加味参苓白术散联合合生元用于肠内营养对胃肠手术后大鼠肠黏膜屏障修复作用研究
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摘要
目的观察加味参苓白术散与合生元联合应用肠内营养对胃肠手术后大鼠肠黏膜屏障受损保护作用。方法取清洁级健康成年雄性SD大鼠40只,统一喂养3 d,建立肠手术后黏膜屏障损坏的动物模型,随机分为联合组与对照组,各20只。联合组肠内营养:整蛋白肠内营养+双歧杆菌三联活菌+加味参苓白术散;对照组肠内营养:整蛋白肠内营养+双歧杆菌三联活菌。比较两组术后第6天结肠内容物的革兰氏阴性菌浓度、门脉血内毒素浓度、乳果糖/甘露醇(L/M)值、肠黏膜厚度、细菌移位率。结果联合组肠内容物的革兰氏阴性菌浓度、尿L/M值与门脉血内毒素浓度分别为(16. 52±6. 71)×10~8cfu/g、(0. 76±0. 16)、(19. 01±3. 22) EU/L,显著低于对照组的(27. 65±5. 45)×10~8cfu/g、(1. 17±0. 25)、(25. 13±3. 46) EU/L(P均<0. 01)。联合组结肠黏膜厚度为(229. 10±21. 30)μm,显著高于对照组的(204. 31±18. 49)μm(P <0. 05)。联合组细菌总移位率为25. 0%,显著低于对照组的60. 0%(P <0. 05)。结论加味参苓白术散联合合生元用于肠内营养可有效改善肠内菌群结构、保护并修复肠黏膜屏障功能,使肠黏膜厚度增加、肠道细菌移位减少。
Objective To observe the protective effect of Jiawei Shenling baizhu powder and Heshengyuan combined with enteral nutrition on intestinal mucosal barrier damage in rats after gastrointestinal surgery. Methods Total of 40 healthy adult male SpragueDawley rats were taken and fed for 3 days. An animal model of intestinal barrier damage after intestinal surgery was established and divided into a combined group and a control group, 20 each. Combined group enteral nutrition: whole protein enteral nutrition +Bifidobacterium triple live bacteria + Jiawei Shenqi baizhu powder, control group enteral nutrition: whole protein enteral nutrition +Bifidobacterium triple live bacteria. The Gram-negative bacteria concentration, portal blood endotoxin concentration, lactulose/mannitol( L/M) value, intestinal mucosal thickness, and bacterial translocation rate of the two groups of colon contents were compared. Results Gram-negative bacteria concentration, urine L/M value and portal blood endotoxin concentration in the intestinal contents of the combined group were( 16. 52 ± 6. 71) × 10~8 cfu/g,( 0. 76 ± 0. 16)( 19. 01 ± 3. 22) EU/L, significantly lower than the control group( 27. 65 ± 5. 45) × 10~8 cfu/g,( 1. 17 ± 0. 25),( 25. 13 ± 3. 46) EU/L, the colonic mucosal thickness( 229. 10 ± 21. 30)μm, significantly higher than the control group( 204. 31 ± 18. 49) μm, the difference were statistically significant( P < 0. 05). The total bacterial translocation rate in the combined group was 25. 0% which was significantly lower than 60. 0% in the control group( P <0. 05). Conclusion The Jiawei Shenqi baizhu Powder combined with Synbiotics for enteral nutrition can effectively improve intestinal flora structure, protect and repair intestinal mucosal barrier function, increase intestinal mucosal thickness, and reduce intestinal bacterial translocation.
Objective To observe the protective effect of Jiawei Shenling baizhu powder and Heshengyuan combined with enteral nutrition on intestinal mucosal barrier damage in rats after gastrointestinal surgery. Methods Total of 40 healthy adult male SpragueDawley rats were taken and fed for 3 days. An animal model of intestinal barrier damage after intestinal surgery was established and divided into a combined group and a control group, 20 each. Combined group enteral nutrition: whole protein enteral nutrition +Bifidobacterium triple live bacteria + Jiawei Shenqi baizhu powder, control group enteral nutrition: whole protein enteral nutrition +Bifidobacterium triple live bacteria. The Gram-negative bacteria concentration, portal blood endotoxin concentration, lactulose/mannitol( L/M) value, intestinal mucosal thickness, and bacterial translocation rate of the two groups of colon contents were compared. Results Gram-negative bacteria concentration, urine L/M value and portal blood endotoxin concentration in the intestinal contents of the combined group were( 16. 52 ± 6. 71) × 10~8 cfu/g,( 0. 76 ± 0. 16)( 19. 01 ± 3. 22) EU/L, significantly lower than the control group( 27. 65 ± 5. 45) × 10~8 cfu/g,( 1. 17 ± 0. 25),( 25. 13 ± 3. 46) EU/L, the colonic mucosal thickness( 229. 10 ± 21. 30)μm, significantly higher than the control group( 204. 31 ± 18. 49) μm, the difference were statistically significant( P < 0. 05). The total bacterial translocation rate in the combined group was 25. 0% which was significantly lower than 60. 0% in the control group( P <0. 05). Conclusion The Jiawei Shenqi baizhu Powder combined with Synbiotics for enteral nutrition can effectively improve intestinal flora structure, protect and repair intestinal mucosal barrier function, increase intestinal mucosal thickness, and reduce intestinal bacterial translocation.
