通腑饮对不同腹内压腹腔高压症大鼠血清TNF-α、IL-6、内毒素水平及预后的影响
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摘要
目的探讨通腑饮对不同腹内压腹腔高压症大鼠血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、内毒素水平及预后的影响。方法随机将健康成年SD雄性大鼠分为低腹内压通腑饮组、高腹内压通腑饮组、低腹内压组、高腹内压组,每组20只。低腹内压2组造模腹内压为20mm Hg(1 mm Hg=0. 133 kPa),高腹内压2组造模腹内压为25 mm Hg,均持续48 h。造模后,低腹内压通腑饮组和高腹内压通腑饮组给予通腑饮方灌肠,低腹内压组和高腹内压组给予等温生理盐水灌肠,均5 m L/次,每6 h 1次,至大鼠死亡或造模后48 h。检测4组大鼠灌肠前及灌肠12 h、24 h、48 h血清TNF-α、IL-6和内毒素水平,并采用Kaplan-Meier生存曲线分析比较4组大鼠48 h生存预后情况。结果灌肠前,低腹内压2组和高腹内压2组组内血清TNF-α、IL-6和内毒素水平比较差异均无统计学意义(P均>0. 05),但高腹内压2组血清TNF-α、IL-6和内毒素水平均明显高于低腹内压2组(P均<0. 05)。灌肠12 h、24 h、48 h,低腹内压通腑饮组和高腹内压通腑饮组血清TNF-α、IL-6和内毒素水平均明显低于灌肠前(P均<0. 05);低腹内压组和高腹内压组血清TNF-α、IL-6和内毒素水平均明显高于灌肠前(P均<0. 05),且高腹内压组均明显高于低腹内压组(P均<0. 05)。低腹内压通腑饮组、高腹内压通腑饮组、低腹内压组和高腹内压组48 h生存率分别为90%,60%,50%和35%,低腹内压通腑饮组大鼠48h生存率明显高于其余3组(P均<0. 05),而其余3组间比较差异均无统计学意义(P均> 0. 05)。结论腹内压与腹腔高压症大鼠预后相关,通腑饮可减轻腹腔高压症大鼠炎症反应,其更适用于病情较轻的腹腔高压症治疗。
Objective It is to investigate the effects of Tongfuyin Decoction on the levels of serum tumor necrosis factor-α( TNF-α),interleukin-6( IL-6),endotoxin and prognosis in rats with intra-abdominal hypertension at different intra-abdominal pressure. Methods Healthy adult male Sprague-Dawley rats were randomly divided into low-abdominal pressure Tongfuyin group( group A),high-abdominal pressure Tongfuyin group( group B),low intra-abdominal pressure group( group C) and high intra-abdominal pressure group( group D),with 20 rats in each group. The intra-abdominal pressure of the low-intra-abdominal pressure groups was 20 mm Hg,and the intra-abdominal pressure of the high-intra-abdominal pressure groups was 25 mm Hg,which lasted for 48 hours. After modeling,group A and group B were given Tongfuyin Decoction by clyster,group C and group D were given isothermal saline by clyster,all 5 m L/time,once every 6 hours,until the rats died or 48 hours after modeling. The levels of serum TNF-α,IL-6 and endotoxin were measured before treatment and treatment for 12 h,24 h,48 h in the rats of the 4 groups. The prognosis after treatment for 48 h of the rats in the 4groups was compared by Kaplan-Meier survival curve. Results There was no significant difference in serum TNF-α,IL-6and endotoxin levels between group A and group C,group B and group D before clyster( P > 0. 05),but the levels in high intra-abdominal pressure groups were significantly higher than those in the low intra-abdominal pressure groups( P <0. 05). The levels of serum TNF-α,IL-6 and endotoxin in group A and group B were significantly lower after treatment for12,24,48 h than those before enema( P < 0. 05),but the levels in group C and group D were significantly higher than those before enema( P < 0. 05),and the levels in group D were significantly higher than those in group C( P < 0. 05). The survival rates in group A,group B,group C and group D were 90%,60%,50% and 35%,respectively,the rate of the rats in group A was significantly higher than that in the other 3 groups( P < 0. 05),but there was no significant difference in the rates between the other 3 groups( P > 0. 05). Conclusion Intra-abdominal pressure is related to the prognosis of rats with abdominal hypertension. Tongjiyin Decoction can alleviate the inflammatory reaction in rats with abdominal hypertension,it is more suitable for the treatment of milder abdominal hypertension.
