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力胃颗粒对胃肠动力的影响
http://www.100md.com 《世界华人消化杂志》 2000年第4期
     作者:王晶 侯家玉

    单位:北京市医药大学药理教研室 北京市 100029

    关键词:力胃颗粒;胃肠动力;胃排空;胃疾病;药物疗法

    摘 要摘 要: 目的 观察力胃颗粒对实验动物胃肠动力的影响。方法 通过测定力胃颗粒对动物胃排空、肠推进及胃内压力的影响,研究其促胃肠动力作用.给小鼠ig饲料糊,观察力胃颗粒ig对胃排空率的影响;给小鼠ig炭末,观察力胃颗粒ig对肠推进率的影响;给小鼠ip盐酸多巴胺导致小鼠胃排空延迟,观察力胃颗粒ig对胃内酚红残留率的影响;给小鼠ip盐酸多巴胺导致小鼠肠胃反流,观察力胃颗粒id对胃内酚红残留率及肠胃反流量的影响;利用胃内安置水囊法观察力胃颗粒id对胃内压的影响。结果 力胃颗粒10g/kg及5g/kg可显著抑制小鼠饲料糊胃排空,胃排空率分别为(43.8±13,9)%及(44.7±20.2)%,与空白对照组(61.4±12.9)%比,均PO.05;气滞胃痛冲剂5g/kg连续7dig给药对肠推进率无明显影响,ip多巴胺可导致小鼠肠胃反流,力胃颗粒10g/kg id可显著减少反流量至(0.28±0.07)g/L,与模型对照组(0.37±0,07)g/L比,PO.01,PO.01.在大鼠胃内压力测定实验中,生理盐水组基础胃收缩频率(f),平均振幅(A)及最大振幅(Amax)分别为(1.0±O.6)次/min,(0.10±O.02)kPa及(0,21±0.09)kPa.力胃颗粒5g/kg及2.5g/kg均可显著增加胃收缩f,作用持续时间达120min以上;而气滞胃痛冲剂5g/kg对于胃收缩f则无显著影响.力胃颗粒5g/kg及2.5g/kg均可显著增加胃收缩A.作用持续时间达120min以上;而气滞胃痛冲剂5g/kg对于胃收缩A则无显著影响, 力胃颗粒2.5g/kg可显著增加胃收缩Amax,作用持续时间达120min以上;而气滞胃痛冲剂5g/kg对于胃收缩Amax则无显著影响。结论 力胃颗粒可能通过协调胃及十二指肠的收缩活动而起到促胃肠动力作用。
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    Effect of granulae Li Wei on gastrointestinal activity

    Jing Wang ,Jia Yu Hou

    (Department of Pharmacology,Beijing University of Traditional Chinese Medicine,Beijing 100029,China)

    Abstract:AIM To observe the prokinetic effects of granulae Li Wei on experimental animals.METHODS The prokinetic effects of grenulae Li Wei on semisolid meals gastric emptying were evaluated. Mice were given charcoal powder orally to determine theeffects of granulae Li Wei on small intestinal promotion of charcoal powder. Dopamine given intraperitoneally coulddelay gastric emptying and induce retrograde power contractions with enterogastric reflux. Gastric motility was measured in conscious rats using a miniature balloon positioned in the glandular part of the stomach. The balloun was connected to a pressure transducer and polygraph.RESULTS Granulae Li Wei observably inhibited gastric emptying rate of oataplasma feedetuff from 61.4% ±12.9% to 44.7% ±20.2% at 5 g/kg and to 43.8%± 13.9%at 10g/kg. Granulae Li Wei given orally at dose of 10 g/kg once and continuously for seven days both couldremarkably increase small intestinal promotion of charcoal powder,the promotion rate was increased from 41.0%±5.0% to 45.0% ± 5.3% and to 45.4%±5.9% respectively.Granulae Li Wei given duedenally at dose of 10 g/kg markedly reduced the refluxing volume of phenol red from 0.37g/L± 0.07g/L to 0.28g/L±0.07g/L Granulae Li Wei also markedly inhibited the delay of gastric emptying induced by dopomine. Gastric emptying rates were increased from 18.66%± 5.63% to 9.6% ± 5.2% at 2.5 g/kg to 12.8%±6.9% at 5g/kg and to 6.6% ±3.6% at 10g/kg. Intraduodenal administration of granules Li Wei at 2.5 g/kg and 5g/kg significantly increased the intragastric pressure. The increases in frequency, mean amplitude and the maximal amplitude on gastric muscle contractions could be seen.CONCLUSION Granulae Li Wei could influence the gastric contractile activity. It was suggested that granulae Li Wei could harmonize the contactions of stomach and duodenum.
