“扶正清热通淋”方剂对产ESBLs大肠埃希菌所致复杂性尿路感染大鼠的作用研究

Effect of "Fuzheng Qingre Tonglin" prescription on rats with complicated urinary tract infection caused by ESBLs-producing Escherichia coli

目的:观察“扶正清热通淋”方剂对产ESBLs大肠杆菌所致大鼠复杂性尿路感染的作用及其可能机制。方法:建立复杂性尿路感染大鼠模型,大鼠随机分为模型组,左氧氟沙星组,扶正清热通淋低、高剂量组,左氧氟沙星+扶正清热通淋组,另设空白组,造模后2 d开始灌胃给药,连续14 d。观察大鼠一般情况,大鼠尿液做细菌培养,HE染色光镜下观察肾脏病理改变,检测血液白细胞(WBC)及中性粒百分比(NEUT%),ELISA法检测血液C反应蛋白(CRP)、CD4+、CD8+分子及尿液中分泌型免疫球蛋白A(SIgA)和N-乙酰-β-D-葡萄糖苷酶(NAG)分子的浓度。结果:模型组和左氧氟沙星组肾脏可见大量炎症细胞,余治疗组炎性细胞明显减少;除左氧氟沙星组,余各治疗组大鼠血液中NEUT%和CRP以及尿液中NAG明显低于模型组(P<0.05);与模型组相比,除左氧氟沙星外,余治疗组血清CD4分子浓度以及CD4/CD8比值明显降低,CD8分子明显升高(P<0.05)。结论:“扶正清热通淋”方能减轻复杂性尿路感染大鼠全身和局部的炎症,并且可能有使不敏感抗菌药重新对细菌敏感的作用,也可能有调节大鼠免疫功能及保护肾功能的作用。

Objective:To observe the effect of"Fuzheng Qingre Tonglin"prescription on rats with complicated urinary tract infection caused by ESBLs-producing Escherichia coli and its possible mechanism.Methods:A rat model with complicated urinary tract infection was established.Rats were randomly divided into model group,levofloxacin group,Fuzheng Qingre Tonglin groups at low and high doses,levofloxacin+Fuzheng Qingre Tonglin group,blank group.Each group was administered intragastrically 2 days after model establishment for 14 consecutive days.The general condition of the rats was observed andthe urine of the rats was cultured by bacteria.Renal pathological changes were observed by light microscopy by HE staining.In addtion,the number of white blood cell(WBC)and the percentage of neutral particles(NEUT%)were detected,andC-reactive protein(CRP),CD4+,CD8+in the blood,secretory immunoglobulin A(SIgA)and N-acetyl-β-D-glucosidase(NAG)molecules in urine were determined by ELISA.Results:There were a large number of inflammatory cells in the kidney of the model group and levofloxacin group.The inflammatory cells in the treatment group were significantly reduced.The NEUT%and CRP in the blood of each treatment group and the NAG in the urine were significantly lower than those in the model group(P<0.05),except levofloxacin group.Compared with the model group,except levofloxacin group,serum CD4 concentration and CD4/CD8 ratio in the treatment group were significantly decreased,whileCD8 molecules were significantly increased(P<0.05).Conclusion:"Fuzheng Qingre Tonglin"can alleviate systemic and local inflammation of rats with complicated urinary tract infection.It may restore the sensitivity of insensitive antibacterial drug to bacteria,regulate immune function and protect kidney function in rats.