【摘要】 目的观察调胃承气汤通过对肠源性脓毒症大鼠血液流变学指标及凝血功能的影响,探讨其对肠黏膜屏障功能的改善作用。方法将40只SD雄性大鼠随机分为假手术组、GOS模型组、乌司他丁组、调胃承气汤(TWCQT)高、低剂量组,每组8只。术后2 h、10 h和24 h按照相应剂量分别进行灌胃给药,TWCQT高剂量组与低剂量组相应浓度灌胃调胃承气汤,假手术组与GOS模型组大鼠灌胃0.9%氯化钠注射液,乌司他丁组腹腔注射乌司他丁。最后一次给药0.5 h后结束实验,检测大鼠全血黏度、红细胞聚集指数和血浆黏度;检测大鼠血清中活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)与凝血酶时间(TT);检测血清中肿瘤坏死因子-α(TNF-α)和D乳酸(D-LA)的含量;电镜下观察各组小肠组织超微结构。结果与假手术组相比,GOS模型组大鼠全血黏度、红细胞聚集指数与血浆黏度显著升高(P <0.01)。与GOS模型组相比,乌司他丁组、TWCQT高剂量与低剂量组大鼠全血黏度、红细胞聚集指数与血浆黏度显著降低(P <0.01);与假手术组相比,GOS模型组大鼠血清中APTT、PT与TT显著延长(P <0.01)。与GOS模型组相比,乌司他丁组、TWCQT高剂量与低剂量组大鼠血清中APTT、PT与TT明显缩短(P <0.01);与假手术组相比,模型组血清中TNF-α和D-LA含量显著提高(P <0.01);与GOS模型组相比,乌司他丁组、TWCQT高剂量与低剂量组血清中TNF-α和D-LA含量显著降低(P <0.01);与假手术组相比,GOS模型组小肠黏膜组织微绒毛断裂脱落、线粒体断裂、内质网扩张与紧密连接结构破坏严重。与GOS模型组相比,乌司他丁组、TWCQT高剂量与低剂量组小肠黏膜组织微绒毛无断裂脱落、线粒体无严重肿胀、内质网无变形,紧密连接结构相对完整。结论调胃承气汤能有效地改善肠黏膜结构屏障功能,这种改善作用的机制可能是调胃承气汤能通过对肠源性脓毒症大鼠血液流变学指标和凝血功能的影响,减少炎症反应的损伤作用。更多还原

【Abstract】 Objective: To observe the effect of Tiaowei Chengqi Decoction on blood rheology and coagulation function in intestinal sepsis rats,and to improve intestinal mucosal barrier function. Methods: 40 SD male rats were randomly divided into sham operation group,GOS group,ulinastatin group,Tiaowei Chengqi Decoction high dose group and low dose group,with 8 rats in each. After 2 hours,10 hours and 24 hours,the corresponding doses were given by intragastric administration respectively. Tiaowei Chengqi Decoction groups were given Tiaowei Chengqi Decoction. The sham operation group and the model group were given the same amount of saline,and the ulinastatin group was intraperitoneally injected with ulinastatin. The experiment was terminated 0.5 h after the last administration. The whole blood viscosity,erythrocyte aggregation index and plasma viscosity were measured;APTT,PT and TT in rat serum were detected;the serum levels of TNF-α and D-LA were measured. The ultrastructure of intestinal tissue were observed under electron microscope. Results: Compared with the sham operation group,the whole blood viscosity,erythrocyte aggregation index and plasma viscosity of GOS group were significantly increased(P < 0.01). Compared with GOS group,those were significantly lower in the ulinastatin group and Tiaowei Chengqi Decoction groups(P < 0.01). Compared with the sham operation group,the serum levels of APTT,PT and TT in the GOS group were significantly prolonged(P < 0.01). Compared with GOS group,those were significantly shorter in the ulinastatin group and Tiaowei Chengqi Decoction groups(P < 0.01). Compared with the sham operation group,the serum levels of TNF-α and D-LA in the model group were obviously increased(P < 0.01). Compared with GOS group,those were evidently reduced in the ulinastatin group and Tiaowei Chengqi Decoction groups(P < 0.01). Compared with the sham operated group,the small intestinal mucosal microvilli of GOS group were broken off;mitochondria were broken;endoplasmic reticulum was dilated,and the tight junction structure was severely damaged. Compared with GOS group,the situation in Ulinastatin group and Tiaowei Chengqi Decoction groups were opposite. Conclusion: Tiaowei Chengqi Decoction can effectively improve intestinal mucosal barrier function. Its mechanism may be related to affecting the blood rheology and coagulation function in sepsis rats,thus to reduce the damaging effects of inflammatory reactions.更多还原