摘要
目的探讨红藤中空栓对盲肠结扎穿孔脓毒症模型兔腹腔感染的干预作用。方法将50只大耳兔随机分为假手术组、模型组、红藤中空栓组、抗生素组、联合组,每组10只。除假手术组外,其余组以盲肠结扎穿孔法建立腹腔感染兔模型。造模后24 h,假手术组、模型组给予生理盐水16.3 mg/kg肌注和栓壳纳肛3次/d,间隔6 h 1次,间隔期间禁食,连续干预5 d;红藤中空栓组给予红藤中空栓纳肛,3次/d,间隔6 h 1次,间隔期间禁食,连续干预5 d;抗生素组给予硫酸庆大霉素注射液16.3 mg(4057 IU)/kg肌注,1次/d,连续干预5 d;联合组按照红藤中空栓组和抗生素组给药方法联合干预。肉眼观察各组大耳兔术后呼吸及精神状况,分别于术后第1天和干预1,3,5 d后检测血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、降钙素原(PCT)水平,干预5 d后处死各组大耳兔进行腹腔内感染的大体病理观察。结果假手术组大耳兔术后切口愈合良好,正常进食;各造模组大耳兔均出现精神不振、不思饮食、活动减少,呼吸声粗快且逐渐加重等异常症状。术后第1天,各造模组间血清TNF-α、IL-6、PCT水平均明显高于假手术组(P均<0.05),但各造模组间比较差异均无统计学意义(P均>0.05);干预1 d后,抗生素组、联合组血清TNF-α、IL-6水平均明显低于模型组(P均<0.05);干预3 d后,红藤中空栓组、抗生素组、联合组血清TNF-α、IL-6水平和抗生素组、联合组血清PCT水平均明显低于模型组(P均<0.05);干预5 d后,红藤中空栓组、抗生素组、联合组血清TNF-α、IL-6、PCT水平均明显低于模型组(P均<0.05);抗生素组、联合组干预3 d和5 d后血清TNF-α、IL-6水平均明显低于同期红藤中空栓组(P均<0.05),且联合组均明显低于同期抗生素组(P均<0.05);抗生素组、联合组干预5 d后血清PCT水平均明显低于红藤中空栓组(P均<0.05),且联合组明显低于抗生素组(P<0.05)。干预5 d后,联合组腹腔内的脓性分泌物较其他造模组少,腹水颜色淡且无臭味,肠管上无脓苔,阑尾与肠管无粘连,病变范围局限。结论红藤中空栓、抗生素单用和联合应用均可降低血清中炎性因子水平,控制腹腔感染,但红藤中空栓联合抗生素干预效果更好。
Objective It is to investigate the intervention effect of Hongteng hollow type suppository on intra-abdominal infection of rabbit model with sepsis after cecal ligation and perforation.Methods Fifty rabbits were randomly divided into sham operation group,model group,Hongteng hollow suppository group,antibiotic group,and combination group,with 10 rabbits in each group.Except for the sham operation group,the rabbit models of abdominal cavity infection were established by cecal ligation and perforation in the other groups.24 hours after modeling,the sham operation group and the model group were given normal saline 16.3 mg/kg intramuscularly and hollow suppository plugged into the anus,3 times a day,at an interval of 6 hours,fasting during the interval,and continuous intervention for 5 days;the Hongteng hollow suppository group was given Hongteng hollow suppository plugged into the anus,3 times/d,at an interval of 6 hours,fasting during the interval,and continuous intervention for 5 days;the antibiotic group was given gentamicin sulfate injection 16.3 mg(4057 IU)/kg by intramuscular injection,1 time/d,continuous intervention for 5 days;the combination group was intervened in accordance with the administration method of Hongteng hollow suppository group and antibiotic group.The postoperative respiratory and mental status of big-eared rabbits in each group were observed with naked eyes.The levels of serum tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6),procalcitonin(PCT)were detected On the first day after surgery and after 1,3,and 5 days of intervention.After 5 days of intervention,the rabbits in each group were sacrificed for gross pathological observation of intra-abdominal infection.Results The incision of the big-eared rabbits in the sham-operated group healed well after the operation,and the rabbits were eating normally;all the big-eared rabbits in each modeled group showed abnormal symptoms such as lack of energy,reluctance to eat,decreased activity,and rapid breathing and gradually aggravated.On the first day after surgery,the levels of serum TNF-α,IL-6,and PCT in the modeled groups were significantly higher than those in the sham operation group(all P<0.05),but there was no statistically significant difference between the models(P>0.05);after 1 day of intervention,the levels of serum TNF-αand IL-6 of the antibiotic group and the combination group were significantly lower than those of the model group(P<0.05);after 3 days of intervention,the levels of serum TNF-αand IL-6 in the Hongteng hollow suppository group,antibiotic group,combination group and the levels of serum PCT in the antibiotic group and the combination group were significantly lower than those in the model group(P<0.05);after 5 days of intervention,the levels of serum TNF-α,IL-6,and PCT in the Hongteng hollow suppository group,antibiotic group,and combination group were significantly lower than those in the model group(all P<0.05);after 3 days and 5 days of intervention,the levels of serum TNF-αand IL-6 in the antibiotic group and the combination group were significantly lower than those of Hongteng hollow suppository during the same period(all P<0.05),and the combination group was significantly lower than the antibiotic group during the same period(P<0.05);after 5 days of intervention,the levels of serum PCT in the antibiotic group,the combination group were significantly lower than those in the Hongteng hollow suppository group(P<0.05),and the combination group was significantly lower than the antibiotic group(P<0.05).After 5 days of intervention,the combination group had fewer purulent secretions in the abdominal cavity than other models,the ascites was light in color and odorless,there was no purulent coating on the intestine,no adhesion between the appendix and the intestine,and the scope of the disease was limited.Conclusion Single use and combined application of Hongteng hollow suppository and antibiotics can reduce the levels of serum inflammatory factor and control abdominal infection,but Hongteng hollow suppository combined with antibiotic intervention is more effective.
作者
张金梅
刘世超
颉玙
张敏
雷霆
ZHANG Jinmei;LIU Shichao;XIE Yu;ZHANG Min;LEI Ting(Shaanxi University of Chinese Medicine,Xianyang 712046,Shaanxi,China;The Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,Shaanxi,China)
出处
《现代中西医结合杂志》
CAS
2021年第25期2764-2768,共5页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
陕西省咸阳市科学技术局科研项目(2018K02-100)
陕西省自然科学基础研究计划项目(2021JM-474)。
