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[目的]研究重症急性胰腺炎(SAP)大鼠促炎抗炎细胞因子和外周血γδT细胞的变化及大承气汤的调节作用,探讨大承气汤治疗SAP的作用机制。[方法]采用胰胆管逆行注射5%牛磺胆酸钠法建立大鼠SAP模型。将SD大鼠随机分为假手术组、SAP模型(模型)组和大承气汤治疗(治疗)组,观察各组不同时间点血清淀粉酶、肿瘤坏死因子α(TNF-α)、白细胞介素10(IL-10)水平及外周血CD3、γδT细胞百分率。[结果]模型组与假手术组比较,血清淀粉酶、TNF-α水平明显升高(P<0.01),IL-10水平及CD3、γδT细胞百分率降低(P<0.01),TNF-α/IL-10比值降低;治疗组与模型组比较,血清淀粉酶、TNF-α水平明显降低(P<0.01),IL-10水平不同程度上升(P<0.05,<0.01),TNF-α/IL-10比值回复接近假手术组水平。CD3百分率有不同程度上升(P<0.05),γδT细胞百分率没有明显变化。[结论]大承气汤治疗SAP的作用结果可能为改善机体的免疫状态,重建促炎抗炎细胞因子的平衡,进而减轻SAP的炎症反应。
[Objective] To study the changes of pro-inflammatory and anti-inflammatory cytokines and peripheral blood γδT cells in rats with severe acute pancreatitis (SAP) and the regulatory effect of Dachengqi Decoction. To explore the mechanism of Dachengqi Decoction in the treatment of SAP. [Methods] Rat SAP model was established by retrograde injection of 5% sodium taurocholate into pancreatic duct. SD rats were randomly divided into sham operation group, SAP model group and Dachengqi Decoction treatment group. Serum amylase, tumor necrosis factor-α (TNF-α), and leukocytes were observed at different time points in each group. The level of IL-10 and the percentage of CD3 and γδ T cells in peripheral blood. [Results] Compared with the sham-operated group, the levels of serum amylase and TNF-α in the model group increased significantly (P<0.01), and the levels of IL-10 and the percentage of CD3 and γδT cells decreased (P<0.01). TNF-α/IL The ratio of -10 decreased; the levels of serum amylase and TNF-α were significantly lower in the treatment group than in the model group (P<0.01), and the levels of IL-10 increased in different degrees (P<0.05, <0.01). TNF-α/IL- The 10 ratio returned to near the sham group level. The percentage of CD3 increased to varying degrees (P<0.05), and the percentage of γδT cells did not change significantly. [Conclusion] The effect of Dachengqi Decoction on the treatment of SAP may be to improve the immune status of the body, reconstruct the balance of proinflammatory and anti-inflammatory cytokines, and reduce the inflammatory response of SAP.