Experimental study of“Tong Xia”purgative method in ameliorating lung injury in acute necrotizing pancreatitis

AIM To investigate the role of tumor necrosisfactor(TNF)in lung injury during acutenecrotizing pancreatitis(ANP),and thetherapeutic effect of'Tong Xia'purgativemethod in minimizing the severity of lung injury.METHODS Fourteen canines were randomlydivided into 3 groups:the'Tong Xia'treatmentgroup(n = 5)using Dachengqitang;salinecontrol group(n = 5),and the sham operationgroup(n = 4).TNF activity in serum and inbronchoalveolar lavage fluid(BALF),the serumendotoxin levels were measured,and theseverity of lung injury evaluated.RESULTS Elevation of TNF activity was moreprominent in BALF than in serum.TNF activity inserum at 6 and 12 hours and in BALI:wassignificantly decreased in the'Tong Xia'treatment group than in the saline control one(q=21.11,q=12.07,q=9.03,respectively,P【0.01)and the lung injury was significantlyalleviated at 12 hours as compared with that inthe saline group,manifested as amelioration otthe lung wet/ dry weight ratio,decrease inprotein concentration and neutrophils count inBALF,and improvement of pulmonaryinflammatory changes.A positive correlationwas demonstrated between serum TNF activity and endotoxin level.CONCLUSION Hypersecretion of TNF is shownto be one of the major causes of lung injuryduring ANP;'Tong Xia'purgative method couldalleviate the degree of lung injury mediated byTNF.

通下法抗急性坏死性胰腺炎肺损害的实验研究

为研究肿瘤坏死因子（ＴＮＦ）在急性坏死性胰腺炎（ＡＮＰ）所致肺损害中的作用，１４只家犬随机分成三组。中药组（ｎ＝５）：ＡＮＰ模型＋大承气汤治疗；盐水组（ｎ＝５）：ＡＮＰ模型＋生理盐水治疗；假手术组（ｎ＝４）。术后测定血清、支气管肺泡灌洗液（ＢＡＬＦ）的ＴＮＦ活性及血清内毒素水平等指标。结果：１．ＢＡＬＦ中ＴＮＦ活性升高较血清中升高更明显。２．中药组术后６、１２小时血清及ＢＡＬＦ中ＴＮＦ活性低于盐水组（Ｐ＜０．０１）。３．术后１２小时中药组肺损害程度明显轻于盐水组。４．盐水组血清ＴＮＦ活性与内毒素水平呈正相关（Ｐ＜０．０５）。结论：ＴＮＦ的过度分泌是ＡＮＰ致肺损害的重要因素；通里攻下法治疗能够减轻ＴＮＦ介导的肺损害程度。

TNF在犬急性胰腺炎早期肺损伤中的作用及通里攻下法的影响

本实验旨在研究肿瘤坏死因子（ＴＮＦ）在急性坏死性胰腺炎早期变化规律及与肺损伤的关系，研究观察中药通里攻下法治疗能否阻抑ＴＮＦ的分泌及损伤效应。实验将１４只家犬随机分成三组。承气汤组（ｎ＝５）：ＡＮＰ模型＋大承气汤治疗；盐水组（ｎ＝５）：ＡＮＰ模型＋生理盐水治疗；假手术组（ｎ＝４）。术后测定血清及支气管肺泡灌洗液（ＢＡＬＦ）ＴＮＦ活性和肺损伤情况。结果显示：１ＡＮＰ时外周血及ＢＡＬＦ中ＴＮＦ活性升高，以后者升高更突出。２承气汤组术后６、１２小时血清及ＢＡＬＦ中ＴＮＦ活性低于盐水组（ｐ＜０．０１）。３承气汤组肺损伤程度轻于盐水组。结果表明，ＴＮＦ的过度分泌参与ＡＮＰ病理生理及肺损伤的发生。中药通里攻下法能够减轻ＴＮＦ介导的肺损伤程度。