中药对大鼠自发性慢性胰腺炎的干预作用及其方证病态基础

目的探讨桂枝汤、柴胡桂枝汤、小柴胡汤和卡莫司他对大鼠自发性慢性胰腺炎的干预作用及其方证病态基础。方法57只雄性4周龄WBN/Kob大鼠随机分为5组模型组、桂枝汤组、柴胡桂枝汤组、小柴胡汤组和卡莫司他组,每组大鼠均予以相应药物干预,共12周。每4周取大鼠胰腺组织观察胰腺湿重;HE染色观察胰腺组织病理学改变;RT-PCR技术检测大鼠胰腺胰腺炎相关蛋白(pancreatitis-associatedprotein,PAP)mRNA的表达水平;免疫组织化学方法检测胰腺PAP蛋白的表达。结果模型组自12周龄起胰腺组织发生胰腺炎病理学改变;桂枝汤组未观察到胰腺炎病理学改变;小柴胡汤组和卡莫司他组在16周龄时,胰腺组织均发生明显的胰腺炎病理学改变。桂枝汤组抑制PAPmRNA表达的作用大于其他各中药干预组。桂枝汤组和柴胡桂枝汤组在12周龄时,未发现胰腺PAP的表达。结论桂枝汤、柴胡桂枝汤、小柴胡汤和卡莫司他对大鼠自发性慢性胰腺炎具有不同程度的防治作用,其中以桂枝汤的作用最为明显。“太阳表证”可能是大鼠自发性慢性胰腺炎的中医基本证候病机,PAP的表达可能是其证候病机的病态基础之一。

Effects of Chinese herbal medicines on spontaneous chronic pancreatitis in rats and the pathological relationships between formulas and syndromes

Objective: To investigate the effects of Guizhi Decoction, Chaihu Guizhi Decoction, Xiaochaihu Decoction and camostat on rat spontaneous chronic pancreatitis and the pathological relationships between formulas and syndromes. Methods: Fifty-seven male WBN/Kob rats at age of 4 weeks were divided into five groups: untreated group (n=18), Guizhi Decoction-treated group (n=9), Chaihu Guizhi Decoction-treated group (n=9), Xiaochaihu Decoction-treated group (n=9) and camostat-treated group (n=12). The rats in each group were fed with corresponding drugs for 12 weeks. The pancreatic wet weight and histopathological changes of pancreatic tissue were observed every four weeks. Meanwhile, the expression level of pancreatitis-associated protein (PAP) in pancreas was detected by RT-PCR techique and immunohistochemical method. Results: In the untreated group, the histopathological changes in pancreas were observed in rats at 12-week age, while such changes were absent in the Guizhi Decoction-treated group. The histopathological changes in pancreas were quite remarkable in rats at 16-week age in both the Xiaochaihu Decoction-treated and the camostat-treated groups. The expression level of PAP mRNA was lower in the Guizhi Decoction- treated group than those in the other groups. The PAP expressions were absent in rats at 12-week age in the Guizhi Decoction-treated and the Chaihu Guizhi Decocion-treated groups. Conclusion: Guizhi Decoction, Chaihu Guizhi Decoction, Xiaochaihu Decoction and camostat are all beneficial to prevention and cure of chronic pancreatitis, and Guizhi Decoction is the most effective one. It is speculated that Taiyang exterior syndrome may be the pathogenesis of basic syndrome of spontaneous chronic pancreatitis, and the expression of PAP may be its pathological basis.