 72 hours was 1.38 ± 0.02 vs. 2.51 ± 0.24, 1.95 ± 0.32, SP-A（μg/L）： 48 hours was 58.19 ± 3.46 vs. 49.61 ±5.22, 47.05 ± 3.97, 72 hours was 67.83±6.14 vs. 60.48±2.71, 55.17±3.26, all P 〈 0.05]. Conclusion Wenyang Baidu Yin can effectively reduce the levels of serum cTnI and SP-A in BALF of sepsis rats induced by E.coli endotoxin.