阳明腑实证时内毒素与炎症介质的变化及复方大承气汤的治疗作用

Changes of Endotoxin and Inflammatory Mediators in Yang Ming Fu Shi(阳明腑实) Syndrome and Treament of Compound Da Cheng Qi(大承气) Decoction

目的 :探讨阳明腑实证时内毒素 (ET)、肿瘤坏死因子 (TNFα)、一氧化氮 (NO)的变化情况 ,并观察复方大承气汤的治疗作用。 方法 :2 0例阳明腑实证患者 ,随机分为两组 ,一组给予常规治疗 ,另一组在常规治疗基础上给予复方大承气汤。检测入院时及治疗 5d后血浆ET ,血清TNFα、NO含量的变化 ,并以 10名健康志愿者作为正常对照组。 结果 :阳明腑实证患者血中内毒素、TNFα、NO的含量与正常对照组相比明显增高 (P值均 <0 0 1) ,经治疗后 ,上述指标均降低 (P值均 <0 0 1) ,尤以复方大承气汤治疗组降低更具有显著性 (P <0 0 5 )。 结论 :中药复方大承气汤可明显降低阳明腑实证患者血中内毒素及各炎症介质的水平 。

Objective To investigate the changes of blood endotoxin(ET) and inflammatory mediators in Yang Ming Fu Shi syndrome and to observe the therapeutic effect of compound Da Cheng Qi decoction Methods Twenty patients with Yang Ming Fu Shi syndrome were randomly divided into two groups.One group received conventional treatrnent and the other were treated with compound Da Cheng Qi decoction additionally for five consecutive days.Ten healthy volunteers came to the third or control group.The serum level of tumor necrosis factor alpha(TNF α)and nitriic oxide(NO) and the concentration of plasma endotoxin in the three groups were measured.Results Compared with the control group,significantly increased parameters could be seen in all patients with Yang Ming Fu Shi syndrome including the levels of blood ET,NO,TNF α( P <0 01) .In the conventional treatment group and herbal medicine treated group,after 5 days of treatment,all the parameters were significantly lower than those before treatment ( P <0 01).But the levels of serum TNF α,NO and plasma ET in herbal medicine treated group was markedly decreased compared with the conventional treatment group ( P <0 01). Conclusion In patients with Yang Ming Fu Shi syndrome increased levels of blood ET,NO,and TNF a play an important role in the pathogenesis of Yang Ming Fu Shi syndrome.Compound Da Cheng Qi Decoction can effectively reduce the foregoing release of inflammatory mediators with good clinical effects.