大柴胡汤联合奥曲肽对急性胰腺炎模型大鼠血清细胞因子的影响
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摘要
目的:观察大柴胡汤联合奥曲肽对急性胰腺炎(acute pancreatitis,AP)模型大鼠血清细胞因子表达水平的影响。方法:采用5%牛黄胆酸钠复制急性胰腺炎大鼠模型。将60只SD大鼠随机分为假手术组、AP组、奥曲肽组、大柴胡汤组和联合用药组。比较各组大鼠血清中淀粉酶(amylase,AMY)、脂肪酶、丙氨酸氨基转移酶(alainine aminotransferase,ALT)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、β-半乳糖苷酶的表达水平,各组大鼠存活率及腹水量。结果:联合用药组腹水量少于奥曲肽组和大柴胡汤组,差异均有统计学意义(P <0. 05)。假手术组大鼠全部存活,联合用药组存活率为91. 67%,与其他几组比较,差异有统计学意义(P <0. 05)。与假手术组比较,AP组大鼠β-半乳糖苷酶显著降低,TNF-α、IL-6表达水平明显升高,差异均有统计学意义(P <0. 05)。与大柴胡汤组比较,联合用药组可显著升高大鼠血清β-半乳糖苷酶水平,降低TNF-α、IL-6表达水平,差异均有统计学意义(P <0. 05)。与假手术组比较,AP组大鼠血清AMY、脂肪酶、ALT表达水平显著升高,差异均有统计学意义(P <0. 05)。联合用药组能明显降低大鼠血清AMY、脂肪酶、ALT的表达量,与奥曲肽组及大柴胡汤组比较,差异有统计学意义(P <0. 05)。结论:AP模型大鼠外周血TNF-α、IL-6异常升高,诱导β-半乳糖苷酶急剧下降,导致胰腺组织内AMY、脂肪酶的表达异常,进一步刺激胰腺腺泡细胞的凋亡;联合用药(奥曲肽+大柴胡汤)可在保护肝功能的基础上明显改善外周血的炎症反应,抑制胰腺组织细胞凋亡,改善血清指标的异常表达。
Objective: To observe the effect of Dachaihu decoction combined with octreotide on the expression of serum cytokines in rats with acute pancreatitis( AP). Methods: The rat model of acute pancreatitis was induced by 5% sodium taurocholate. 60 SD rats were randomly divided into sham-operated group,AP group,octreotide group,Dachaihu Decoction group and combined drug group. The levels of serum amylase( AMY),lipase,alainine aminotransferase( ALT),interleukin-6( IL-6),tumor necrosis factor-α( TNF-α),β-galactosidase,survival rate and ascites volume of rats in each group were compared. Results: Ascites volume in combination group was less than that in octreotide group and Dachaihu Decoction group. The difference was statistically significant( P < 0. 05). All rats in the sham-operated group survived,and the survival rate in the combined drug group was 91. 67%. Compared with other groups,the difference was statistically significant( P < 0. 05). Compared with sham-operated group,the expression levels of β-galactosidase and TNF-α and IL-6 in AP group were significantly lower. The difference was statistically significant( P < 0. 05). Compared with the Dachaihu Decoction group,the combined treatment group could significantly increase the level of serum beta-galactosidase and decrease the expression levels of TNF-α and IL-6 in rats. The difference was statistically significant( P < 0. 05). Compared with sham-operated group,the levels of serum AMY,lipase and ALT in AP group were significantly increased. The difference was statistically significant( P < 0. 05). The expression of AMY,lipase and ALT in serum of rats in combination group was significantly decreased compared with that in octreotide group and Dachaihu Decoction group. The difference was significant( P < 0. 05). Conclusion: The abnormal increase of inflammatory factors TNF-α and IL-6 in peripheral blood of AP model rats induced a sharp decrease of β-galactosidase,which resulted in abnormal expression of AMY and lipase in pancreatic tissue and further stimulated apoptosis of pancreatic acinar cells. The combination of octreotide and Dachaihu Decoction can obviously improve the inflammatory reaction of peripheral blood,inhibit the apoptosis of pancreatic tissue,and improve the abnormal expression of serum indicators on the basis of protecting liver function.
