The Comparative Study Of Panaxadiol Saponins And Dexamethasone Using In Rats SAP Treatmeatment

The severe acute pancreatitis (SAP) which is much urgent, develops quickly,and changes complicatedly is commonly severe case of general surgery. In recentyears, domestic and international scientists have carried on the thorough researchon it's occurrence mechanism. The etiopathogenesis of the SAP involves invarious factors. Among them, we have done a lot of work in digestive enzymes,microcirculatory changes, damage of Wirsung's canal barrier, the oxygen freeradicals functions.In1988, Rindernecht introduced the theory of excess activationof leukocytes of SAP.He thinked that the reason of pancreatitis causing deathwasn't the autodigestion of pancreatin,but the leukocytes activated excessively inorder to the whole body excesssively inflammatory reaction. The theory got theconfirmation of many experiments and clinical researches in 1990's, of which coreproblem was that mononuclear macrophage, neutrophil, endothelial cells etc. andthe immune system participated, among them, various cytokins class chainreaction was significant. The cytokins class chain reaction that magnifiedcontinuously destroyed the cytokins in the body, and the cytokins promotinginfalamations such as TNF-α, IL-1 exceeded the anti-inflamation cytokins suchas IL-2, IL-10, IL-12. Clinically it appeared systemic inflammatory reactionsyndrome which resulted that the process of pancreas and other tissues or organsaggravated.Recently many study indicates that nuclear regulatory factor-κB (NF-κB) is the main factor of genetic transcription. including chemokine such asadhesion molecule clan etc. Some reseach indicates that high expression of theNF-κB in acute pancreatitis (AP) together with other factors take a immportantrole in generation and turnover of AP.The function of adrenal cortex in AP the possibility is possibly activated, andglucocorticoid (GC) may inhibit the cytokine, and then inhibit the inflammatorydegree of the pancreatitis. Reichlin thinks that there is two-way directtransportation between the immune system and the nerve endocrine system. TNF-α, IL-1 and IL-6 directly excitates synthesis and secretion of ACTH-releasinghormone in hypothalamus,sequently appendix cerebri-adrenal system is activated,and then impairs the intensity of immune reaction through the secretion ofendogenous GC which can inhabit the release of various inflammatory mediumand histoclasia enzyme. GC makes multi-regulatory effect on AP and two-waysregulatory effect on pancreatitic dysimmunity. Accordingly hormone becomes thetreatment of SAP, but it can make serum amylase higher than normal and induceadverse reaction such as immune suppression of hormone. After saponin diolsaponin applys for the treatment endotoxic shock and hemorrhagic shock, itprotects cell membrane obviously, inhabits mediators of inflammation, improvesmicrocirculation, and appears no obvious side effect with regard to DEX. Ourfoundation medical college have been on research about panoxadiol saponin for20 years, up to now we have acquiried the medicine clinic study by the provincialgovernment of Jilin, and now we draw up into the clinical studies, so we plan toapply panoxadiol saponin to the treatment of SAP and compare it with corson inorder to observe its curative effect and therapeutic mechanism.We makes use of bile duct of pancreas injecting 5% sodium taurocholate in order to build up the SAP animal model, after 6hs it appears that the pancreas bleed and necrosis, a great deal of inflammatory cells infiltrate, hemodiastase heightens obviously, the blood calcium lowers;A great deal of uprightness ascites form, pachyhemia, meanwhile lung tissue oedema, liver and renal function lower, spleen blastisation of lymphocyte inhabit; it illustrates that the SAP method of the bile duct of pancreas injecting 5%sodium taurocholate is actually practicable, and it results in lung, liver, kidney, immune system, tiny circulation, etc. injured.During the experiment we successfully applied Sodium Cholate to injectretrogressively to create the SAP model of rats, the rat's pancreas appears to bleedand necrosis, the liver, kidney, small intestines appears injured obviously, a greatdeal of bloody ascites formed, blood concentrated, meanwhile lung tissue dropsy,the function of the liver and kidney descend, lymphoid cells of spleen inhabited; itillustrates that the SAP method of the bile duct of pancreas injecting 5%sodiumtaurocholate is actually practicable, and it results in lung, liver, kidney, immunesystem, tiny circulation, etc. injured.In the animal model multible organsfunctional disturbance appears. the research indicates that the expression of NF-κB of the lung, small intestines, liver and kidney etc. organization appears higherand moves into the cell nucleus,and then starts linkage effect of Inflammatoryreaction, the COX-2expression of tissue increments and results in a great deal ofmediators of inflammation (IL-6, TNF-α) to release, the NO expression oftissue increments. All these factors participats the tissue damage. Because theblood appears concentrated, it aggravates microcirculation disturbance, tissueischemic anoxemia, and the damage of the function. In the model the lung, liver,kidney, small intestines and the lymphocyte conversion ratio invariably have beenobstacled.following the SAP, it appears that the serum amylase and the blood glucosehigehr, the serum calcium lower.After making use of PDS the serum amylase andthe blood glucose appear lower obviously comparing with the SAP group, butDEX has no obvious influence on the serum amylase and the blood glucose. ThePDS, DEX have eaqually no obvious influence. The pancreas of SAP rat appearsto bleed bad dead and a great deal of inflammatory cells infiltration, after theapplication of PDS, DEX, the pathological changes of pancreas have been lessen.Under the kidney mirror of SAP group it is clear that glomcrulus congests,endepidermis of renal tubule dropsy, inflammatory cells infiltrate interstitium. thepathological changes have been lessen after applying the medicine.The rat of SAP appears the pachemia, it represents that the RBC, HBG andHCTs of blood go up obviously. after applying the corson, hemoglobin andhematocrit of the SAP rat have been lessen invariably. Panoxadiol saponin canimprove the pachemia state (also lower the RBC, Hgb & Hct). The two kinds ofmedicine improve pyknemia eaqually. lymphocyte transformation of the SAP isinhabited. after applying corson, it can increase lymphocyte transformation andcellular immune function. The panoxadiol saponin has no obvious influence onlymphocyte transformation.The rat of SAP appears the liver function injured, it represents that the bloodserum ALTand ALB lower obviously. After applying the growth hormone releaseinhibiting hormone the serum ALT has to descend, and After applying the growthhormone, serum albumin can go up, after applying the PDS, the serum ALPincrements. the reason is not pure.The rat of SAP appears the kidney funct ioninjured, it represents that serum urea nitrogen increases obviously. Applying thecorson and panoxadiol saponin can improve azotemia.The SAP appears a great deal of abdominal dropsy, but applying two kindsof medicine has no obvious improvement. The serum mediators of inflammationof SAP go up obviously, which indicates that the creation of a great deal ofmediators of inflammation has the important influence on the process of SAPgeneration and development. Applying the corson and the panoxadiol saponinequally takes a inhibitory action on the generation of mediators of inflammation,accordingly which achieves to protect the rat liver, kidney, the spleen cell immunefunction and microcirculation.The rat model of SAP appears the lung and mucous membrane of smallintestine injured, which represents that the lung histiocyte cavity expands, alveolarwall breakages, effusion and small amounts of empsyxis in alveoli of lung,...