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目的:从胃动力角度探讨丁香降气方治疗反流性食管炎的作用机制。方法:采用贲门肌切开加幽门半结扎术制作酸反流性食管炎大鼠模型;中药组予丁香降气方颗粒剂混悬液灌胃,西药组予吗丁啉混悬液灌胃,模型组和假手术组予以等量的生理盐水灌胃。半固体排空检测法测定胃排空,免疫组化法观察胃体、胃窦C-kit阳性Cajal间质细胞(ICC)的变化。结果:①胃内残留率:模型组较假手术组高(P<0.01);中药组和西药组较模型组降低(P<0.05,P<0.01),中药组低于西药组(P<0.05)。②胃体、胃窦平滑肌层间、肌层内ICC计数:模型组较假手术组减少(P<0.01);中药组和西药组较模型组增多(P<0.05,P<0.01);中药组胃体平滑肌层间ICC计数多于西药组(P<0.01)。结论:①反流性食管炎大鼠存在胃排空延迟,胃体、胃窦平滑肌层间和肌层内ICC数量减少,可能是引起胃节律性电活动异常,胃动力下降,胃排空延迟的重要机制。②丁香降气方通过增加胃体、胃窦平滑肌层间、肌层内的ICC数量,能促进胃排空,改善胃动力,治疗反流性食管炎。
Objective: To investigate the mechanism of clove down-gas recipe in treating reflux esophagitis from the perspective of gastric motility. Methods: The rat model of acid reflux esophagitis was established by incisional cardia musculotomy and pyloric half-ligation. The rats in the Chinese herb group were treated with the suspension of clove Jiangqijie Granules, the rats in the western medicine group were given gavagen suspension, The model group and sham operation group were given the same amount of saline gavage. Gastric emptying was measured by semi-solid emptying assay. The changes of C-kit positive Cajal interstitial cells (ICC) in gastric and gastric antrum were observed by immunohistochemistry. Results: (1) The gastric residual rate was higher in the model group than that in the sham operation group (P <0.01); the Chinese medicine group and the western medicine group were lower than the model group (P <0.05, P <0.01) ). (2) The ICC counts in gastric mucosa, gastric smooth muscle and intramuscular layer were lower in model group than those in sham operation group (P <0.01); those in traditional Chinese medicine group and western medicine group were more than those in model group (P <0.05, P <0.01) The ICC counts in gastric smooth muscle layer were more than those in western medicine group (P <0.01). Conclusion: (1) Delayed emptying of gastric cavity in reflux esophagitis rats results in the decrease of ICC in the layers of gastric body, gastric antrum and smooth muscle layer, possibly resulting in the abnormal gastric rhythmic electrical activity, decreased gastric motility and delayed gastric emptying The important mechanism. ② clove down the side by increasing gastric body, gastric antral smooth muscle layer, the number of intramuscular ICC, can promote gastric emptying, improve gastric motility, the treatment of reflux esophagitis.