探讨四逆汤抗急性失血性休克的氧自由基、一氧化氮机制

Study on Sini Decoction in treatment of hemorrhagic shock: mechanism relating to oxygen radical and nitro oxide

目的 :从整体初步探讨四逆汤 (附子 ,干姜 ,炙甘草 )抗失血性休克的氧自由基、一氧化氮机制。方法 :复制急性失血性休克大鼠模型 ,分为假手术对照组 ;休克模型组 ;休克 +生理盐水复苏组 ;休克 +四逆汤复苏组。监测各组血压变化。测定休克前、休克 1h、复苏后 1h、复苏后 3h血浆中的SOD(超氧化物歧化酶 )活性、MDA(丙二醛 )的含量 ,各组观察结束后血浆乳酸、NO(一氧化氮 )含量。结果 :四逆汤组与生理盐水相比较 ,复苏 3h后 ,血中SOD活性明显升高 (P <0 .0 1) ,MDA明显降低 (P <0 .0 1) ,乳酸含量也显著下降 (P <0 .0 1)、血中NO含量则明显升高 (P <0 .0 1) ,平均动脉血压也明显高于生理盐水组。结论 :四逆汤通过清除氧自由基 ,减少体内乳酸的堆积 ,升高NO ,改善机体微循环 ,维持机体复苏后的血压 ,理论了减轻了由于休克后缺血缺氧、体内乳酸的堆积、微循环功能障碍造成的不可逆性的休克。

Objective: The work was designed to explore Sini Decoction's (SD) (Radix Aconit: Rateralis Preparata, Rhizoma Zingiberis, Radix Glycyrrhizae Preparata).protective effects on hemorrhagic shock. A mechanism relating to oxygen radical and nitric oxide was also discussed. Methods: Anesthetized Wistar rats were subjected to a hemorrhagic shock protocol for 60 min followed by intravenous injection with normal saline, and Sini Decoction solution, respectively. The mean arterial pressure (MAP) was continually monitored. Plasma superoxide dismutase (SOD), malondialdehyde (MDA), lactic acid and NO were examined for oxidative stress research. Results: The activity change of SOD and the concentration changes of MDA and Lactic acid in blood during hemorrhagic shock were tested. Comparing with control group, for blood samples from Sini Decoction group, the SOD activity was found to be increased significantly, while the MDA concentration decreased. The NO concentrations in blood of Sini Decoction group increased at three hours point after resuscitation vs the normal saline group (P<0.01) and control group (P<0.01). Conclusion: Sini Decoction can reduce the injury caused by oxygen free radicals during hemorrhagic shock. Sini Decoction can increase NO concentration and decrease lactic acid concentration to maintain the perfusion to vital organs and to protect hemorrhagic shock, to avoid the decrease of the mean arterial pressure (MAP).