【摘要】 目的 :观察血液吸附及经胃灌注大承气冲剂对重症急性胰腺炎家兔的治疗作用。 方法 :采用胆胰管内逆行注入牛磺胆酸钠和耳缘静脉注射细菌内毒素造成兔急性胰腺炎合并内毒素血症模型 ,经胃注大承气冲剂及血液吸附 ,观察血中淀粉酶、内毒素、TNF α和IL - 6的变化。 结果 :吸附后 ,血液吸附组、联合应用组内毒素水平低于对照组 (P <0 0 1) ,1h吸附率为 35 39% ;而大承气冲剂组、联合应用组血淀粉酶低于对照组 (P <0 0 5及P <0 0 1) ;各治疗组血中TNF α及IL - 6低于对照组 (P <0 0 5 )。 结论 :EA - 2吸附剂对内毒素具有良好的吸附作用 ,可以有效降低血中内毒素水平 ;而大承气冲剂能减轻胰酶血症 ;两种治疗手段均能有效抑制TNF α和IL - 6的升高更多还原

【Abstract】 Objective To observe the effects of direct hemoabsorption and of extract of Dachengqi decoction on endotoxemia,pancreatic enzymeia and proinflammmatory cytokines in severe acute pancreatitis Methods Experimental model of acute pancreatitis complicated with endothoxemia in rabbits was established by retrograde injection of 2% sodium taurocholate acid(I ml/kg)into the pancreatic duct and injection of bacteria endotoxin(15 μg/kg)into the ear vein of rabbit.Twenty four rabbits were randomly divided into four groups:①model control,②hemoabsorption,③Dachengqi,④hemoabsorption and Dachengqi.The changes of serum concentration of endotoxin,amylase,tumor necrosis factor-alpha and interleukin-6 in early phase of acute pancreatitis complicated with endotoxemia were observed.Results In group ②and ④the serum endotoxin levels were lower than those in control group after hemoabsorption(P<0.01),the absorption rate was 35.39%.In group ③ and ④ the increasing tendency of serum amylase level was restrained than in control group (P<0.05 or P<0.01).Serum TNF-α and IL-6 levels in the three treatment groups were all lower than those in the control group(P<0.05 or P<0.01). Conclusion Endotoxin absorbent-2 can absorb endotoxin favorably,thus decreasing the serum endotoxin level remarkably.Dachengqi decoction and hemoabsorption are beneficial in the treatment of experimental rabbit acute pancreatitis complicated with endotoxemia.更多还原