Influencing Of Shugan Liqi, Nourishing The Liver And Qinggan Lishi On Gallstone Formation In Guinea Pigs And Its Mechanism

Objective:Gallstone is a common and frequently occurring disease, seriously impacting on people’s life and work.Its treatment is mainly surgery, especially the rapid development of endoscopic minimally invasive cholecystolithotomy(EMIC) in recent years. However,the greatest regret is the presence of recurrent stones. Chinese medicine has a good effect on the prevention and treatment of gallbladder stone. In the study, we first establish the guinea pigs model of gallstone with high fat and cholesterol food. Then respectively gavaged by twelve kinds of Shugan Lidan granule,Yi Guan decoction granule,Longdan Xiegan granule. The three medicines are represented for Shugan Liqi, nourishing the liver and Qinggan Lishi. Finally, these were observed : the living of guinea pigs in general situation; stone formation rate;serum low density lipoprotein cholesterol, alanine aminotransferase, aspartate amino transferase, triglyceride, cholesterol and high density lipoprotein cholesterol levels;total bile bile acid, total bilirubin, indirect bilirubin and calcium ion levels; optical microscope observation of gallbladder and liver tissue morphology. Through the above research, clears that wether the medicines standed for Shugan Liqi, nourishing the liver and Qinggan Lishi can prevent and treat guinea pigs gallbladder stones, and further reveals the effect mechanism and the difference between them, providing a theoretical basis for its clinical application.Method:Only 75 guinea pigs randomly divided into 5 groups, respectively: the normal group,model group, Shugan group, Yanggan group and Qinggan group with 15 guinea pigs in each group.⑴Intervention methodNormal group: fed with normal rodent food, normal amount of vegetables, at the same time are gavaged with the same amount of normal saline;Model group: fed with high fat and cholesterol induced stone of guinea pigs food, a small amount of vegetables(equivalent to the normal group of 1/10), at the same time are gavaged with the same amount of normal saline;Shugan group: fed with high fat and cholesterol induced stone of guinea pigs food,and a small amount of vegetables, at the same time are gavaged with twelve kinds of Shugan Lidan granule;Yanggan group: fed with high fat and cholesterol induced stone of guinea pigs food,and a small amount of vegetables, atthe same time are gavaged with Yi Guan decoction granule;Qinggan group: fed with high fat and cholesterol induced stone of guinea pigs food,and a small amount of vegetables, at the same time are gavaged with Longdan Xiegan granule.After the models are finished, observing the living of guinea pigs in general situation,weighting the guinea pigs, killing them and calculating the stone formation rate,detecting the stone components, collecting and detecting the guinea pigs blood and bile, observing the morphology of gallbladder and liver.⑵Test method(1)Using infrared spectroscopy qualitative method detecting the stone components;(2)Using Lai’s method to detect serum alanine aminotransferase and aspartate aminotransferase. Respectively using GPO-PAP and COD-PAP method to detect serum triglyceride ans total cholesterol. Using direct method to detect serum low density lipoprotein cholesterol. Using direct method to detect serum high density lipoprotein cholesterol.(3)Using enzyme colorimetric method to detect bile total bile acid. Using chemical colorimetric method to detect bile total bilirubin and indirect bilirubin.Using methylthymol blue colorimetric method to detect bile calcium ion.⑶Statistical methodAll the data were processed by the 17 version SPSS statistical software package,P<0.05 means that the difference was statistically significant. The count data is expressed by percentage. The difference between the groups was compared by the chi square test. The measurement data is expressed by mean plus or minus standard deviation( sx ±). The comparison between the groups was performed by one factor analysis of variance.Result:⑴Compared with the model group, the living of guinea pigs in general situation of Shugan group, Yanggan group and Qinggan group guinea pigs is improved obviously;the quality of three groups is increased(all P<0.05).⑵Compared with the model group, the stone formation rate ofShugan group,Yanggan group and Qinggan group guinea pigs is significantly decreased(P<0.01).⑶Compared with the model group, the serum alanine aminotransferase and aspartate aminotransferase of Shugan group, Yanggan group and Qinggan group guinea pigs are significantly decreased(all P<0.01). Compared with Yanggan group, the serum aspartate aminotransferase of Shugan group and Qinggan group guinea pigs are observely increased(P<0.01, P=0.002; P<0.05, P=0.034).