中药通腑颗粒治疗脓毒症肠衰竭的疗效及机制探讨

doi:10.3969/j.issn.1006-7795.2015.03.032

首都医科大学学报 ›› 2015, Vol. 36 ›› Issue (3): 497-500.doi: 10.3969/j.issn.1006-7795.2015.03.032

中药通腑颗粒治疗脓毒症肠衰竭的疗效及机制探讨

苏艳丽, 王红, 张淑文, 王宝恩, 任爱民, 苗斌, 王超

首都医科大学附属北京友谊医院感染内科, 北京 100050

收稿日期:2014-01-02 出版日期:2015-06-21 发布日期:2015-06-15
通讯作者: 王红 E-mail:msuer@126.com
基金资助:
国家自然科学基金(81173411),北京市科学技术委员会重大科技项目(H020920050130),北京市中医局中西医结合项目(51510).

Exploring therapeutic mechanisms of traditional Chinese medicine Tongfu granule in preventing sepsis-induced intestinal dysmotility

Su Yanli, Wang Hong, Zhang Shuwen, Wang Baoen, Ren Aimin, Miao Bin, Wang Chao

Department of Infection and Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China

Received:2014-01-02 Online:2015-06-21 Published:2015-06-15
Supported by:
This work was supported by National Natural Science Foundation of China(81173411),Beijing Municipal Science Technology Commission Major Sci-tech Program(H020920050130),Integrated Traditional and Western Medicine of Beijing Traditional Chinese Medicine Bureau(51510).

摘要/Abstract

摘要：

胃肠功能衰竭是脓毒症患者常见合并症,流行病学调查研究显示我国重度脓毒症患者中胃肠功能不全的发病率可高达78.8%,是引起脓毒症患者死亡的重要原因.经多年临床研究证实,中药通腑颗粒(专利号:200710122532.2)可提高临床多脏器功能不全患者的肠动力、降低血浆二胺氧化酶(diamine oxidase,DAO)活性、降低D-乳酸水平,提高APACHE Ⅱ评分为8~20分的患者的28天生存率.动物实验研究证实,通腑颗粒可减轻肠道炎性反应,降低促炎因子水平,改善肠道微生态环境,减少肠道淋巴细胞凋亡,改善肠道免疫屏障功能.厚朴酚是通腑颗粒中的有效成分,可通过调节Cajal细胞Kit/SCF信号通路,改善脓毒症患者的肠动力.

关键词: 通腑颗粒, 厚朴酚, 脓毒症, 肠衰竭, Cajal细胞, 免疫

Abstract:

Intestinal dysmotility is the frequent complications in patients with sepsis. Our epidemiological investigation from 37 hospitals in China showed that the incidence of gastrointestinal dysfunction in the severe sepsis patients were 78.8 %. During treatment of gastrointestinal dysfunction in patients with multiple organ dysfunction syndrome (MODS), Tongfu granule (Chinese patents 200710122532.2) treatment was found to enhance the intestinal motility, lower the activity of plasma diamine oxidase (DAO) and level of D-lactic acid, and lower the mortality in 28 days in patients whose APACHE II score was between 8-20. Animal experimental studies showed that in LPS-induced endotoxemia, Tongfu granules were found to protect the intestinal immune function due to reducing the injury of small intestinal mucosa and immune cells and decreasing intestinal lymphocyte apoptosis. In addition, Tongfu granules could protect the intestinal microflora barrier function. Magnolol (5,5-diallyl-2,2-dihydroxybiphenyl) is one of the major active compounds of Tongfu granules. Magnolol treatment was found to prevent by regulating SCF/c-kit and NO signaling to maintain functional interstitial cells of Cajal (ICCs).

Key words: Tongfu granule, magnolol, sepsis, intestinal dysmotility, Cajal cells, immunity

中图分类号:

R285

苏艳丽, 王红, 张淑文, 王宝恩, 任爱民, 苗斌, 王超. 中药通腑颗粒治疗脓毒症肠衰竭的疗效及机制探讨[J]. 首都医科大学学报, 2015, 36(3): 497-500.

Su Yanli, Wang Hong, Zhang Shuwen, Wang Baoen, Ren Aimin, Miao Bin, Wang Chao. Exploring therapeutic mechanisms of traditional Chinese medicine Tongfu granule in preventing sepsis-induced intestinal dysmotility[J]. Journal of Capital Medical University, 2015, 36(3): 497-500.

