Clinical And Experimental Study On Treatment Of Intestinal Endotoxemia Of Liver Cirrhosis With Bletilla Striata And Its Extract

Part I Effect of Bletilla Striata powder on endotoxin level in patients with decompensated liver cirrhosisObjective To investigate the effect of Bletilla Striata powder on the level of endotoxin in the serum of patients with decompensated liver cirrhosis.Methods Forty patients with decompensated liver cirrhosis were randomly divided into treatment group and control group,20 in each group.The control group was given conventional treatment.The treatment group was given bletilla striata powder on the basis of routine treatment.The patients in both groups all received 2 weeks of treatment.Elisa method was used to detect serum level of endotoxin in both groups.Results After two weeks of treatment,the level of endotoxin in the serum of the two groups were significantly lower than those before treatment(P <0.05).After treatment,the level of endotoxin in the serum of the two groups was lower than that of the control group(P <0.01).Conclusion bletilla striata powder can significantly reduce the level of endotoxin in cirrhotic patients and provide clinical basis for endotoxemia in patients with cirrhosis.Part II Effects of Bletilla Striata Extract-Bletilla Striata Polysaccharide on intestinal endotoxemia of liver cirrhosis ratsObjective To establish a rat model of liver cirrhosis and study the effect of Bletilla Striata Extract-Bletilla Striata Polysaccharide on intestinal endotoxemia of liver cirrhosis rats.Methods The establishment of rat model of liver cirrhosis by TAA intraperitoneal injection,Fifty rats were randomly divided into high,medium and low dose of Bletilla striata polysaccharide group,normal group and model group,10 rats in each group.The corresponding drug intervention was given after 12 weeks of TAA injection,and the model group and the normal group were given equal dose of saline.After 2 weeks of continuous gavage,the rats were killed at the end of the fourteenth week,and serum and ileum specimens were collected.Elisa method was used to detect serum levels of ALT,AST and endotoxin(LPS),The levels of IL-6 and TNF-? in the ileum tissue were detected by Elisa,The m RNA levels of IL-6 and TNF-? in ileum tissue were detected by RT-PCR,The protein expression of IL-6 and TNF-? in ileum tissue were detected by western blot,The histopathological changes in the ileum of rats were observed by HE staining.Immunohistochemical method was used to detect the expression of ZO-1 and occludin.Results Compared with the normal group,the levels of ALT,AST and endotoxin in the serum of the model rats were significantly increased(P < 0.01).Compared with the model group,the levels of ALT,AST and endotoxin in the serum of the treatment group were significantly decreased(P < 0.05).meanwhile,compared with the normal group,the levels of IL-6 and TNF-? in the ileum tissue of the model group were significantly increased(P < 0.01).after treatment with Bletilla striata polysaccharide,the levels of IL-6 and TNF-? in the treatment groups were significantly decreased(P < 0.05).Compared with normal group,at transcriptional level and translation level,the m RNA levels of ZO-1 and occludin in model group were decreased significantly(P < 0.01),while the protein levels of ZO-1 and occludin were decreased significantly(P < 0.01).Compared with the model group,the ZO-1 and occludin m RNA levels in the treatment group were significantly increased(P < 0.05),ZO-1 and occludin protein were increased significantly(P < 0.05),and the expression level increased with the increase of the dose of Bletilla striata polysaccharide.Compared with the normal group,the HE staining in the model group showed that the damage of the intestinal mucosa was serious,the villus was broken and lodged.Compared with the model group,after treatment with Bletilla striata polysaccharide,the destruction of intestinal mucosal reduce.Compared with the normal group,the positive staining area of ZO-1 and occludin in the ileum tissue of the model group was significantly decreased(P < 0.01).Compared with the model group,the positive staining area of ZO-1 and occludin in the ileum tissue of the treatment group was significantly increased(P < 0.05).Conclusion Bletilla striata extract-Bletilla striata polysaccharide can improve the expression of inflammatory cytokines in liver cirrhosis rats,increase the expression of tight junction protein in intestinal mucosa,protect the intestinal mucosa,reduce the level of endotoxin and reduce the liver injury.