中药清胰汤及双歧杆菌合剂对急性坏死性胰腺炎肠道细菌移位影响的比较研究

An Experimental Study of the Influence of Chinese Medicine "Qing Yi Tang" and Bifidobacterium Mixture on Intestinal Bacterial Translocation Following Acute Necrotizing Pancreatitis

目的 观察中药清胰汤(CM)及双歧杆菌合剂(BM)对犬急性坏死性胰腺炎(ANP)肠道细菌移位(BT)的影响。方法 杂种犬31只,分对照组(n=7)、ANP组(n=8)、中药治疗组(CM,n=8)和双歧杆菌合剂治疗组(BM,n=8)。结照组犬仅行剖腹术;经主胰管注入5％牛磺胆酸钠(0.5ml/kg)和胰蛋白酶(3000U/kg)复制ANP模型,CM组和BM组犬术后每天分别经胃管灌服中药清胰汤及双歧杆菌合剂。结果 与ANP组比较,CM及BM组肠粘膜损害明显减轻;肠粘膜菌群中大肠杆菌、类杆菌数量减少,双歧杆菌、乳杆菌数量显著增加(P<0.05),肠道微生态趋于平衡;CM组脏器细菌移位率减少SO％,BM组减少37.5％,两组移位细菌数量减少10～40倍:两组血培养阳性率均由100％降为37.5％;两组血中内毒素水平下降1～2倍,淀粉酶水平下降2～3倍,磷脂酶A_2活性亦显著下降,并均于第7天后接近正常;肠通透性下降。结论 中药清胰汤及双歧杆菌合剂具有减轻ANP后肠粘膜损害,调节肠道菌群微生态平衡、保护肠屏障功能。

Objetive To examine the effect of Chinese mecdicine "Qing Yi Tang" and bifidobacterium mixture on intestinal bacterial translocation (BT) in acute necrotizing pancreatitis (ANP). Methods The dogs were randomly divided into four groups: Control group ( n = 7), Dogs of control group received laparotomy only; ANP group ( n = 8) , ANP model was induced by injection of 0. 5ml/kg 5% sodium taurocholate with 3000U/kg trypsin into the pancreatic duct; Chinese medicine group (CM, n =8) and bifidobacterium mixture group (BM, n =8), In CM and BM groups, dogs were fed every day with "Qing Yi Tang" and bifidobacterium mixture (containing bifidobacteria 109cfu/g, lacto-bacilli 108cfu/g and enterococci 108cfu/g), respectively. Results It showed that in CM and BM groups, histologic and uhrastructural damages in pancreas and ileal mucosa were much milder than those of ANP group. IN ANP group, there was a significant increase of E. coli and bacteroids and a significant decrease of bifidobacteria, lactobacilli and enterococci in the intestinal mucosa and cecal content, while in CM and BM groups, these changes were alleviated sigificantly ( P &lt; 0.05).As compared wi th those of ANP group, the BT rate was reduced by 50 % in CM group and 37.5 % in BM group, and the counts of translocated bacteria were decreased 10-40 times as well. Intestinal permeability and the levels of LPS, AMY and PLA2 were decreased 2 - 3 times significantly in CM and BM groups ( P &lt; 0.05). Conclution The results indicated that both Chinese medicinal formula "Qing Yi Tang" and bifidobacterium mixture showed their protective effects on gut barrier function by alleviating the damage of intestinal mucosa and microecologic disturbance following acute pancreatitis. As a result, the chances of BT and enterogenic infection declined. These two preparations might be promising in the prophylaxis and treatment of infection complicating ANP.