⑷Compared with the model group, the serum triglyceride, total cholesterol and low density lipoprotein cholesterol of Shugan group, Yanggan group and Qinggan group guinea pigs are significantly lower(P<0.01); at the same time the serum high density lipoprotein cholesterol of the three groups are significantly increased(P<0.01).Compared with Qinggan group, the serum triglyceride of Shugan group and Yanggan group guinea pigsare decreased(P<0.05, p=0.029, p=0.027). Compared with Qinggan group, the serum total cholesterol of Shugan group and Yanggan group guinea pigs are significantly decreased(all P<0.01, P=0.000, P=0.000). Compared with Yanggan group, the serum total cholesterol of Shugan group guinea pigs is significantly decreased(P<0.01, P=0.002). Compared with Yanggan group, the serum low density lipoprotein cholesterol of Shugan group and Qinggan group guinea pigs are significantly increased(P<0.01, P=0.000, P=0.000).⑸Compared with the model group, the bile total bile acid of Shugan group, Yanggan group and Qinggan group guinea pigs is significantly increased(P<0.01); at the same time the bile indirect bilirubin of the three groups is significantly decreased(P<0.05). Compared with the model group, the bile total bilirubin of the three groups is slightly higher, but the difference have no statistically significent(P>0.05, p=0.596, P=0.221,p=0.166). Among the three groups only Qinggan group guinea pigs bile calcium ion decreased(P<0.05, P=0.037).⑹Compared with the model group, the gallbladder tissue pathological changes of Shugan group, Yanggan group and Qinggan group guinea pigs is significantly improved significantly. Among the five groups only a few liver cells of the model group guinea pigs showed eosinophilic change and having no significant difference compared with the normal group.Conclusion:⑴Twelve kinds of Shugan Lidan granule, Yi Guan decoction granule and Longdan Xiegan granule can promote guinea pigs eating, increase their body weight, improve the growth of thesituation and maintain them survival.⑵Twelve kinds of Shugan Lidan granule, YiGuan decoction granule and Longdan Xiegan granule can decrease serum alanine aminotransferase and aspartate aminotransferase of guinea pigs.In lowing guinea pigs serum aspartate aminotransferase, the effect of Yi Guan decoction granule is the most significant,followed by Longdan Xiegan granule, twelve kinds of Shugan Lidan granule effects weaker comparing with the previous two. In decreasing guinea pigs serum alanine aminotransferase concentrations their effect have no obvious difference.⑶Twelve kinds of Shugan Lidan granule, Yi Guan decoction granule and Longdan Xiegan granule can decrease serum triglyceride, total cholesterol and low density lipoprotein cholesterol of guinea pigs, at the same time they can also increase serum high density lipoprotein cholesterol of guinea pigs.In lowing guinea pigs serum triglyceride and total cholesterol concentration, the effect of twelve kinds of Shugan Lidan granule is the most significant. followed by Yi Guan decoction granule,Longdan Xiegan granule effects weaker comparing with the previous two.In lowing guinea pigs serum low density lipoprotein cholesterol concentrations, the effect of Yi Guan decoction granule is the most significant, followed by twelve kinds of Shugan Lidan granule, Longdan Xiegan granule effects weaker comparing with the previous two.In increasing guinea pigs serum high density lipoprotein cholesterol concentrations their effect have no obvious difference.⑷Twelve kinds of Shugan Lidan granule, Yi Guan decoction granule and Longdan Xiegan granule can increase bile total bile acid and decrease bile indirect bilirubin of guinea pigs. Butthe three medicines have no significant effect on bile total bilirubin concentration of guinea pigs.Among the three medicines, only Longdan Xiegan granule can decrease bile calcium ion of guinea pigs, twelve kinds of Shugan Lidan granule and Yi Guan decoction granule have no significant effect on bile calcium ion of guinea pig.In increasing guinea pigs bile total bile acid concentration, the effect of Yi Guan decoction granule is the most significant, followed by Longdan Xiegan granule, twelve kinds of Shugan Lidan granule effects weaker comparing with the previous two. In decreasing guinea pigs bile indirect bilirubin concentrations their effect have no obvious difference.⑸Twelve kinds of Shugan Lidan granule, Yi Guan decoction granule and Longdan Xiegan granule have effect on improvement of histopathological changes in the guinea pigs gallbladdeand and their effect have no obvious difference.⑹Twelve kinds of Shugan Lidan granule, Yi Guan decoction granule and Longdan Xiegan granule, represented for Shugan Liqi, nourishing the liver and Qinggan Lishi.can lessen the damage degree of the gallbladder in guinea pigs, improve the pathological changes of gallbladder, and protect the function of gallbladder; increase serum high density lipoprotein cholesterol, bile total bile acid and decrease serum triglyceride, low density lipoprotein cholesterol and total cholesterol of guinea pigs.They can reversal the stone bile, inhibite the formation of gallstone in guinea pigs and reduce the formation rate of gallstone formation in guinea pigs, and in inhibiting gallstone formating, they have no obvious difference.