引文
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[8]黄丽,李慢中,李佳,等.参苓白术散对腹泻型肠易激综合征模型大鼠胃肠激素、消化酶及炎性细胞因子的影响[J].国际中医中药杂志,2018,40(9):836-839.
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[10]高春波.参苓白术散加艾灸治疗腹泻型肠易激综合征的临床观察[J].陕西中医,2016,37(8):944-945.
[11]姜华,杨景明.参苓白术散对脾虚小鼠肠道功能的影响及其机制研究[J].亚太传统医药,2016,12(7):16-17.
[12]文跃强,贾波,彭腾.茯苓多糖及其修饰物的药理研究进展[J].时珍国医国药,2014,25(2):432-434.
[13]周璐丽,周汉林,王定发,等.3种姜科植物提取物的体外抗菌活性[J].热带农业科学,2016,36(5):90-92,101.
[14]张雪青,邵邻相,吴文才,等.白术挥发油抑菌及抗肿瘤作用研究[J].浙江师范大学学报(自然科学版),2016,39(4):436-442.
[15]洪宇.HPLC测定三拗汤不同煎液中甘草酸的含量及其体外抑菌效果分析[J].中药材,2014,37(6):1071-1073.
[16]庄贤栩,裴仁治,陆滢,等.双歧杆菌三联活菌胶囊对白血病化疗所致腹泻患者肠黏膜屏障功能的影响及疗效观察[J].中国医药导报,2015,12(3):110-113.
[17]刘彩君,朱芹.参苓白术散高效液相色谱特征指纹图谱研究及5个指标性成分的含量测定[J].中国药业,2018,27(15):12-16.
[18]王雪梅.参苓白术散对溃疡性结肠炎患者血浆MMP-2、MMP-9水平的影响[J].环球中医药,2016,9(4):398-401.
[19]王雪梅,李艳娇,宋燕青,等.基于高效液相指纹图谱检测参苓白术散中人参皂苷的含量测定[J].世界中医药,2018,13(11):2876-2879,2883.
[20]赵艳.参苓白术散加减方联合匹维溴铵片治疗腹泻型肠易激综合征临床观察及其作用机制探讨[J].河北中医,2016,38(6):876-879,923.
[21]贾育新,毕殿勇,段永强,等.参苓白术散对脾虚湿困型溃疡性结肠炎大鼠结肠p38 MAPK及TNF-α、IL-4的干预作用[J].中医药学报,2018,46(5):11-17.
[22]周华,张敏,李华,等.参苓白术散治疗大鼠脾虚湿困型溃疡性结肠炎的机制[J].中国老年学杂志,2017,37(3):547-549.
[23]刘喜平,崔国宁,董俊刚,等.参苓白术散与痛泻要方对溃疡性结肠炎大鼠内源性间充质干细胞动员的比较研究[J].中国中医药信息杂志,2018,25(11):41-45.
[24]诸葛远莉,金海林,刘万里,等.参苓白术散对慢性腹泻幼年大鼠肠黏膜屏障影响的研究[J].江苏中医药,2015,47(5):80-82,85.
[25]张小军,赵国栋,邢军卫,等.蒙脱石散联合双歧杆菌四联活菌片对儿童腹泻肠黏膜5-HT和血浆NPY、VIP的影响[J].现代消化及介入诊疗,2016,21(4):587-589.
[26]毕殿勇,贾育新,成映霞,等.参苓白术散对脾虚湿困型溃疡性结肠炎模型大鼠IL-1β、IL-4及p38MAPK基因蛋白表达的影响[J].中药药理与临床,2017,33(1):7-11.
[2]丁少桢,丁浩,梅俏,等.同型半胱氨酸影响实验性结肠炎大鼠肠黏膜上皮细胞紧密连接蛋白表达的研究[J].中华炎性肠病杂志,2018,2(2):108-109.
[3]张勇胜,黄可可,贺瑜,等.强化谷氨酰胺及合生元的肠内营养对老年住院患者营养状况与胃肠道耐受性的影响[J].中华老年多器官疾病杂志,2017,16(12):898-901.