Objective It is to investigate the effects of Tongfuyin Decoction on the levels of serum tumor necrosis factor-α( TNF-α),interleukin-6( IL-6),endotoxin and prognosis in rats with intra-abdominal hypertension at different intra-abdominal pressure. Methods Healthy adult male Sprague-Dawley rats were randomly divided into low-abdominal pressure Tongfuyin group( group A),high-abdominal pressure Tongfuyin group( group B),low intra-abdominal pressure group( group C) and high intra-abdominal pressure group( group D),with 20 rats in each group. The intra-abdominal pressure of the low-intra-abdominal pressure groups was 20 mm Hg,and the intra-abdominal pressure of the high-intra-abdominal pressure groups was 25 mm Hg,which lasted for 48 hours. After modeling,group A and group B were given Tongfuyin Decoction by clyster,group C and group D were given isothermal saline by clyster,all 5 m L/time,once every 6 hours,until the rats died or 48 hours after modeling. The levels of serum TNF-α,IL-6 and endotoxin were measured before treatment and treatment for 12 h,24 h,48 h in the rats of the 4 groups. The prognosis after treatment for 48 h of the rats in the 4groups was compared by Kaplan-Meier survival curve. Results There was no significant difference in serum TNF-α,IL-6and endotoxin levels between group A and group C,group B and group D before clyster( P > 0. 05),but the levels in high intra-abdominal pressure groups were significantly higher than those in the low intra-abdominal pressure groups( P <0. 05). The levels of serum TNF-α,IL-6 and endotoxin in group A and group B were significantly lower after treatment for12,24,48 h than those before enema( P < 0. 05),but the levels in group C and group D were significantly higher than those before enema( P < 0. 05),and the levels in group D were significantly higher than those in group C( P < 0. 05). The survival rates in group A,group B,group C and group D were 90%,60%,50% and 35%,respectively,the rate of the rats in group A was significantly higher than that in the other 3 groups( P < 0. 05),but there was no significant difference in the rates between the other 3 groups( P > 0. 05). Conclusion Intra-abdominal pressure is related to the prognosis of rats with abdominal hypertension. Tongjiyin Decoction can alleviate the inflammatory reaction in rats with abdominal hypertension,it is more suitable for the treatment of milder abdominal hypertension.
引文
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[10]孟凡水,阮长山,成忠了,等.羟乙基淀粉对重症急性胰腺炎合并腹腔高压患者早期腹腔压力及炎症因子的影响[J].中华胰腺病杂志,2015,15(1):1-5
[11]吴苏华,曾沛扬,戚应静,等.大承气汤联合谷氨酰胺对重症患者合并腹腔内高压的疗效观察[J].内蒙古中医药,2014,33(12):16-17
[12]许敏怡,熊秀萍,奚美娟.胃肠功能障碍的中医病因病机探讨[J].吉林中医药,2015,27(8):800-802
[13]刘敏,谷欣,吴虹,等.通腑饮对危重症腹腔内高压症患者腹内压及血清炎症指标变化的影响[J].中国民族民间医药,2017,26(14):104-107
[2]孙发律,李会朋,滕勇生,等.大鼠骨髓间充质干细胞联合大承气汤对重症急性胰腺炎模型大鼠的保护作用及机制[J].世界华人消化杂志,2015,22(26):4167-4176
[3]杨大刚.自拟通腑逐饮祛瘀汤为主综合治疗不完全性肠梗阻临床疗效观察[J].亚太传统医药,2014,10(15):115-116
[4]莫非,赵晓琴,黄宗海,等.腹腔高压对大鼠肝功能的独立影响[J].蛇志,2013,25(1):6-8
[5]赵晓琴,秦志丹,邝晓聪,等. SD大鼠腹腔高压动物模型建立及肝损伤的实验研究[J].中华急诊医学杂志,2013,22(10):1127-1131
[6]王沛云,刘童蕾,曾玉剑,等.腹腔高压作用时间对大鼠肝肾功能的影响[J].广东医学,2017,38(z1):1-4
[7] Dabrowski W,Jaroszynski A,Jaroszynska A,et al. Intraabdominal hypertension increases spatial QRS-T angle and elevates ST-segment J-point in healthy women undergoing laparoscopic surgery[J]. J Electrocardiol,2017,50(2):214-222
[8] Mazzeffi MA,Stafford P,Wallace K,et al. Intra-abdominal Hypertension and Postoperative Kidney Dysfunction in Cardiac Surgery Patients[J]. J Cardiothorac Vasc Anesth,2016,30(6):1571-1577
[9]谷欣,桑云华,龙宏杰.腹内压变化率对评估腹腔内高压症患者病情及预后的价值[J].东南国防医药,2014,19(3):246-248
[10]孟凡水,阮长山,成忠了,等.羟乙基淀粉对重症急性胰腺炎合并腹腔高压患者早期腹腔压力及炎症因子的影响[J].中华胰腺病杂志,2015,15(1):1-5
[11]吴苏华,曾沛扬,戚应静,等.大承气汤联合谷氨酰胺对重症患者合并腹腔内高压的疗效观察[J].内蒙古中医药,2014,33(12):16-17
[12]许敏怡,熊秀萍,奚美娟.胃肠功能障碍的中医病因病机探讨[J].吉林中医药,2015,27(8):800-802
[13]刘敏,谷欣,吴虹,等.通腑饮对危重症腹腔内高压症患者腹内压及血清炎症指标变化的影响[J].中国民族民间医药,2017,26(14):104-107