参考文献

[1] Angus D C, Linde-Zwirble W T, Lidicker J, et al. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care[J]. Crit Care Med, 2001,29(7):1303-1310.
[2] MacFie J, O'Boyle C, Mitchell C J,et al. Gut origin of sepsis: a prospective study investigating associations between bacterial translocation, gastric microflora, and septic morbidity[J]. Gut,1999, 45(2):223-228.
[3] 林瑾,王海曼,李昂,等. 多器官功能障碍综合征患者胃肠功能损伤流行病学调查[J].中国临床医学,2009,16(6):863-864.
[4] Eskandari M K, Kalff J C, Billiar T R, et al. LPS-induced muscularis macrophage nitric oxide suppresses rat jejunal circular muscle activity[J]. Am J Physiol,1999, 277 (2 Pt 1):G478-G486.
[5] Lodato R F, Khan A R, Zembowicz M J, et al. Roles of IL-1 and TNF in the decreased ileal muscle contractility induced by lipopolysaccharide[J]. Am J Physiol, 1999, 276 (6 Pt 1): G1356-G1362.
[6] Torihashi S, Ozaki H, Hori M, et al. Resident macrophages activated by lipopolysaccharide suppress muscle tension and initiate inflammatory response in the gastrointestinal muscle layer[J]. Histochem Cell Biol, 2000, 113(2): 73-80.
[7] de Winter B Y, van Nassauw L, de Man J G, et al. Role of oxidative stress in the pathogenesis of septic ileus in mice[J]. Neurogastroenterol Motil,2005, 17(2):251-261.
[8] 段美丽,董军,陈曦,等. 多器官功能障碍综合征胃肠功能障碍中西医结合治疗——附208例患者的多中心临床疗效观察报告[J].中国中西医结合急救杂志,2009,16(1): 30-33.
[9] Baumgart D C, Dignass A U. Intestinal barrier function[J]. Curr Opin Clin Nutr Metab Care,2002, 5(6): 685-694.
[10] Reilly P M, Wilkins K B, Fuh K C, et al. The mesenteric hemodynamic response to circulatory shock: an overview[J]. Shock, 2001, 15(5):329-343.
[11] Liu C, Li A, Weng Y B, et al. Changes in intestinal mucosal immune barrier in rats with endotoxemia[J]. World J Gastroenterol,2009, 15(46):5843-5850.
[12] 刘冲,李昂,翁以炳,等.内毒素血症大鼠肠组织免疫分子的变化及通腑颗粒的干预作用[J].世界华人消化杂志,2010,18(33):3515-3519.
[13] 刘冲,段美丽,李昂,等.内毒素血症大鼠肠黏膜免疫细胞的变化及通腑颗粒的干预作用[J].胃肠病学和肺病学杂志, 2011,20(2):171-174.
[14] 李丹,任爱民,王红,等. 中药复方通腑颗粒对抗生素相关性肠炎大鼠肠黏膜微生态屏障损伤的保护作用[J].首都医科大学学报,2012,33(3):315-321.
[15] 王贺玲,白菡,王学清,李岩. 厚朴对实验大鼠的胃动力影响[J].实用药物与临床,2007, 10(2):65-66.
[16] 次秀丽,王宝恩,郭昌燕,等.厚朴对正常和内毒素休克大鼠胃肠电活动影响的实验研究[J].中国中医药科技,1999,6(3):154-156.
[17] Wang J P, Ho T F, Chang L C, et al. Antiinflammatory effect of magnolol, isolated from Magnolia officinalis, on A23187-induced pleurisy in mice[J]. J Pharm Pharmacol,1995, 47(10): 857-860.
[18] Yang T C, Zhang S W, Sun L N, et al. Magnolol attenuates sepsis-induced gastrointestinal dysmotility in rats by modulating inflammatory mediators[J]. World J Gastroenterol, 2008, 14(48): 7353-7360.
[19] Shen J L, Man K M, Huang P H, et al. Honokiol and magnolol as multifunctional antioxidative molecules for dermatologic disorders[J]. Molecules, 2010,15(9):6452-6465.
[20] Zhao C, Liu Z Q. Comparison of antioxidant abilities of magnolol and honokiol to scavenge radicals and to protect DNA[J]. Biochimie,2011,93(10):1755-1760.
[21] Zhang W W, Li Y, Wang X Q, et al. Effects of magnolol and honokiol derived from traditional Chinese herbal remedies on gastrointestinal movement[J]. World J Gastroenterol, 2005,11(28):4414-4418.
[22] Jeong S I, Kim Y S, Lee M Y, et al. Regulation of contractile activity by magnolol in the rat isolated gastrointestinal tracts[J]. Pharmacol Res, 2009,59(3): 183-188.
[23] Miao B, Zhang S, Wang H, et al. Magnolol pretreatment prevents sepsis-induced intestinal dysmotility by maintaining functional interstitial cells of Cajal[J]. Inflammation,2013,36(4):897-906.

