Study The Intervention Advantage On The SAP In Rats And The Protect Of Intestinal Mucosal Barrier By Using Modified Dachengqi Decoction Through The Whole Course Of SAP

Objective:1、Observing the effects of Modified Dachengqi Decoction on pancreatic necrosis、tumor necrosis factor-α(TNF-α)、high mobility group box protein 1(HMGB1)、blood calcium and liver function of rats with severe acute pancreatitis(SAP).2、Making clear the intervention advantage on the intestinal mucosal barrier by using Modified Dachengqi Decoction through the whole course of SAP compared to just at early stage of SAP.Methods:Establishing SAP model on rats by retrograde injection of 5%sodium taurocholate into biliopancreatic duct through duodenal wall.After the SAP model was established,the rats were divided into model group,early stage group,whole course group and OT group with random number table method,and setting up sham operation group in addition.There were 38 rats in each group.Then the five groups are respectively diveded into four different time point groups:the 4h,6h,24h,48h time point group,and the number of 4h and 6h time point was 7,24h and 48h time point was 12.Each different groups adopted different treatment methods after the model was established.All groups rats were opened abdominal again at 4h,6h,24h,48h time point,observing the tissue of the pancreas,then making pathological scores;taking blood to detect the concentration of serum AMY、TNF-α、calcium and liver function;and detecting the expression of HMGB1 protein in small intestine tissue.Results:1、At 4h,6h,24h,48h,the pathological score of the pancreas of model group,early stage group,OT group,whole course group are higher than sham operation group(P<0.05),but at 4h,there is no significant difference among model group,early stage group,OT group and whole course group(P<0.05);At 6h,the pathological score of the pancreas of early stage group,OT group,whole course group are lower than model group(P<0.05),but there is no significant difference among these three groups(P>0.05);At 24h,48h,the pathological score of the pancreas of OT group and whole course group are lower than model group and early stage group(P<0.05),but there is no significant difference between model group with early stage group(P>0.05),also is OT group with whole course group(P>0.05).2、At 4h,6h,the concentrations of the TNF-a of model group,early stage group,OT group,whole course group are higher than sham operation group(P<0.05),but at 4h,there is no significant difference among model group,early stage group,OT group and whole course group(P<0.05);At 6h,the concentrations of the TNF-a of early stage group,OT group,whole course group are lower than model group(P<0.05),the concentrations of the TNF-a of early stage group,whole course group are higher than OT group(P<0.05),but there is no significant difference between model group with early stage group(P>0.05);At 24h,48h,there is no significant difference between five groups(P>0.05).3、At 4h,6h,24h,48h,the level of HMGB1 in intestinal tissue of model group,early stage group,OT group,whole course group are higher than sham operation group(P<0.05),but at 4h,there is no significant difference among model group,early stage group,OT group and whole course group(P>0.05);At 6h,the level of HMGB1 in intestinal tissue of early stage group,OT group,whole course group are lower than model group(P<0.05),but there is no significant difference among early stage group,OT group and whole course group(P>0.05);At 24h,48h,the level of HMGB1 in intestinal tissue of early stage group,OT group,whole course group are lower than model group(P<0.05),the level of HMGB1 in intestinal tissue of OT group,whole course group are lower than early stage group(P<0.05),but there is no significant difference between OT group and whole course group(P>0.05).4、At 4h,there is no significant difference among sham operation group,model group,early stage group,OT group and whole course group in the concentrations of blood calcium(P>0.05);At 6h,24h,the concentrations of blood calcium of model group,early stage group,OT group,whole course group are lower than sham operation group(P<0.05),but at 6h,there is no significant difference among model group,early stage group,OT group and whole course group(P>0.05);At 24h,the concentrations of blood calcium of OT group and whole course group are higher than model group and early stage group(P<0.05),but there is no significant difference between model group and early stage group(P>0.05),also in OT group and whole course group(P>0.05);At 48h,the concentrations of blood calcium of model group,early stage group,OT group are lower than sham operation group(P<0.05),the concentrations of blood calcium of early stage group,OT group,whole course group are higher than model group(P<0.05),the concentrations of blood calcium of OT group,whole course group are higher than early stage group(P<0.05),but there is no significant difference between OT group and whole course group(P>0.05).5、At 4h,6h,the concentrations of blood ALT、AST of model group,early stage group,OT group,whole course group are higher than sham operation group(P<0.05),the concentrations of blood ALT、AST of early stage group,OT group,whole course group are lower than model group(P<0.05),but there is no significant difference among early stage group,OT group and whole course group(P>0.05);At 24h,48h,the concentrations of blood ALT of model group,early stage group,OT group,whole course group are higher than sham operation group(P<0.05),also in blood AST at 24h;At 24h,48h,the concentrations of blood ALT、AST of early stage group,OT group,whole course group are lower than model group(P<0.05),the concentrations of blood ALT、AST of OT group,whole course group are lower than early stage group(P<0.05),but there is no significant difference between OT group and whole course group(P>0.05);At 48h,the concentrations of blood AST of model group,early stage group,whole course group are higher than sham operation group(P<0.05).6、The AMY in the serum of the blood and ALT、AST are positively correlated(r = 0.771,P<0.001;r = 0.936,P<0.001).7、The AMY in the serum of the blood and calcium are negatively correlated(r =-0.303,P<0.001).8、The area under the ROC curve of calcium is 0.793,high than 0.50(P<0.05).Conclusion:1、Modified Dachengqi Decoction can significantly reduce the pancreatic necrosis degree、effective inhibition the expression of TNF-a and HMGB1,significantly improve the concentrations of blood calcium and liver function inSAP rats;2、Modified Dachengqi Decoction can reduce liver cell damage,improve liver function in SAP rats,which may be related to the role of protecting of intestinal mucosal barrier、reducing bacteria translocation and endotoxin;3、Using Modified Dachengqi Decoction through the whole course of SAP has intervention advantage on reducing the pancreatic necrosis degree and improving the concentrations of blood calcium and liver function compared to just using Modified Dachengqi Decoction at early stage;4、Using Modified Dachengqi Decoction through the whole course of SAP has intervention advantage on inhibiting the expression of HMGB1 protein in intestinal tissue and reducing pancreatitis-associated ascitic fluid,so as to improve the intestinal mucosal barrier function,reduce the permeability of intestinal mucosa,prevent bacterial translocation and secondary infection compared to just using Modified Dachengqi Decoction at early stage.