赤芍加清胰汤联合早期空肠营养对大鼠重症急性胰腺炎肠屏障功能的保护作用

目的观察赤芍加清胰汤联合早期空肠营养对大鼠重症急性胰腺炎肠屏障功能的保护作用。方法采用胰胆管内逆行注射5%牛黄胆酸钠复制重症胰腺炎大鼠模型。32只重症胰腺炎大鼠随机分为模型对照组(A组)、清胰汤加赤芍治疗组(B组)、早期空肠营养组(C组)、清胰汤加赤芍联合早期空肠营养组(D组),每组8只。B组在手术清醒后及术后8h中药汤剂灌胃;C组术后12h予肠内营养;D组在B组治疗基础上,于术后12h加用肠内营养,A组在D组给药相同时间点分别给予等量的生理盐水灌胃及经营养管注入空肠。术后24h处死动物。处死前1h将一段长约20 cm小肠两端夹闭,向其内注入FITC-dextran溶液1ml以观察肠黏膜通透性;无菌采取肠系膜淋巴结及门静脉血检测其中的细菌量;取门静脉血测定血浆D-乳酸及内毒素水平。结果 (1)肠黏膜通透性:4组血浆D-乳酸及FITC-dextran水平比较,A组>B组、C组>D组,差异均有统计学意义(P<0.05),B组、C组间差异无统计学意义(P>0.05)。(2)细菌移位情况:细菌培养及内毒素水平检测结果显示,A组>B组>C组>D组,差异均有统计学意义(P<0.05)。结论赤芍、清胰汤、空肠营养三者联合治疗,能明显降低重症急性胰腺炎大鼠肠黏膜通透性,起到保护肠屏障功能的作用。

Qingyi soup and red peony root combined with early enteral nutrition ameliorates intestinal permeability on rats with severe acute pancreatitis

Objective To examine the efficacy of Qingyi soup and red peony root combined with enteral nutrition on rats with severe acute pancreatitis. Methods The acute panereatitis was set up with injection sodium taurocholate A retrograde from bill duct. Totally 32 rats with SAP were randomly divided into four groups： control （A group）, Qingyi soup and red peo- ny root treatment group （B group） ; early enteral nutrition treatment group （C group） ; Qingyi soup and red peony root com- bined with early enteral nutrition experimental treatment group （D group）. In B group, the rats was gavaged with traditional Chinese medicine after operation and 8 h later. In C group, the enteral nutrition was lasted 12h after operation. As for D group, the enteral nutrition was added on the fundermental treatment as well as B group. The same dose of saline was applied to gavage in A group. The animals were sacrificed after 24h post-operation. Intestinal permeability was assessed by measuring FITC dextran in plasma. The amount of bacteria was detected in mesenteric lymph nodes and portal vein. The levels of serum D-lactic acid and endotoxin were detected in portal vein. Results （ 1 ） Intestinal permeability ： compared with the levels of serum D-lactic acid, the A group was higher than B group, and the C group was higher than D group （ P 〈 0. 05）. While no significant difference between B and C group （ P 〉 0. 05）. （2） Bacterial translocation ： compared with the levels of endotoxin and the amount of bateria, the order was listed as follow A group 〉 B group 〉 C group 〉 D group （ P 〈 0.05）. Conclusion Qingyi soup and red peony root combined with enteral nutrition could reduce the increased intestinal permeability, and protect Intestinal barrier function.