中药通腑颗粒治疗脓毒症肠衰竭的疗效及机制探讨

Exploring therapeutic mechanisms of traditional Chinese medicine Tongfu granule in preventing sepsis-induced intestinal dysmotility

PDF

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	白若靖, 吕诗韵, 画伟, 吴昊, 代丽丽. LILRB2过表达慢病毒载体以及THP-1-LILRB2稳转细胞株的构建[J]. 首都医科大学学报, 2023, 44(1): 93-98.
[2]	杨敏, 燕翔, 刘锡娟, 安国, 丁慧荣, 蔡英, 葛会争. 人肺癌细胞原位移植瘤小鼠模型免疫细胞的多色流式细胞术检测方法的建立[J]. 首都医科大学学报, 2023, 44(1): 99-106.
[3]	李颖, 陈彪, 王乃利, 郝欣平. 人体内耳冰冻切片免疫组织化学染色技术探讨[J]. 首都医科大学学报, 2022, 43(6): 905-910.
[4]	王芸, 李文坤, 苏珈仪, 王亚丹, 吴静. 系统免疫炎症指数在早期结直肠癌及癌前病变筛查中的应用价值[J]. 首都医科大学学报, 2022, 43(5): 760-766.
[5]	赵越, 阮祥燕, 程姣姣, 谷牧青, 许新, 王月姣. 乳腺癌中PGRMC1表达与临床病理参数的相关性[J]. 首都医科大学学报, 2022, 43(3): 350-356.
[6]	孟欢, 王爽, 何超男, 韩莹, 潘美晨, 殷商启, 郑梅, 金方方, 王雅杰. SAT法检测人巨细胞病毒pp67 mRNA在人类免疫缺陷病毒合并人巨细胞病毒感染患者临床诊疗中的价值探讨[J]. 首都医科大学学报, 2021, 42(5): 739-746.
[7]	高歌, 查旭, 刘伟进, 杨慧. 129位丝氨酸磷酸化α-突触核蛋白DELFIA检测方法的建立及初步应用[J]. 首都医科大学学报, 2021, 42(5): 776-782.
[8]	谭晓刚, 张毅. 新辅助免疫治疗在可切除非小细胞肺癌中的应用前景[J]. 首都医科大学学报, 2021, 42(5): 862-867.
[9]	孙熙木, 王华光, 赵昕, 吕少诚, 贺强, 刘丽宏. 肝移植患者术后巨细胞病毒感染的危险因素分析[J]. 首都医科大学学报, 2021, 42(4): 664-671.
[10]	迟博闻, 王佳伟. 单纯疱疹病毒感染后自身免疫性脑炎的研究进展[J]. 首都医科大学学报, 2021, 42(3): 341-346.
[11]	韩鸿举, 苏子阳, 周玉洁, 王玺. IL-33调控肿瘤免疫微环境中IFN-γ的生物信息学分析[J]. 首都医科大学学报, 2021, 42(2): 243-250.
[12]	李沛霖, 崔磊. 真皮内脂肪组织调控皮肤生理病理过程与机制的研究进展[J]. 首都医科大学学报, 2020, 41(6): 896-900.
[13]	王欣, 张俊璇, 高健, 石汉平. 免疫营养改善肿瘤患者预后[J]. 首都医科大学学报, 2020, 41(6): 1019-1024.
[14]	王菲, 刘海杰, 杨佳, 刘峥, 郝峻巍. 神经免疫之峰的攀登者——郝峻巍教授[J]. 首都医科大学学报, 2020, 41(5): 763-767.
[15]	李默, 韩德强, 赵宇, 陈志国. 使细胞治疗成为攻克疾病的新一代技术手段——陈志国教授[J]. 首都医科大学学报, 2020, 41(5): 778-782.