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目的观察芪黄煎剂对大鼠胃切除后小肠黏膜免疫屏障的影响。方法将60只Wistar大鼠随机分为假手术组、模型组、芪黄煎剂组(中药组),每组20只。模型组与中药组均行胃切除手术,模型组术后给予小肠内滴注肠内营养制剂能全素;中药组予小肠内滴注能全素和中药芪黄煎剂。假手术组仅行腹部正中切开及关腹处理,术后正常进食水,不予药物及营养干预。干预1周后,分离出大鼠小肠集合淋巴小结(Peyer’s patches,PPs)细胞、固有层淋巴细胞(lamina propria lymphocytes,LPLs)、黏膜上皮内淋巴细胞(intraepithelial lymphocytes,IELs)和肠腔黏膜表面分泌型免疫球蛋白A(secretory IgA,s IgA),应用流式细胞术、免疫组织化学、双抗体-PEG放射免疫等技术,检测肠黏膜不同解剖部位T细胞抗原受体(αβT cell antigen receptor)-CD3~+、CD4~+、CD8~+T细胞比例、IgA~+B细胞数量、s IgA含量。结果与假手术组比较,模型组肠黏膜s IgA含量、PPs中IgA~+B细胞数量和LPLs中IgA~+B细胞数量均降低(P<0.01);模型组IELs中CD3~+、CD8~+T细胞比例,LPLs中CD3~+、CD4~+、CD8~+T细胞比例,PPs中CD3~+、CD4~+T细胞比例降低(P<0.01,P<0.05)。与模型组比较,中药组肠黏膜s IgA含量、PPs中IgA~+B细胞数量和LPLs中IgA~+B细胞数量升高(P<0.01,P<0.05),中药组IELs中CD3~+、CD8~+T细胞比例,LPLs中CD3~+、CD4~+T细胞比例,PPs中CD3~+、CD4~+T细胞比例升高(P<0.01,P<0.05)。结论芪黄煎剂能促进大鼠胃切除术后小肠黏膜免疫屏障中CD3~+、CD4~+、CD8~+T、IgA~+B淋巴细胞的增殖与分化及s IgA含量的增加,能够促进大鼠胃切除术后肠道免疫屏障功能障碍的恢复。
Objective To observe the effect of Qili Huang decoction on intestinal mucosal immune barrier after gastrectomy in rats. Methods Sixty Wistar rats were randomly divided into sham operation group, model group and Qihuang decoction group (TCM group), with 20 rats in each group. Gastrectomy was performed in the model group and the traditional Chinese medicine group. Enteral infusion of enteral nutrition was given to the small intestine in the model group after operation. The traditional Chinese medicine group was given intravenous drip of veterinary medicine and Qihuang decoction. Sham-operated group only underwent midline abdomen incision and closed abdomen treatment, normal postoperative water intake, no medication and nutrition intervention. One week after the intervention, Peyer’s patches (PPs), lamina propria lymphocytes (LPLs), intraepithelial lymphocytes (IELs) and intestinal mucosal surface secretion The secretory IgA (s IgA) was detected by flow cytometry, immunohistochemistry and double antibody-PEG radioimmunoassay to detect the expression of T cell antigen receptor- CD3 ~ +, CD4 ~ +, CD8 ~ + T cell ratio, IgA ~ + B cell number, s IgA content. Results Compared with sham operation group, the content of IgA ~ + B cells in intestinal mucosa and the number of IgA ~ + B cells in LPLs in model group were significantly decreased (P <0.01). In model group, CD3 ~ + and CD8 ~ (P <0.01, P <0.05). The percentage of CD3 ~ +, CD4 ~ + and CD8 ~ + T cells in LPLs and the percentage of CD3 ~ + and CD4 ~ + T cells in PPs decreased. Compared with the model group, the content of IgA ~ + B cells in the intestinal mucosa and the number of IgA ~ + B cells in the LPLs increased (P <0.01, P <0.05) (P <0.01, P <0.05). The percentage of CD3 ~ +, CD4 ~ + T cells in LPLs and the proportion of CD3 ~ + and CD4 ~ + T cells in PPs increased. Conclusion Qilihuang decoction can promote the proliferation and differentiation of CD3 ~ +, CD4 ~ +, CD8 ~ + T, IgA ~ + B lymphocytes and the increase of s IgA in gut mucosal immune barrier after gastrectomy in rats, which can promote Recovery of intestinal immune barrier dysfunction after gastrectomy in rats.