养肝柔肝法防治胆色素结石中干预胆道动力学异常的机理研究

The Impact of Yang-Gan-Rou-Gan Therapy of TCM On Biliary Kinetic Disorder in Pigment Gallstone Disease

目的 :利用生物学技术从胆道动力学角度探讨养肝柔肝法防治胆色素结石的机理。 方法 :清洁级豚鼠共 6 0只 ,随机分为正常对照组 ,致石饲料造模组、养肝利胆颗颗粒剂治疗组 ,饲养 4周观察胆囊成石情况 ,检测血浆CCK含量、胆囊CCK AR、十二脂肠粘膜CCK 8分泌细胞免疫组化、Oddi括约肌调宁蛋白 (Calponin ,Cap)表达。 结果 :(1)模型组成石率明显增高 (P <0 0 5 )。 (2 )模型组血浆CCK水平显著降低 (P <0 0 1)。 (3)模型组胆囊平滑肌CCK R数目明显减少 (P <0 0 5 ) ,治疗组与正常组之间无明显差异 (P >0 0 5 )。 (4 )模型组十二指肠CCK 8内分泌阳性数明显减少 (P <0 0 1) ,治疗组与正常组之间无显著性差异 (P >0 0 5 )。 (5 )模型组Oddi括约肌调宁蛋白 (Cap)表达 ,条带灰度密度值明显小于正常组和治疗组 (P <0 0 5 )。结论 :(1)养肝柔肝法具有稳定的防石作用。 (2 )养肝柔肝法可提高血和肠腔内CCK的浓度 ,改善胆道动力学。 (3)养肝柔肝法可提高CCK AR数目 ,使CCK缩胆囊的效应增加。 (4 )养肝柔肝法可以使Cap表达增加 ,增强了对Oddi括约肌收缩抑制作用 ,使胆道动力系统协调性增强。

Objective:Using biological technique to probe into the mechanisms of regulating the biliary kinetics of Yang-Gan-Rou-Gan therapy(YGRG)of TCM in the prevention and treatment of pigment gallstone disease Methods:60 guinea pigs were divided randomly into three groups:group A (fed normal diet,n=20),group B(fed lithogenic diet,n=20)and group C (fed lithogenic diet with YGRG drug).After 4-week feeding,the animals were sacrificed and sampled to analyze the rate of stone-formed and to examine the serum CCK,CCK-AR at the gallbladder,CCK-8 and calponin at duodenum. Results: 1.The rate of stone-formed in group B was significantly higher( P <0.05);2.The serum CCK level reduced remarkably in group B ( P <0.05);3.The number of CCK-AR at gallbladder decreased significantly in group B,but no significant difference was found between group A and group C.4.The positive number of CCK-8 endocrine immune reaction cells was decreased significantly in group B,but no significant differrnce was found between group A and group C.5.The express of calponin of Oddi's sphincter was much less in group B than in both group A and group C.Conclusion:1.YGRG therapy of TCM has pharmaceutical effects in prevention of gallstone formation.2.YGRG therapy of TCM can increase CCK concentration in both serum and intestine which maybe beneficial in modulate biliary kinetics.3.YGRG therapy of TCM is likely to increase the number of CCK-AR and to enhance gallbladder contractility.4.YGRG therapy of TCM is able to increase calponin express and enhance the inhibition on Oddi's sphincter contractility which maybe benefit to compliance of biliary kinetics.