摘要
目的:探讨重症急性胰腺炎(SAP)胃肠动力障碍的发病机制以及清胰汤对其作用。方法:将48只SD大鼠随机均分为假手术组,SAP模型组(模型组),SAP模型+清胰汤治疗组(清胰汤治疗组)。SAP模型采用5%牛磺胆酸钠胰腺被膜下多点注射诱导,清胰汤治疗组造模后给予清胰汤灌胃,假手术组与模型组给予等体积生理盐水代替。术后24 h采用双极银丝电极记录大鼠胃窦部消化间期复合肌电活动(IMC),随后采用ELISA法测定血清胃动素(MTL)及血管活性肠肽(VIP)的浓度,并进行胰腺组织病理学检查及评分。结果:与假手术组比较,模型组与清胰汤治疗组均表现为MTL浓度降低而VIP浓度升高(均P<0.05),但清胰汤治疗组MTL浓度降低与VIP浓度升高的程度低于模型组,且胰腺组织病理学评分也低于模型组(均P<0.05);模型组与清胰汤治疗组IMC的周期及I,II相时间延长,而IMC III相时间缩短,IMC III相峰电位的振幅及频率降低(均P<0.05),但清胰汤治疗组IMC的各项指标改变不如模型组明显(均P<0.05)。相关性分析显示,SAP大鼠的IMC III相时间与MTL浓度呈正相关(r=0.967,P<0.05),与VIP浓度及胰腺组织病理学评分呈负相关(r=-0.592,P<0.05;r=-0.736,P<0.05)。结论:SAP胃肠动力障碍的发病与胃肠激素紊乱有关,清胰汤可能通过对胃肠激素的调节作用而改善胃肠动力。
Objective： To investigate the mechanism of gastrointestinal motility disorders in severe acute pancreatitis （SAP） and the related effects of Odngyi decoction administration.Methods： Forty-eight SD rats were randomized into sham opera1 and SAP model with Odngyi decoction treatment group （Odngyi .tion group, SAP model group （model group） decoction treatment group）, q-he SAP model was created by multi-point uniform injection of 5% sodium taurocholate beneath the pancreatic capsule, and rats in O^mgyi decoction treatment group were given qmgyi decoction by gavage, while rats in sham operation group and model group were treated with normal saline of the same volume instead. Twenty-four hours after operation, the interdigestive myoelectric complex （IMC） of the gastric antrum of rats was recorded by using bipolar silver electrodes, the serum concentration of motilin （MTL） and vasoactive intestinal peptide （VIP） were measureed by ELISA assa）5 and the pathological observation and scoring of the pancreatic tissues were performed. Results： Compared with sham operation group, both model group and Odngyi decoctio presented with decreased MTL level and increased VIP level （all P〈0.05）, but the degrees n treatment group of MTL reduction and VIP elevation in Qjngyi decoction treatment group were lower than those in model group, and the pathological score of Odngyi decoction treatment group was also lower than that of model group （all P〈0.05）. The time periods oflMC cycle and phase I and II were prolonged but those oflMC phase III were shortened, and the amplitude and frequency of phase III peak potential in both model group and Odngyi decotion treatment group decreased in comparison with sham operation group （all P〈0.05）, but all these IMC indices in Qjngyi decoction treatment group altered less than those in model group （all P〈0.05）. Correlation analysis showed that the IMC phase III time in SAP rat was positively correlated with MTL concentration （r=0.967, P〈0.05）, while negatively correlated with VIP concentration and pathological scores of the pancreatic tissue （r=-0.592, P〈0.05; r=-0.736, P〈0.05）. Conclusion： Gastrointestinal motility disorders in SAP is associated with abnormal function of the gastrointestinal hormones, and the improving effect on gastrointestinal motility of Qjngyi decoction is probably attributable to its regulation of the levels of gastrointestinal hormones.
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2013年第3期275-280,共6页
China Journal of General Surgery
基金
湖南省科技计划资助项目(2012SK3242)
关键词
胰腺炎
急性坏死性
胃肠活动
胃肠激素类
清胰汤
Pancreatitis, Acute Necrotizing
Gastrointestinal Motility
Gastrointestinal Hormones
Q^ngyi Decoction
