目的:研究补阳还五汤与瑞代合用对脑缺血再灌注老龄大鼠炎症损伤的保护作用及肠道菌检测群的影响。方法:用线拴法建立大鼠大脑中动脉栓塞(MCAO)模型,60只SD大鼠随机分为假手术组、模型组、补阳还五汤组、瑞代组、补阳还五汤与瑞代合用组,连续口服给药7 d,ELISA法检测脑组织中肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、白细胞介素-1β(IL-1β)、脂蛋白相关磷脂酶A2(Lp-PLA2)、超酶C反应蛋白(Hs-CRP),采用酶比色法在全自动生化分析仪测定低密度脂蛋白(LDL-C)和高密度脂蛋白(HDL-C)的含量,流式细胞技术检测T细胞亚群CD3、CD4、CD8及其比例,取大鼠粪便稀释一定浓度后涂布于相应的选择性培养基计数大肠杆菌、双歧杆菌、乳酸杆菌。结果:补阳还五汤组、补阳还五汤与瑞代合用组能显著降低脑组织内IL-1β、TNF-α和IFN-γ的表达,显著降低脑缺血再灌注大鼠血清中Lp-PLA2和Hs-CRP的表达,升高血浆HDL-C含量并降低血浆LDL-C含量,合用组效果更明显(P<0.05);补阳还五汤与瑞代合用组能有效降低CD3+T阳性细胞、增高CD4+T阳性细胞、降低CD8+T阳性细胞,增加CD4/CD8比例;补阳还五汤与瑞代合用组、瑞代组能有效增加乳酸杆菌和双歧杆菌数量,补阳还五汤与瑞代合用组显著降低大肠杆菌数量(P<0.05)。结论:补阳还五汤组、补阳还五汤与瑞代合用组对于脑缺血再灌注损伤中的炎症损伤有较明显的改善作用。其机制与抑制炎症、调节机体免疫功能有关。补阳还五汤与瑞代合用通过调节肠道菌群比例,进一步促进吸收,使补阳还五汤的药效功能更显著。本研究为缺血性中风ICU病患机体运动量少,内分泌紊乱,药物吸收差,药效不明显提供参考治疗方法,也为中药与肠内营养在脑血管方面的用途提供实验依据。 Objective: To study the protective effect of Buyang Huanwu Decoction combined with Rui Dai on the inflammatory injury in the aged rats with cerebral ischemia and reperfusion and the effect of intestinal flora detection group. Methods: The rat model of middle cerebral artery occlusion (MCAO) was established by tethering method. Sixty SD rats were randomly divided into sham operation group, model group, Buyang Huanwu Decoction group, Ruideng group, Buyang Huanwu Decoction The rats in the combined groups were given orally for 7 consecutive days and the levels of TNF-α, IFN-γ, IL-1β, Lipoprotein-associated phospholipase A2 (Lp-PLA2) and hypersensitive C-reactive protein (Hs-CRP) were detected by enzyme-colorimetric assay using automatic biochemical analyzer for determination of low density lipoprotein (LDL- HDL-C) were detected by flow cytometry. T cell subsets CD3, CD4, CD8 and their proportions were detected by flow cytometry. The rat feces was diluted to a certain concentration and applied to the corresponding selective medium for counting E. coli, Bifidobacterium, Lactobacillus. Results: The combination of Buyang Huanwu Decoction, Buyang Huanwu Decoction and Ruideng can significantly reduce the expression of IL-1β, TNF-α and IFN-γ in brain tissue, and significantly reduce the serum levels of IL-1β, Lp-PLA2 and Hs-CRP expression, increased plasma HDL-C levels and lower plasma LDL-C levels, the combination group effect is more obvious (P <0.05); Buyang Huanwu Decoction combined with Ruide can effectively reduce the CD3 + T positive cells, increased CD4 + T positive cells, decreased CD8 + T positive cells and increased the ratio of CD4 / CD8. The combination of Buyang Huanwu Decoction and Ruidai, Rui Dai group can effectively increase the number of Lactobacillus and Bifidobacterium, Buyang Huanwu Decoction combined with Rui Dai significantly reduced the number of Escherichia coli (P <0.05). Conclusion: The combination of Buyang Huanwu Decoction, Buyang Huanwu Decoction and Ruidai can significantly improve the inflammatory injury in cerebral ischemia-reperfusion injury. Its mechanism and inhibition of inflammation, regulating immune function. Buyang Huanwu Decoction combined with Rui Dai by regulating the proportion of intestinal flora, and further promote the absorption, the efficacy of Bu Yang Huanwu Tang more significant. This study provides a reference treatment for ischemic stroke ICU patients with less body movement, endocrine disorders, poor drug absorption, drug efficacy is not obvious, but also provide experimental evidence for the use of traditional Chinese medicine and enteral nutrition in cerebrovascular.