清胰汤和汉防己甲素对香猪重症急性胰腺炎的治疗作用及血药浓度测定

Therapeutic Effect of Qingyi Decoction and Tetrandrine in Treating Severe Acute Pancreatitis in Miniature Pigs and Serum Drug Level Determination

目的:探讨中药复方清胰汤及汉防己甲素(Tet)单独或联合应用时对香猪重症急性胰腺炎的治疗作用及其机制,并测定血清大黄素、血浆Tet的含量,比较血药浓度与疗效之间的关系。方法:采用胰管逆行加压推注牛磺脱氧胆酸钠诱发香猪重症急性胰腺炎模型,然后将动物随机均分4组,分别接受相应药物治疗;并在造模前后不同时间采集各组动物门静脉和腔静脉血,检测血清淀粉酶活性及白细胞介素1、6(IL-1、IL-6)含量;用高效液相色谱检测其血清大黄素及血浆Tet的含量;光镜观察制模后96h胰、肺等组织病理变化及动物死亡情况。结果:与对照组比较,清胰汤和Tet均可降低重症急性胰腺炎香猪的死亡率(联合组动物全部存活),减轻其胰腺及胰外器官的病理性损伤,显著降低不同时间点血清淀粉酶活性及门静脉、腔静脉血清IL-1、IL-6的含量(P<0.05或P<0.01),且联合组各时间点血浆Tet含量显著高于单用药组(P<0.05或P<0.01)。结论:清胰汤及Tet可通过多个环节治疗重症急性胰腺炎,二者联合应用可提高血药浓度,并在疗效上体现出协同效应。

Objective: To investigate the therapeutic effect of Qingyi Decoction (QYD) and tetrandrine (Tet), used singly or combind, in treating miniature pigs with severe acute pancreatitis (SAP) and its mechanism. Methods: Thirty-two Guizhou miniature pigs were made into SAP model by pancreatic duct retrograde injection of 5% sodium taurocholate. They were randomly divided into 4 groups: the control group, the QYD group, the Tet group and the combined treated group. The serum amylase activity and interleukin-1 and 6 (IL-1, IL-6) contents in serum from vena cava and portal vein were tested by biochemistry and radioimmunoassay (RIA). Serum emodin and plasma Tet levels were measured by high performance liquid chromatography (HPLC) 24, 48 and 72 hrs after treatment. And the pathological changes of pancreas, lung and liver were observed under microscope. Results: The mortality of SAP pigs was reduced significantly and the inflammatory injury of the organs was ameliorated obviously in all treated groups, and the increased amylase activity and IL-1, IL-6 levels was attenuated. The therapeutic effect was much more obvious, and the plasma Tet level at different time points were much higher in the combined treated group than those in the other two groups treated by single drug (P < 0.01). Conclusion: Both QYD and Tet could treat effectively SAP through multiple pathways, combination of them reveals an elevation of serum drug concentration and shows a synergistic effect.