Objective: To observe the effect of Dachaihu decoction combined with octreotide on the expression of serum cytokines in rats with acute pancreatitis( AP). Methods: The rat model of acute pancreatitis was induced by 5% sodium taurocholate. 60 SD rats were randomly divided into sham-operated group,AP group,octreotide group,Dachaihu Decoction group and combined drug group. The levels of serum amylase( AMY),lipase,alainine aminotransferase( ALT),interleukin-6( IL-6),tumor necrosis factor-α( TNF-α),β-galactosidase,survival rate and ascites volume of rats in each group were compared. Results: Ascites volume in combination group was less than that in octreotide group and Dachaihu Decoction group. The difference was statistically significant( P < 0. 05). All rats in the sham-operated group survived,and the survival rate in the combined drug group was 91. 67%. Compared with other groups,the difference was statistically significant( P < 0. 05). Compared with sham-operated group,the expression levels of β-galactosidase and TNF-α and IL-6 in AP group were significantly lower. The difference was statistically significant( P < 0. 05). Compared with the Dachaihu Decoction group,the combined treatment group could significantly increase the level of serum beta-galactosidase and decrease the expression levels of TNF-α and IL-6 in rats. The difference was statistically significant( P < 0. 05). Compared with sham-operated group,the levels of serum AMY,lipase and ALT in AP group were significantly increased. The difference was statistically significant( P < 0. 05). The expression of AMY,lipase and ALT in serum of rats in combination group was significantly decreased compared with that in octreotide group and Dachaihu Decoction group. The difference was significant( P < 0. 05). Conclusion: The abnormal increase of inflammatory factors TNF-α and IL-6 in peripheral blood of AP model rats induced a sharp decrease of β-galactosidase,which resulted in abnormal expression of AMY and lipase in pancreatic tissue and further stimulated apoptosis of pancreatic acinar cells. The combination of octreotide and Dachaihu Decoction can obviously improve the inflammatory reaction of peripheral blood,inhibit the apoptosis of pancreatic tissue,and improve the abnormal expression of serum indicators on the basis of protecting liver function.
引文
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[11]张玮,朱艳娜,刘守信.血必净治疗腹腔感染的实验研究[J].中国现代医学杂志,2017,27(12):21-24.
[2]PHILLIP V,STEINER J M,ALGUL H. Early phase of acute pancreatitis:assessment and management[J]. World J Gastrointest Pathophysiol,2014,5(3):158-168.
[3]NORMAN J. The role of cytokines in the pathogenesis of acute pancreatitis[J]. Am J Surg,1998,175(1):76-83.
[4]刘大晟,吴先林,李接兴,等.三种不同造模方法建立大鼠急性胰腺炎模型的对比[J].中国老年学杂志,2016,36(5):2315-2318.
[5]韦栋余,王光耀.大柴胡汤的临床应用[J].现代中西医结合杂志,2013,22(13):1476-1478.
[6]陈亚峰,奉典旭,陈腾,等.大柴胡汤对急性坏死性胰腺炎大鼠胰腺水通道蛋白1的作用[J].中华中医药杂志,2012,27(5):1438-1442.
[7]潘庆华,曾莉蓉.大黄保留灌肠对内镜下逆行胰胆管造影术后胰腺炎和高淀粉酶血症的影响[J].中医学报,2017,32(1):149-152.
[8]张小丽.穴位埋线与穴位注射对2型糖尿病大鼠pander及Caspase-3表达影响的比较研究[J].中医学报,2017,32(1):97-100.
[9]林明强,吕有凯,王日兴.β-半乳糖苷酶在急性胰腺炎模型大鼠血清中的活性变化水平及意义[J].广东医学,2016,37(18):2742-2745.
[10]JIN H,YU J,WANG W,et al. Serum GC-golbulin levels are reduced in patients with severe acute pancreatitis[J]. Eur J Gastroenterol Hepatol,2012,24(5):501-505.
[11]张玮,朱艳娜,刘守信.血必净治疗腹腔感染的实验研究[J].中国现代医学杂志,2017,27(12):21-24.