Study Of The Effect Of "Qing Yi Tang" On Motilin, Vasoactive Intestinal Peptide And Interdigestive Myoelectric Complex In Rats With Acute Necrotizing Pancreatitis

Objective By investigating the effect of “Qing Yi Tang” treating acute Necrotizingpancreatitis（ANP） on plasma motilin, vasoactive intestinal peptide and interdigestivemyoelectric complex （IMC） in rats, and then discuss the pathogenesis ongastrointestinal motility disorder of ANP in rats and the role of Qing Yi Tang on it, toprovide the theoretical basis and experimental Foundation for clinical application onQing Yi Tang treating Severe acute pancreatitis（SAP） for improving gastrointestinalmotility disorder in patientsMethods48SD rats were divided into three groups randomly by sortition:16ratswere selected into ANP group, Qing Yi Tang （QYT） group and sham operative（SO）group respectively. All rats in ANP group and QYT group were set up ANP model byinjecting5%sodium taurocholate （0.1ml/100g） under the pancreatic envelope, SOgroup were performed operation to flip the pancreas. After setting up the model, allrats were planted a couple of silver electrode on gastric sinus anterior wall submergedserosa, the distance between electrodes and pylori is about1.0centimeter, fixed theelectrodes firmly, then led the couple of silver electrode to the back of the neck fromthe subcutaneous tunnel and fixed. After modeling and closed abdomen, QYT groupwere indoctrinated Qing Yi Tang（1ml/100g） into stomach, SO group and ANP groupwere indoctrinated normal saline（1ml/100g） instantly and12hours1atercorrespondingly. All rats after modeling are fasting, each was given5%glucose andsodium chloride fluid （2ml/100g） by subcutaneous injection every other6hour. Allrats were recorded interdigestive myoelectric complex after24hours and werere-operated for observing the general changes of ascites, saponified spots,pancreasand gastrointestinal tract, measured the concentration of serum motilin （MTL） andvasoactive intestinal peptide （VIP） of Portal vein blood, and taken pancreatic tissue pathology review and score.Results （1）Celiac general situation：Hemorrhagic ascites,saponified spots,lamellarhemorrhage and necrosis of pancreas, significant expansion of the gastrointestinaltract and gastric retention could be observed in rats of ANP group; Light hemorrhagicascites, saponified spots, punctiform or lamellar hemorrhage and necrosis on pancreascould be found in QYT group, but the expansion of the gastrointestinal tract andgastric retention are lighter than ANP groups; SO group did not has these changes.（2）The concentration of AMY in serum: The concentration of AMY in serum ofANP group and QYT group were significantly higher than that of SO group（P <0.01）.And the concentration of AMY in serum of QYT group was significantly lower thanthat of ANP group（P<0.01）.（3）The concentration of Ca²⁺in serum: The concentration of Ca²⁺in serum of ANPgroup and QYT group were significantly lower than that of SO group（P <0.01）. Andthe concentration of Ca²⁺in serum of QYT group was significantly higher than that ofANP group（P<0.01）.（4）The concentration of motilin in serum: The concentration of motilin in serum ofANP group was significantly lower than that of SO group（P <0.01）.The concentrationof motilin in serum of QYT group was significantly higher than that of ANPgroup（P<0.01）.However, the difference of the concentration of motilin between QYTgroup and SO group was not significantly（P＞0.05）.（5）The concentration of vasoactive intestinal peptide in serum: The concentration ofvasoactive intestinal peptide in serum of ANP group was significantly higher than thatof SO group（P <0.01）.The concentration of vasoactive intestinal peptide in serum ofQYT group was significantly lower than that of ANP group（P<0.05）.However, theconcentration of vasoactive intestinal peptide in serum of QYT group wassignificantly higher than that of SO group（P <0.05）.（6）The change of each phase and cycle of interdigestive myoelectric complex（IMC）:The cycle of IMC of ANP group was significantly extended than that of QYT groupand SO group（P <0.01）; Ⅰand Ⅱphase time of ANP Group were significantly extended than that of QYT group and SO group（P <0.01）; Ⅲ phase time of ANPGroup were significantly shortened then that of QYT group and SO group（P <0.01）.（7）The change of the amplitude and frequency of peak electric of Ⅲ phase of IMC:The amplitude and frequency of peak electric of Ⅲ phase of IMC of ANP group wassignificantly less than that of QYT group and SO group（P <0.01or P <0.05）.（8）The pathological review of the pancreas: Hemorrhage and necrosis of thepancreas tissue was significant, a large number of inflammatory cells infiltrated, mostof the normal gland structure disappeared, obvious thrombosis in pancreatic vascular,these could be observed in rats of ANP group; Hemorrhage and necrosis of thepancreas tissue,a number of inflammatory cells infiltrated, a part of the normal glandstructure disappeared, these could be observed in rats of QYT group; The glandstructure of the pancreas is normal, acinar cells integrity, no necrosis, hemorrhage andno inflammatory cells infiltrated, these could be observed in rats of SO group.（9）The pathological score of the pancreas: The pathological score of the pancreas ofANP group was significantly higher than that of QYT group and SO group（P <0.01）.（10）Correlation analysis: The concentration of MTL ofANP group showing positivecorrelation with the time of III phase of IMC （r=0.967）（p﹤0.01）, the concentrationof VIP of ANP group showing negative correlation with the time of III phase of IMC（r=-0.592）（p﹤0.05）; The pathological score of the pancreas of ANP group wasnegative correlation with the time of III phase of IMC （r=-0.736）（p﹤0.01）.Conlusions （1）Compared with SO group，Ⅲ phase time of ANP Group wereshortened and the cycle of IMC of ANP group was significantly extended, It indicatesthat there is gastrointestinal motility disorder in ANP rats.（2） Compared with SO group, the concentration of gastrointestinal hormones suchas MTL and VIP would chang in rats with ANP, and Ⅲ phase time of ANP Groupwere shortened, and the change of them were correlative. It indicates thatgastrointestinal hormones disorder could be a reason of gastrointestinal motilitydisorder in ANP rats.（3）Compared with ANP group, the concentration of MTL and VIP would chang in rats with QYT, and Ⅲ phase time were extended. It indicates that the “Qing YiTang” could accommodate the concentration of gastrointestinal hormones such asMTL and VIP, and then improve the gastrointestinal motility.