健脾降逆方治疗脾虚型反流性食管炎的机制研究

Mechanism of decoction for fortifying spleen and downbear counterflow in the treatment of reflux esophagitis of spleen deficiency type

目的探究健脾降逆方治疗脾虚型反流性食管炎的作用机制。方法取6只雄性SD大鼠作为假手术组,取34只雄性SD大鼠进行脾虚型反流性食管炎造模。将造模成功的30只大鼠随机分为模型组、奥美拉唑组、健脾降逆方低剂量组、健脾降逆方中剂量组、健脾降逆方高剂量组,每组6只。从手术后第5天开始,奥美拉唑组给予奥美拉唑肠溶片溶液灌胃,健脾降逆方低、中、高剂量组分别给予1.02 g/mL、2.04 g/mL、4.08 g/mL健脾降逆方药液灌胃,假手术组和模型组给予等量蒸馏水灌胃,均灌胃14 d。灌胃结束后,ELISA法检测血清血管活性肠肽(VIP)、生长激素释放肽(Ghrelin)水平,RT-PCR法检测食管下段组织中VIP和Ghrelin mRNA表达量,免疫荧光法观察食管下段组织中肌球蛋白轻链(MLC)表达情况。结果健脾降逆方中、高剂量组血清VIP水平及食管下段组织中VIP mRNA相对表达量均明显低于模型组、健脾降逆方低剂量组、奥美拉唑组(P均<0.05),血清Ghrelin水平及食管下段组织中Ghrelin mRNA相对表达量、食管下段组织中MLC表达平均光密度值均明显高于模型组、健脾降逆方低剂量组、奥美拉唑组(P均<0.05)。结论健脾降逆方可通过下调VIP表达、上调Ghrelin表达、促进MLC活化而恢复胃肠动力以治疗因贲门括约肌松弛而导致的反流性食管炎。

Objective It is to study the mechanism decoction for fortifying spleen and downbear counterflow in the treatment of reflux esophagitis of spleen deficiency type.Methods Six male SD rats were taken as the sham operation group,and another 34 male SD rats were selected to establish models of reflux esophagitis of spleen deficiency type.30 successfully modeled rats were randomly divided into model group,omeprazole group,low-dose,medium-dose and high-dose groups of decoction for fortifying spleen and downbear counterflow,with 6 rats in each group.Starting from the 5th day after surgery,the omeprazole group was given omeprazole enteric tablet solution,the low,medium and high dose groups of decoction for fortifying spleen and downbear counterflow were given decoction for fortifying spleen and downbear counterflow 1.02 g/mL,2.04 g/mL and 4.08 g/mL by gavage,respectively,and the sham operation group and model group were given equal amounts of distilled water by gavage,all of the groups were continuously treated for 14 days.After gavage,the levels of serum vasoactive intestinal peptide(VIP),growth hormone-releasing peptide(Ghrelin)were measured by ELISA,the mRNA expressions of VIP and Ghrelin in lower esophageal tissues were measured by RT-PCR,and the expression of myosin light chain(MLC)in lower esophageal tissues was observed by immunofluorescence.Results The levels of serum VIP and the relative expression of VIP mRNA in the lower esophageal tissues in the medium and high dose groups of decoction for fortifying spleen and downbear counterflow were significantly lower than those in the model group,the low dose group of decoction for fortifying spleen and downbear counterflow and omeprazole group(all P<0.05),and the levels of serum Ghrelin and the relative expression of Ghrelin mRNA in the lower esophageal tissues and the mean optical density value of MLC expression in the lower esophageal tissues were significantly higher than those in the model group,the low-dose group of of decoction for fortifying spleen and downbear counterflow and omeprazole group(all P<0.05).Conclusion Decoction for fortifying spleen and downbear counterflow can restore gastrointestinal motility via down-regulating VIP expression and up-regulating Ghrelin expression and promoting MLC activation,thus to treat reflux esophagitis caused by cardiac sphincter relaxation.