, 百拇医药
    Keywords:granulae Li Wei;gastrointestinal activity; gastric emptying; stomach diseases/drug therapy

    引言力胃颗粒由百合,乌药,枳实及虎杖四味中药组成,主治胃气失和,胃阴不足兼有血瘀者.我们观察了力胃颗粒对胃肠动力的影响,并对其作用机制进行探讨,以期为其临床应用提供实验依据。1材料和方法1.1材料Wistar大鼠,雌雄兼用,体质量180g~250g中国医学科学院实验动物研究所繁育场提供.昆明种小鼠,,体质量18g~22g,力胃颗粒由北京中医药大学中药学院制剂教研室提供.1g药粉相当于5g生药,使用时以常水配制,所用四个剂量,2.5g/kg,5g/kg,10g/kg及20g/kg,分别相当于临床人用剂量lg生药/kg的2.5,5,10及20倍;气滞胃痛冲剂,辽宁本溪第三制药厂,研究采用剂量5g/kg,相当于临床人用剂量的10倍;西沙比利(普瑞博思),杨森制药有限公司;硫酸阿托品注射液,无锡市第七制药厂;戊巴比妥钠,佛山市化工实验厂;苯酚红,北京化工厂;盐酸多巴胺,瑞士Fluka.其他试剂为进口或国产分析纯试剂.电生理数据处理系统Maclab/400(澳大利亚Adl),722型分光光度计(上海第三分析仪器厂).1.2方法1.2.1小鼠饲料糊胃排空小鼠禁食24h后随机分组;设空白对照组;阿托品0.5mg/kg组;新斯的明0.08mg/kg组;力胃颗粒5g/kg组及力胃颗粒10g/kg组,参考吴春福etal[1]的方法:每只灌胃糊状饲料0.6mL,15min后拉断颈椎处死,结扎胃贲门及幽门,立即取胃,在电子天平上称全胃质量,然后剪开胃,洗掉胃内容物,将空胃在滤纸上轻拭,蘸去多余水分,再称质量.胃排空率(%)=[食料质量-(全胃质量-空胃质量)]÷食料质量x100%。1.2.2小鼠炭末肠推进没空白对照组;力胃颗粒10g/kg一次给药组,灌胃给药后3h灌胃炭末;力胃颗粒10g/kg连续7d给药组,末次灌胃给药后1.5h灌胃炭末;气滞胃痛冲剂5g/kg连续7d给药组,末次灌胃绐药后1.5h灌胃炭末;新斯的明0.08mg/kg组,ip新斯的明15min后灌胃炭末.小鼠禁食24h,灌胃50g/L炭末混悬液,10min后脱断颈椎处死,开腹,分离自幽门至回盲部全部小肠,测量小肠全长及炭末头端至幽门距离,计算炭末推进率(%)=炭末头端至幽门距离÷小肠全长×100%[2]。1.2.3盐酸多巴胺致小鼠肠胃反流及胃排空延迟①力胃颗粒对盐酸多巴胺致小鼠肠胃反流的影响.设空白对照组;模型对照组;力胃颗粒10g/kg组;力胃颗粒5g/kg组;气滞胃痛冲剂5g/kg组;西沙比利0.5mg/kg组。空白对照组为乙醚麻醉后十二指肠注射常水1h后灌胃酚红糊,20min后处死;模型对照组为十二指肠注射常水1h后灌胃酚红糊,20min后腹腔注射DA0.2mg/kg,5min后处死;其余各组均为乙醚麻醉后十二指肠药1h后灌胃酚红糊,20min后腹腔注射DA0.2mg/kg,5min后处死.