麻杏石甘汤对铜绿假单胞菌肺炎大鼠细菌清除效应及中性粒细胞浸润和炎症因子的影响

Effection of Maxing Shigan Tang on bacterial clearance，polymorphioc neutrophils infiltration，and inflammatory factors in rats with pseudomonas aeruginosa pneumonia

关键词:  麻杏石甘汤  铜绿假单胞菌  肺炎  细菌清除  中性粒细胞  炎症因子

Key words:  Maxing Shigan Tang  pseudomonas aeruginosa  pneumonia  bacterial clearance  neutrophil  inflammatory factor

摘要:

[目的] 观察麻杏石甘汤对铜绿假单胞菌（PA）肺炎大鼠细菌清除效应及炎症因子和中性粒细胞（PMNs）浸润的影响。[方法] 选取雄性SD大鼠120只，随机分为5组（空白组、模型组、西药组、中药组、中西医结合组），每组24只，采用气管滴注法，建立肺炎模型，空白组和模型组予生理盐水灌胃，西药组肌注头孢他啶，中药组予麻杏石甘汤浓缩煎剂灌胃，中西医结合组采用肌注头孢他啶联合麻杏石甘汤浓缩煎剂灌胃，分4个时点（造模后0、12、24、72 h）处死大鼠，每组每个时点处死6只，取肺组织及腹主动脉血，观察肺组织病理改变、检测肺组织匀浆细菌计数、髓过氧化物酶（MPO）表达、外周血PMNs、血清肿瘤坏死因子-α（TNF-α）、白细胞介素-8（IL-8）、白细胞介素-10（IL-10）水平。[结果] 1）造模后各组组内前后时点比较，模型组和药物干预组（西药组、中药组和中西医结合组）肺部炎症均逐渐改善，肺组织细菌计数均逐渐下降，差异具有统计学意义（P＜0.05）；72 h时点，药物干预组与模型组比较，肺部炎症均明显改善，肺组织细菌计数均降低，差异具有统计学意义（P＜0.05）。2）外周血PMNs计数，模型组和西药组呈持续上升趋势，中药组和中西医结合组呈先上升后下降趋势，不同时点组间比较，差异无统计学意义（P＞0.05）。3）肺组织MPO表达量，模型组呈先上升后下降趋势，药物干预组均呈下降趋势；72 h时点，药物干预组MPO表达量低于模型组，差异有统计学意义（P＜0.05）。4）炎症因子比较，造模后72 h内，模型组和药物干预组血清IL-10水平均呈上升趋势，72 h时点，中药组和中西医结合组IL-10水平均高于模型组，差异有统计学意义（P＜0.05）；造模后0、12、24 h，模型组和药物干预组血清TNF-α、IL-8水平均呈上升趋势，24 h后，中药组和中西医结合组TNF-α呈下降趋势，药物干预组IL-8均呈下降趋势，72 h时点，药物干预组TNF-α水平较模型组均降低，差异具有统计学意义（P＜0.05）。[结论] 麻杏石甘汤可促进机体清除PA，减少肺组织PMNs浸润，调节血清炎症因子TNF-α、IL-8、IL-10水平，减轻肺部炎症损伤。

Abstract:

[Objective] To observe the effection of Maxing Shigan Tang on bacterial clearance，inflammation factors， and polymorphic neutrophils（PMNs） infiltration in rats with Pseudomonas aeruginosa（PA） pneumonia. [Methods] 120 male SD rats were randomly divided into 5 groups （blank group，model group，western medicine group，Chinese medicine group，and integrated Chinese and western medicine group）. 24 rats were divided into each group. The pneumonia model was established with tracheal instillation. The blank group and model group were given saline by gavage，the western medicine group was injected with cefotaxime，the Chinese medicine group was given Maxing Shigan Tang concentrated decoction by gavage，and the integrated Chinese and western medicine group was given cefotaxime and Maxing Shigan Tang concentrated decoction by gavage. Rats were sacrificed at 4 time points（0 h， 12 h，24 h，and 72 h after modeling），with 6 rats in each group at each time point. Lung tissue and abdominal aortic blood were collected to observe the pathological changes in lung，to detect the bacterial counts in lung，the expression of MyeloPeroxidase（MPO），the PMNs in blood，and the levels of Tumour necrosis factor alPha（TNF-α）， Interleukin-8（IL-8） and Interleukin-10（IL-10）. [Results] 1） Within-group comparisons before and after modeling showed that the inflammation in lung gradually improved and lung tissue bacterial counts gradually decreased in the model group and drug intervention groups（western medicine group，traditional Chinese medicine（TCM） group，and integrated Chinese and western medicine group）（P＜0.05）. At the 72 h time point，compared with the model group， the inflammation in lung was significantly improved and lung tissue bacterial counts were significantly reduced in the drug intervention groups（P＜0.05）. 2） The PMNs counts in peripheral blood showed a continuous upward trend in the model group and western medicine group，and a trend of increasing and decreasing in Chinese medicine group and integrated Chinese and western medicine group，with no significant differences between groups at different time points（P＞0.05）. 3） The expression of MPO in lung showed a trend of increasing and decreasing in the model group， which was a decreasing trend in the drug intervention groups. At the 72 h time point，the expression of MPO in the drug intervention groups was significantly lower than that in the model group（P＜0.05）. 4） In terms of inflammation factors，the levels of IL-10 showed an upward trend in the model group and drug intervention groups within 72 h，and at the 72 h time point，the levels of IL-10 in the Chinese medicine group and integrated Chinese and western medicine group were significantly higher than those in the model group（P＜0.05）. The levels of TNF-α and IL-8 showed an upward trend in the model group and drug intervention groups at 0 h，12 h，and 24 h after modeling. After 24 h，the levels of TNF-α in Chinese medicine group and integrated Chinese and western medicine group showed a downward trend，and the levels of IL-8 in the drug intervention groups showed a downward trend. At the 72 h time point，the levels of TNF-α in the drug intervention groups were significantly low（P＜0.05）. [Conclusion] Maxing Shigan Tang can promote the clearance of pseudomonas aeruginosa，reduce the infiltration of PMNs in lung tissue，regulate the levels of inflammation factors（TNF-α，IL-8，and IL-10） in serum，and alleviate lung inflammation damage.