The Empirical Study On Chronic Pancreatitis Pancreatic Exocrine And Sinus Ventriculi Motility And The Intervention Of Chaihu Shugan San

Objective:To explore the changes of exocrine pancreas in the rats with chronic pancreatitis combined exocrine pancreatic insufficiency and the intervention effect of the traditional Chinese drug.Methods:Fifty Wistar rats were divided into control, model, traditional Chinese drug, trypsogen and Trimebutine Maleate Capsules group randomly(n=10). Rats in model group were used to induce chronic pancreatitis by injecting oleic acid into the pancreatic duct. The control and model groups, administered intragastrically with physiological saline everyday. The traditional Chinese drug group, administered intragastrically with 0.56g/ml Chaihu shugan san physiological saline 2ml/100g everyday; the trypsogen group, administered intragastrically with 7.8mg/ml Pancreatin Capsules 2ml/100g everyday; the Trimebutine Maleate group, administered intragastrically with 1.5mg/ml Trimebutine Maleate 2ml/100g everyday. The experiment period of each group are twe weeks. Eight weeks later, spot fecal fat and fecal elastase-1(FE-1) were detected, Serum cholecystokinin(CCK) was detected. Contractility of gastric circular muscle stripe and the contractile response of dispersed gastric circular smooth muscle cells stimulated by Aceylcholine (Ach) were measured. RT-PCR was used to detect the expression of inducible nitric oxide synthase (iNOS), mRNA within sinus ventriculi muscularis, the level of nitric oxide (NO) in cell cultures was quantified. Results:The counts of fecal fat in model group increased, level of FE-1 decreased obviously than that in control group. The gastric circular smooth muscle stripes contractility and contractile response of dispersed circular smooth muscle cells stimulated by Ach were declined obviously than the control (P<0.05) while the levels of serum CCK, iNOS mRNA expression and NO production were significantly elevated (P<0.05). Compared with the model group, the counts of fecal fat in traditional Chinese drug and trypsogen groups were less, and level of FE-1 higher (P<0.05), gastric circular smooth muscle stripes contractility and contractile response of dispersed circular smooth muscle cells stimulated by Ach in traditional Chinese drug, trypsogen and Trimebutine Maleate Capsules groups were elevated obviously than the model group, while the levels of serum CCK, iNOS mRNA expression and NO production were significantly declined (P<0.05), especially in the traditional Chinese drug group.Conclusions:Elevated CCK secretion caused by insufficiency of pancreatic exocrine up-regulated the expression of iNOS mRNA and increased the output of NO within the gastric muscularis. It might be one of the mechanisms of gastric motility dysfunction in chronic pancreatitis that NO inhibited the contractility of gastric circular smooth muscle. The traditional Chinese drug(Chaihu shugan san) can improve the gastric motility dysfunction caused by exocrine pancreatic insufficiency efficiently, by inhibiting the release of CCK.