小鼠禁食24h,每只灌胃0.5g/L酚红糊0.25mL,20min后拉断颈椎处死,立即取胃,置于40mL0.1mol/LNaOH溶液中,剪碎,混匀静置,60min后取上清液5mL,加入200g/L三氯醋酸1mL,离心10min(1400r/min)后取上清液lmL,加入0.5mol/LNaOH溶液1mL显色,置722型分光光度计56nm处比色,记录吸光度A.零点对照组为灌胃0.5g/L酚红糊0.25mL后立即处死取胃,测吸光度A.制作酚红标准曲线:C=0.323+4.609A.残留率(%)=各组A÷零点对照组A×100%.肠胃反流公式为:肠胃反流量(g/L)=各组胃内残存酚红浓度-空白对照组胃内残存酚红浓度.②力胃颗粒对盐酸多巴胺致小鼠胃排空延迟的影响.设空白对照组;模型对照组;力胃颗粒2,5g/kg组;力胃颗粒5g/kg组;力胃颗粒10g/kg组;气滞胃痛冲剂2.5g/kg组;西沙比利5mg/kg组.空白对照组为灌胃常水1h后灌胃酚红糊,25min后处死;模型对照组为灌胃常水1h后灌胃酚红糊,15min后ipDA0.2mg/kg,10min后处死;其余各组均为连续4d给药,末次绐药后1h灌胃酚红糊,15min后ipDA,10min后处死.小鼠禁食24h,每只灌胃0.5g/L酚红糊0.25mL,25min后拉断颈椎处死,立即取胃,置于40mL0.1mol/L.NaOH溶液中,剪碎.混匀静置,60min后取上清液5mL,加入200g/L三氯醋酸1mL,离心10min(1400r/min)后取上清液1mL,加入0.5mol/LNaOH溶液1mL显色,置722型分光光度计560min处比色.记录吸光度A.零点对照组为灌胃0.05%酚红糊0.25mL后立即处死取胃,测吸光度A,制作酚红标准曲线:C=0.323-4.609A,残留率(%)=各组A÷零点对照组A×l00%.1.2.4清醒大鼠胃内压力设空白对照组;力胃颗粒2.5g/kg组;力胃颗粒5g/kg组;气滞胃痛冲剂5g/kg组;西沙比利2.5mg/kg组;阿托品1mg/kg组,各组均十二指肠给药,0.5mL/kg.大鼠禁食12h,戊巴比妥钠溶液(15g/L,35mg/kg,ip)麻醉下开腹,暴露出胃及十二指肠,在胃体部前壁上部,靠胃大弯处开一小孔,埋入水囊(最大容积0.8mL的乳胶小球,硅橡胶管长12cm,Di1.5mm,Do2.0mm),结扎固定,十二指肠同时埋人插管(硅橡胶管长10cm,Di0.8mm,Do1.0mm),关腹,将两管自耳后皮下引出体外.术后恢复12h,进行胃内压描记,将大鼠放人鼠盒内保持正常卧姿,将水囊硅橡胶管连接到电生理数据处理系统MacLab/400上,使用Chartforwindows95软件,描记时水囊内注入36-°C生理盐水0.8mL,先记录1h基础压力波,然后经十二指肠硅橡胶管给入药物,0.5mL/kg,持续观察药物作用120min以上[3]。2结果2.1小鼠饲料糊胃排空甲基硫酸新斯的明可显著促进胃排空,其余各给药组均显著抑制胃排空(表1)。2.2小鼠炭末肠推进除气滞胃痛冲剂5g/kg对炭末肠推进无显著影响外,其余各给药组均显著促进肠推进,使推进率显著增加(表2).aP<0.05,bP<0.01,vs模型对照。aP<0.05,bP<0.01,vs生理盐水。aP<0.05bp<0.01,vs空白对照。2.3盐酸多巴胺致小鼠肠胃反流及胃排空延迟①力胃颗粒对盐酸多巴胺致小鼠肠胃反流的影响.