[4]黄玉珍,刘万里,诸葛远莉,等.参苓白术散对脾虚泄泻幼鼠肠粘膜屏障的修复作用[J].中医药学报,2016,44(5):40-43.
[5]孟德欣,于莲,李雪欣,等.纳米山药多糖合生元结肠靶向微生态调节剂对大鼠肠道菌群的影响[J].中国新药杂志,2016,25(23):2756-2760.
[6]周敏,廖天芬,朱京慈,等.添加合生元的早期肠内营养对重度颅脑损伤病人CRP和PCT的影响[J].肠外与肠内营养,2017,24(2):90-93.
[7]韩东景,陈文芳.合生元制剂联合早期肠内营养治疗老年重型颅脑损伤后感染的疗效[J].中国老年学杂志,2015,35(7):1819-1821.
[8]黄丽,李慢中,李佳,等.参苓白术散对腹泻型肠易激综合征模型大鼠胃肠激素、消化酶及炎性细胞因子的影响[J].国际中医中药杂志,2018,40(9):836-839.
[9]王萌,张会存,刘欣,等.参苓白术散对非酒精性脂肪性肝病模型大鼠瘦素及胰岛素抵抗的影响[J].中国中医药信息杂志,2018,25(10):35-39.
[10]高春波.参苓白术散加艾灸治疗腹泻型肠易激综合征的临床观察[J].陕西中医,2016,37(8):944-945.
[11]姜华,杨景明.参苓白术散对脾虚小鼠肠道功能的影响及其机制研究[J].亚太传统医药,2016,12(7):16-17.
[12]文跃强,贾波,彭腾.茯苓多糖及其修饰物的药理研究进展[J].时珍国医国药,2014,25(2):432-434.
[13]周璐丽,周汉林,王定发,等.3种姜科植物提取物的体外抗菌活性[J].热带农业科学,2016,36(5):90-92,101.
[14]张雪青,邵邻相,吴文才,等.白术挥发油抑菌及抗肿瘤作用研究[J].浙江师范大学学报(自然科学版),2016,39(4):436-442.
[15]洪宇.HPLC测定三拗汤不同煎液中甘草酸的含量及其体外抑菌效果分析[J].中药材,2014,37(6):1071-1073.
[16]庄贤栩,裴仁治,陆滢,等.双歧杆菌三联活菌胶囊对白血病化疗所致腹泻患者肠黏膜屏障功能的影响及疗效观察[J].中国医药导报,2015,12(3):110-113.
[17]刘彩君,朱芹.参苓白术散高效液相色谱特征指纹图谱研究及5个指标性成分的含量测定[J].中国药业,2018,27(15):12-16.
[18]王雪梅.参苓白术散对溃疡性结肠炎患者血浆MMP-2、MMP-9水平的影响[J].环球中医药,2016,9(4):398-401.
[19]王雪梅,李艳娇,宋燕青,等.基于高效液相指纹图谱检测参苓白术散中人参皂苷的含量测定[J].世界中医药,2018,13(11):2876-2879,2883.
[20]赵艳.参苓白术散加减方联合匹维溴铵片治疗腹泻型肠易激综合征临床观察及其作用机制探讨[J].河北中医,2016,38(6):876-879,923.
[21]贾育新,毕殿勇,段永强,等.参苓白术散对脾虚湿困型溃疡性结肠炎大鼠结肠p38 MAPK及TNF-α、IL-4的干预作用[J].中医药学报,2018,46(5):11-17.
[22]周华,张敏,李华,等.参苓白术散治疗大鼠脾虚湿困型溃疡性结肠炎的机制[J].中国老年学杂志,2017,37(3):547-549.
[23]刘喜平,崔国宁,董俊刚,等.参苓白术散与痛泻要方对溃疡性结肠炎大鼠内源性间充质干细胞动员的比较研究[J].中国中医药信息杂志,2018,25(11):41-45.
[24]诸葛远莉,金海林,刘万里,等.参苓白术散对慢性腹泻幼年大鼠肠黏膜屏障影响的研究[J].江苏中医药,2015,47(5):80-82,85.
[25]张小军,赵国栋,邢军卫,等.蒙脱石散联合双歧杆菌四联活菌片对儿童腹泻肠黏膜5-HT和血浆NPY、VIP的影响[J].现代消化及介入诊疗,2016,21(4):587-589.
[26]毕殿勇,贾育新,成映霞,等.参苓白术散对脾虚湿困型溃疡性结肠炎模型大鼠IL-1β、IL-4及p38MAPK基因蛋白表达的影响[J].中药药理与临床,2017,33(1):7-11.