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目的观察辛开苦降法对反流性食管炎(reflux esophagitis,RE)模型大鼠食管黏膜细胞间隙的影响。方法 100只Wistar大鼠按照随机数字表法分为对照组、模型组、西药组、中药组,每组25只,共4组。对照组只行腹腔开关术,其余3组均采用改良部分贲门肌切开加外置幽门部分结扎术,制备RE大鼠模型。术后第3天西药组灌胃混合剂:吗丁啉片(3.2 mg/kg)+奥美拉唑胶囊(4.3 mg/kg)+铝碳酸镁片(161.4mg/kg),中药组灌胃半夏泻心汤加减汤剂(5.7 g/kg),1次约2.5 m L,1天2次,连续14天;同时对照组和模型组大鼠每天给予灌胃等量生理盐水。观察实验第7、14天各组模型食管下段p H值、黏膜大体标本、病理组织学变化,并测量各组食管黏膜上皮细胞间隙进行对照研究。结果与本组治疗第7天比较,西药组和中药组在第14天大鼠食管下段p H值均升高(P<0.01),食管黏膜肉眼积分均降低,上皮细胞间隙亦降低(P<0.05)。与对照组同期比较,模型组大鼠食管下段p H值均降低(P<0.01),模型组大鼠食管黏膜肉眼积分升高,上皮细胞间隙亦升高(P<0.01)。与模型组同期比较,中药组和西药组第7、14天大鼠食管下段p H值升高,食管黏膜肉眼积分降低(P<0.01),中药组和西药组第14天大鼠食管黏膜上皮细胞间隙亦降低(P<0.01)。与西药组同期比较,中药组第7天大鼠食管下段p H值降低(P<0.05),中药组第14天大鼠食管黏膜肉眼积分和上皮细胞间隙均降低(P<0.05)。结论辛开苦降法对RE动物模型有良好的治疗作用,并随疗程增加效果更加明显,其机制可能是通过对损伤黏膜良好的修复作用、增加下食管括约肌的压力及抑制胃酸实现的。
Objective To observe the effect of Xinkai biting method on esophageal mucosal cell gap in reflux esophagitis (RE) model rats. Methods 100 Wistar rats were randomly divided into control group, model group, western medicine group and traditional Chinese medicine group with 25 rats in each group. The control group only underwent abdominal surgery, and the remaining three groups were treated with modified partial cardiomyotomy plus external pyloric ligation to prepare RE rat model. On the 3rd day after operation, the rats in the traditional Chinese medicine group were given gavage (3.2 mg / kg), omeprazole capsules (4.3 mg / kg) and aluminum magnesium carbonate tablets (161.4 mg / kg) Banxiaxiexin Decoction (5.7 g / kg), once about 2.5 m L twice a day for 14 days; the same time, the control group and the model group rats were given the same daily dose of saline. On the 7th and 14th day after operation, the p value of the lower esophagus, gross mucosa and histopathological changes in the esophageal mucosa were observed. The esophageal mucosal epithelial cells in each group were measured for the control study. Results Compared with the 7th day of treatment, the p value of esophageal lower segment of western medicine group and traditional Chinese medicine group were all increased on the 14th day (P <0.01), the esophageal mucosa ’s macroscopic integral decreased and the gap of epithelial cells also decreased (P < 0.05). Compared with the control group, p H value in the lower esophagus of the model group was decreased (P <0.01). The esophageal mucosal macroscopic integral of the model group was increased and the gap between the epithelial cells was also increased (P <0.01). Compared with the model group, the p value of esophageal mucosa in the lower esophagus and the esophageal mucosa decreased on the 7th and the 14th day in the traditional Chinese medicine group and western medicine group (P <0.01) Intercellular space also decreased (P <0.01). Compared with western medicine group, the p value of esophageal lower segment in Chinese medicine group decreased on the 7th day (P <0.05), and the esophageal mucosal integral and epithelial cell gap of Chinese medicine group decreased on the 14th day (P <0.05). Conclusion Xinkai biting method has a good therapeutic effect on animal model of RE, and its effect is more obvious with the increase of course of treatment. The mechanism may be that it can increase the pressure of the lower esophageal sphincter and inhibit the gastric acid through the good repairing effect on injured mucosa.