Effect Of Dachengqi Decoction Combined With Lactobacillus Acidophilus On Gastrointestinal Function Of Mice With Severe Head Injury

The incidence of gastrointestinal dysfunction after severe head injury(SHI) is80%. It isnot only restricting the implementation of the early enteral nutrition, leading to malnutritionand low immunity, which still can cause intestinal flora disorder, bacterial translocation,increase systemic inflammatory response syndrome(SIRS) and even occur multiple organdysfunction syndrome(MODS). Therefore, the prevention and treatment of gastrointestinaldysfunction will have a profound significant on reducing the related complications of SHI.Previous research has shown that probiotics could improve gastrointestinal dysfunction andpromote the recovery of gastrointestinal motility after SHI, but it’s a moderate role. Basic andclinical study indicate that dachengqi decoction(DCQD) is promoting gastrointestinal motilityoutstanding, which also can have the role of protecting the mucosal barrier. But its power isintensity, cause easily diarrhoea without end and more than insufficiency of the yin-blood,which will restricted the application in trauma patients. So we speculate that dachengqidecoction and probiotics are used in combination, which can effectively promotegastrointestinal motility recovery, protect intestinal mucosa barrier, prevent bacterialtranslocation, and also can improve the intestinal flora disturbance, to prevent the occurrenceof causing diarrhea too hard with dachengqi decoction, which can play dachengqi decoctionand probiotics as an important role on improving gastrointestinal function of SHI patientsbetter. This study was undertaken to observe the effect of dachengqi decoction combined withLactobacillus acidophilus(LA) on recovering gastrointestinal function of mice with SHI, inorder to providing fresh thinking for improving gastrointestinal function after SHI in Clinical.MethodsAccording to random number table method,150male C57BL/6mice were divided into6groups, including sham injury group, normal saline group, DCQD group, LA group,DCQD+LA group,1/2DCQD+LA group, which were freedom of food and drink, gastricperfusion twice a day. Only was sham injury group opened the bone window not to hit, the rest of the group were established SHI model in accordance with the modified method offree fall. DCQD group was given dachengqi decoction0.4ml/d. LA group was givenLactobacillus acidophilus more than1×1010cfu/d. DCQD+LA group was givenLactobacillus acidophilus with the same dosage and method of LA group, after4h offeeding DCQD.1/2DCQD+LA group was given half dosage of dachengqi decoction, whilethe rest of the method is the same as DCQD+LA group. At the same time, sham injurygroup and NS group was fed the same amount of normal saline. Respectively, afterintervention the time of1d,3d,7d, detecting the plasmatic diamine oxidase (DAO), D-lacticacid and motilin (MTL) contents, occludin protein expression of intestinal epithelium andthe number of small intestine interstitial cells of Cajal (ICC), and observing networkstructure of ICC and change of enteric nervous system-ICC-smooth muscle cell(ENS-ICC-SMC) network morphology.Results1. The effect of dachengqi decoction combined with Lactobacillus acidophilus on theintestinal mucosa barrier of mice with SHI1.1Western blot for detecting the change of Intestinal epithelium occludin proteinexpressionCompared with NS group, the expression of occludin protein was significantlyincreased in1/2DCQD+LA group in the first day of injury and DCQD+LA group after1d,3d,7d of injury(P<0.05).1.2Change of the plasmatic diamine oxidase and D-lactic acid contentsAfter3d,7d of injury, compared with NS group, DAO content were lower in LA group,DCQD group and DCQD+LA group (P<0.05). After1d,3d of injury, compared with NSgroup, D-lactic acid content were obviously lower in LA group and1/2DCQD+LA group(P<0.05). After1d,3d,7d of injury, compared with NS group, D-lactic acid content wereobservably lower in DCQD group and DCQD+LA group(P<0.05).2. The effect of dachengqi decoction combined with Lactobacillus acidophilus on thegastrointestinal motility of mice with SHI2.1Transmission electron microscopy (sem) technology for observation of the changeof ENS-ICC-SMC network morphology The phenomenon of the remarkable decreasing of nerve fiber bundle, the tumidness ofsmooth muscle cells, the destruction of structure, the lessen or disappearance of ICC neurite,the dilated intercellular space between peripheral nerve and smooth muscle cells,ENS-ICC-SMC network structure had been heavily damaged in NS group after SHI. Thesituation of above was improved with giving drug intervention, even complete networkstructure could be seen in mice of DCQD+LA group and1/2DCQD+LA group.2.2Immunofluorescence staining for detecting the change of the number and networkstructure of ICC2.2.1ICC network structureICC network was crowded together in sham injury group. The network structure wasdestroyed, network noticeably sparse branching hurt less than sham injury group. The ICCnetwork was considerably dense than NS group with giving drug intervention. After7d ofinjury,the situation was much better in DCQD+LA group, the network structure of which issimilar as sham injury group.2.2.2The number of ICCAfter7d of injury, the number of ICC in DCQD group, LA group and1/2DCQD+LAgroup were more than NS group(P<0.05). After1d,3d,7d of injury, the number of ICC inDCQD+LA group were higher than NS group(P<0.05). After1d,7d of injury, the numberof ICC in DCQD+LA group were higher than DCQD group and1/2DCQD+LA group (P<0.05).2.3Change of the plasmatic MTL contentsAfter1d of injury, the contents of LA group were higher than NS group(P<0.05). After3d of injury, the contents of DCQD+LA group were more than both NS group and DCQDgroup(P<0.05). After7d of injury, the contents of DCQD group were obviously higher thanNS group, LA group(P<0.05) and DCQD+LA group (P<0.01).Conclusion1.The decrease of the intestinal epithelial tight junction occludin protein expressionafter SHI, Intestinal mucosal barrier was damaged and increased permeability of intestinalmucosa, the plasmatic DAO and D-lactic acid contents. Dachengqi decoction combinedLactobacillus acidophilus can repair intestinal mucosal barrier better than using Dachengqidecoction or Lactobacillus acidophilus solely, which were closely related to both of them could enhance the expression of occludin protein, protect the intestinal mucosal mechanicalbarrier, drop the permeability of intestinal mucosa.2.Gastrointestinal motility disorders after SHI were caused by the following reasons,the number of ICC was decreased and network structure was destroyed, ENS-ICC-SMCnetwork were damaged, MTL was dyssecretosis. Dachengqi decoction combinedLactobacillus acidophilus were able to recover gastrointestinal motility better than usingDachengqi decoction or Lactobacillus acidophilus solely, concerned with both of themcould reduce the degree of reduction in the number of ICC, repair the damaged networkstructure, maintain network morphology of ENS-ICC-SMC completely and adjust thesecretion of MTL.3. Rather than the large amount of half dachengqi decoction combined Lactobacillusacidophilus, dachengqi decoction combined Lactobacillus acidophilus have much bettereffect of improving intestinal mucosal barrier and gastrointestinal motility with SHI.