给小鼠ipDA可导致小鼠酚红肠胃反流,胃内酚红残留率显著高于空白对照组;力胃10g/kg及西沙比利0.5mg/kg均可显著抑制多巴胺所致小鼠酚红肠胃反流,与模型对照组比,胃内酚红残留率及反流量显著降低(表3).②力胃颗粒对盐酸多巴胺致小鼠胃排空延迟的影响.给小鼠ipDA可导致小鼠胃排空延迟,胃内酚红残留率显著高于空白对照组;各给药组均可显著抑制多巴胺所致小鼠胃排空延迟,与模型对照组比,胃内酚红残留率显著降低(表4)。表3中药力胃颗粒对盐酸多巴胺致小鼠肠胃反流的影响aP0.01,vs模型对照,2.4清醒大鼠胃内压力生理盐水组基础胃收缩f,A及Amax分别为(1.0±0.6)次/min,(0.10±0.02)kPa及(0.21=0.09)kPa.①对于胃收缩频率(f)的影响:力胃颗粒5g/kg可显著增加胃收缩f,给药后30min,60min,90min及120min胃收缩f分别增加至(2.2±0.9)次/min,(2.0±1.0)次/min,(2.0±0.8)次/min及(1.9±0.7)次/min,与生理盐水组比,分别P<0.01,P<0.05,P<0.01及P<0.01;力胃颗粒2.5g/kg亦可显著增加胃收缩f,给药后30min,90min及120min胃收缩f分别增加至(2.2=1.0)次/min,(2.8=1.4)次/min及(2.8±1.6)次/min,与生理盐水组比,均P<0.01(表5).②对于胃收缩平均振幅(A)的影响:力胃颗粒5g/kg可显著增加胃收缩A,给药后60min及90min胃收缩A分别增加至(0.19±0.11)kpa及(0.19±0.12)kPa,与生理盐组比,分别P<0.01及P<0.05;力胃颗粒2.5g/kg亦可显著增加胃收缩A,给药后30min,60min,90min及120min胃收缩A分别增加至(0.18±0.07)kPa,(0.21±0.08)kPa,(0.20±0.08)kPa及(0.17±0.08)kPa,与生理盐水组比,分别P<0.0l,P<0.01,P<0.01,及P<0.05(表6).③对于胃收缩最大振幅(Amax)的影响:力胃颗粒5g/kg可显著增加胃收缩Amax,给药后90min胃收缩Amax增加至(0.32=0.20)kPa,与生理盐水组比,P<0.05;力胃颗粒2.5g/kg亦可显著增加胃收缩Amax,给药后30min,60min.90min及120min胃收缩Amax分别增加至(0.46±0.23)kPa,(0.41±0.18)kPa,(0.44±0.29)kPa及(0.45±0.26)kPa,与生理盐水组比,均P<0.01(表7).表6中药力胃颗粒对清醒大鼠胃收缩平均振幅的影响aP<0.05,bP<0.01,vs生理盐水。表7中药力胃颗粒对清醒大鼠胃收缩最大振幅的影响aP<0.05,bP<0.01,vs生理盐水。2讨论力胃颗粒是治疗胃失和降,胃阴不足兼有血瘀之胃脘痛的调补之剂,临床上,胃脘痛除主要表现疼痛症状之外,还常伴有脘闷等症状,中医理论认为,脾胃为气机“冲和”之脏,胃与大肠均属阳明经,主通主降,通降则生化有源,出入有序,否则胃失和降,肠失传化,壅塞为病,进而气机上逆,肠道阻滞,气道不宣,气机阻遏,引起胃饱胀痛,在西医学上可表现为胃肠动力的减弱或紊乱[4-8].