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目的:研究重症急性胰腺炎(SAP)大鼠促炎抗炎细胞因子TNF-α、IL-1、IL-10不同时间点的动态变化及大黄复方的调节作用,探讨大承气汤治疗SAP的作用机制。方法:采用胰胆管逆行注射5%牛磺胆酸钠法建立大鼠SAP模型。将SD大鼠随机分为假手术组、SAP模型组和大承气汤治疗组,观察各组不同时间点血清淀粉酶、TNF-α、IL-1、IL-10水平。结果:SAP模型组与假手术组比较,血清淀粉酶、TNF-α、IL-1水平均明显升高(P<0.01),IL-10水平降低(P<0.01),TNF-α/IL-10比值降低;大承气汤治疗组与SAP比较,血清淀粉酶、TNF-α、IL-1水平明显降低(P<0.01),IL-10水平不同程度上升(P<0.05,P<0.01),TNF-α/IL-10比值回复接近假手术组水平。结论:大承气汤治疗SAP的作用机制可能通过下调IL-1、TNF-α等促炎细胞因子的释放,并一定程度提高抗炎细胞因子IL-10水平,重建促炎和抗炎细胞因子的平衡,进而减轻组织损伤,阻止SAP的进一步发展。
Objective: To study the dynamic changes of pro-inflammatory and anti-inflammatory cytokines TNF-α, IL-1 and IL-10 in rats with severe acute pancreatitis (SAP) at different time points and the regulatory effect of rhubarb compound Mechanism. Methods: The rat model of SAP was established by retrograde injection of 5% sodium taurocholate into pancreaticobiliary duct. The SD rats were randomly divided into sham operation group, SAP model group and Dachengqi Decoction group. The levels of serum amylase, TNF-α, IL-1 and IL-10 were observed at different time points. Results: The levels of serum amylase, TNF-α and IL-1 in SAP model group were significantly higher than those in sham operation group (P <0.01), IL-10 level was decreased (P <0.01). The level of IL-10 in serum of Dachengqi Decoction group was significantly lower than that of SAP group (P <0.05, P <0.01) , The ratio of TNF-α / IL-10 returned to the level of sham group. Conclusion: The mechanism of Dachengqi Decoction in the treatment of SAP may be through down-regulating the release of proinflammatory cytokines such as IL-1, TNF-α and so on, and to some extent, increase the level of anti-inflammatory cytokines IL-10 and rebuild proinflammatory and anti-inflammatory cytokines Balance, thereby reducing tissue damage, prevent the further development of SAP.