| Objective: Infectious complication is the familiar clinical question in treatment of acute pancreatitis. Secondary infection is rarely few in mild acute pancreatitis and the incidence is below 1%. The incidence of secondary infection is about 40%～70% in patients with severe acute pancreatitis(SAP), which is the primary cause of death. Intestinal bacterial translocation is the prime source of pancreas infection. The impairment of intestinal mucosa barrier is the important pathogenesis of intestinal bacterial and endotoxin translocation. There are still lack of specially good effect methods to protect intestinal mucosa barrier in clinic. It is emphasized in recent years that to treat SAP with Chinese herbs with principles of "Tongli Gongxia" can decrease the incidence of secondary infection and mortality. As the representative drug of "Tongli Gongxia",Dahuang whose rule is "Hanxia" was studied to be able to protect the intestinal mucosal barrier, and decrease the bacterial translocation. This research is in order to study the effects of Chinese herbs "Yiyanheji" whose rule is "Wenli Gongxia" on bacterial translocation in rats after SAP.Methods: Animal models of SAP were induced by retrograde injection of 5% sodium taurocholate(0.1ml/100g) into the common biliopancreatic duct. 90 health Wistar rats weighing 250±30g were randomly divided into 5 groups: shan operation group(SO, n=10), SAP group( SAP,n=20), antibiotic treatment group(AB, n=20) ,Dahuang treatment group(DH,n=20)and Yiyanheji treatment group(YH, n=20). Three treated groups were treated with ampicillin,Dahuang or Yiyanheji respectively after operation. The SAP group was treated with physiological saline. The groups of rats were killed at 48 hours after operation or treatment. Bacterial cultures were performed together with the measurement of plasma endotoxin level in all animals. The changes of pancreatic and terminal ileum' tissue were observed by optical microscopy or electron microscopy. The data of test were analyzed by statistic software.Results: The incidence of bacterial translocation was 22.5% in Yiyanheji treated group, and was 30.0% in Dahuang treated group, each was lower than that in SAP group which was 90.0% or in ampicillin treated group which was 87.6%. The difference were significant (P<0.01). There was no different between ampicillin treated group and SAP group(P>0.05). The quantity of bacteria in liver tissue in SAP group and in ampicillin treated group were 3.60±2.18×103CFU/g and 3.76±2.04×103CFU/g respectively, and were much higher than that in sham operationgroup(P<0.01). The quantity of bacteria in liver issue in Yiyanheji group and in Dahuang treated group were 1.98±0.97×103CFU/g and 2.21±1.14×103CFU/g respectively. All were lower than that in ampicillin treated group(P<0.01). The quantity in Yiyanheji group was lower than that in Dahuang group(P<0.05), while there was on different between ampicillin treated group and SAP group(P>0.05). The quantity of bacteria in MLN in SAP group and in ampicillin treated group were 5.84±3.67×103CFU/g and 5.21±2.89×103CFU/g respectively, and were much higher than that in sham operation group(P<0.01), Yiyanheji group(P<0.01) and Dahuang group(P<0.01). The quantity in Yiyanheji group was lower than that in Dahuang group(P<0.05), while there was on different between ampicillin treated group and SAP group(P>0.05). The endotoxin levels in Yiyanheji group and in Dahuang group were significantly lower than that in SAP group(P<0.01) or ampicillin treated group(P<0.01). The endotoxin levels in Yiyanheji group was lower than that in Dahuang group(P<0.05). There was on different between ampicillin treated group and SAP group(P>0.05). In rats with SAP and with ampicillin treated, there were vascular congestion, interstitial edema and infiltration of inflammatory cells and exfoliation of epithelial in the ileal mucosa. The central chyle ducts were dilation. Morphological measurement indicated that ileal mucosa was atrophic. The intestinal epithelialm... |
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