古往今来,众医家以陈修园“百合汤”基础上化裁得到的验方治疗胃脘痛属气痛热痛者颇有良效[9-23].本方中百合为君药,《本草经疏》云:“百合主邪气腹胀,听谓邪气者,即热邪也.热邪在腹故腹胀,清其邪则胀消矣.”方中另一君药乌药能行气导滞,兴奋胃肠平滑肌,加强其收缩活动.有实验表明乌药水煎液可使家兔胃电幅值明显增加[24].臣药枳实所含挥发油具有促进胃肠蠕动的作用[25-28],佐使药虎杖亦可消除肠胃积滞,四药相合,共奏理气和胃之功。本文通过测定力胃颗粒对胃内压力,胃排空及肠推进的影响,观察到力胃颗粒对于胃运动具有一定影响,对于肠运动具有促进作用,可为临床应用提供参考。胃内压,即容积,压力两种变化,反映了胃体部平滑肌收缩的强弱,以水囊法测定清醒大鼠胃内压时采用了先进的电生理数据处理系统MacLab/400及Chartforwindows95软件,使数据处理更加精确而简捷.实验结果显示力胃颗粒5g/kg及2.5g/kg可不同程度地显著增加胃收缩的频率及振幅,且这种兴奋作用可持续120min以上,表明力胃颗粒可显著增加胃内压力。胃排空的动力是胃的收缩活动,胃十二指肠连接部的协调运动是胃排空的生理基础,胃和十二指肠收缩紊乱可以导致胃排空的延缓或加速.只有胃内压超过十二指肠内压,压差足以克服幽门阻力时才发生排空,液体的排空速度主要取决于胃内压与十二指肠内压之差;固体的排空速度主要取决于胃窦和幽门的运动.此外胃排空的速度与摄人食物的酸碱度,渗透压大小及食物的组成密切相关[29-32].鉴于液体的排空速度很快,为减少取材时造成的人为误差,采用了酚红糊及饲料糊这两种半固体物质来研究动物胃排空情况。本实验的先进之处是设计了多巴胺(DA)致小鼠肠胃反流及胃排空延迟的模型,实验结果表明,腹腔注射DA0.2mg/kg可致小鼠肠胃反流,力胃颗粒10R/kg可显著抑制DA所致小鼠肠胃反流,使胃内酚红残留率及反流量均显著降低.此外,力胃颗粒2.5,5及10g/kg可显著抑制DA所致小鼠胃排空延迟,显著降低胃内酚红残留率,加速胃排空.这两项结果均提示力胃颗粒对于多巴胺能神经系统可能有抑制作用,从而阻止了多巴胺对上消化道的抑制作用。本文还观察了力胃颗粒对小鼠饲料糊胃排空的影响。结果显示力胃颗粒的各个剂量组对胃排空都有不同程度的抑制作用。由于此项实验出现了与前面实验相反的结果,因而尚有待于在今后的工作中进一步深入研究力胃颗粒对胃动力的影响。此外,力胃颗粒对小鼠炭末肠推进的影响一项实验结果显示,力胃颗粒10g/kg一次给药及连续7d给药均可显著加速小鼠炭末肠推进,提示力胃颗粒对于小肠有促进收缩的作用。结论:力胃颗粒对于实验动物的胃动力有一定的影响,它可能通过抑制多巴胺能神经系统而起到一定的促胃动力的作用;力胃颗粒可增强小肠的收缩功能,它可能通过协调胃及十二指肠的收缩活动而发挥促胃肠动力作用。
, http://www.100md.com
    作者简介:王晶,女,1973年2月出生,河北藁城市人,汉族。1996年北京中医药大学本科毕业,1999年在北京中医药大学硕士研究生毕业,助教,主要从事消化系统疾病的药理研究,发表论文4篇。

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    收稿日期:1999-12-12, 百拇医药