健脾通里中药芪黄煎剂对胃切除大鼠肠上皮紧密连接的影响

目的 观察健脾通里中药芪黄煎剂对大鼠胃切除创伤模型肠黏膜紧密连接蛋白的影响，并探讨其作用机制。方法 将45只大鼠随机分为假手术组、标准肠内营养组、中药组，每组15只。假手术组大鼠仅腹壁切开，未切除胃；其余两组采用胃切除手术方案建立大鼠模型。假手术组术后正常饮食饮水，标准肠内营养组术后注射肠内营养液，中药组注射肠内营养液+中药煎剂。干预7 d后取材，透射电镜下观察大鼠肠黏膜上皮紧密连接形态及其结构的连续性和完整性，并测量肠黏膜上皮细胞间紧密连接宽度；实时荧光定量聚合酶链式反应法检测紧密连接蛋白（zonula occludin-1，ZO-1）、封闭蛋白、咬合蛋白mRNA表达水平。结果 与假手术组比较，标准肠内营养组大鼠肠黏膜上皮细胞紧密连接宽度显著减小（P＜0.05），小肠组织中ZO-1、封闭蛋白、咬合蛋白mRNA表达水平均显著下调（P＜0.05）；与标准肠内营养组比较，中药组大鼠肠黏膜上皮细胞紧密连接宽度显著增加（P＜0.05），小肠组织中ZO-1、封闭蛋白、咬合蛋白mRNA表达水平均显著上调（P＜0.05）。结论 芪黄煎剂可以减轻胃切除术后大鼠肠黏膜上皮细胞间紧密连接的损伤，其作用机制与调节ZO-1、封闭蛋白、咬合蛋白mRNA的表达有关。

Effect of the Spleen-strengthening and Interior-penetrating Traditional Chinese Medicine Qihuang Decoction on Tight Junction in the Intestinal Epithelium in Rats After Gastrectomy

Objective To investigate the effect of the spleen-strengthening and interior-penetrating traditional Chinese medicine (TCM) Qihuang Decoction on tight junction proteins in intestinal mucosa in rats after gastrectomy and its mechanism of action. Methods A total of 45 rats were randomly divided into sham-operation group, standard enteral nutrition group, and TCM group, with 15 rats in each group. The rats in the sham-operation group were given abdominal incision alone without gastric resection, and those in the other two groups were given gastrectomy to establish a rat model. The rats in the sham-operation group were given normal diet and drinking water after surgery, those in the standard enteral nutrition group were given injection of enteral nutrient solution, and those in the TCM group were given injection of enteral nutrient solution+TCM decoction. Related samples were collected after 7 days of intervention. A transmission electron microscope was used to observe the morphology, structural continuity, and integrity of tight junction in the intestinal epithelium, and the width of tight junctions between intestinal mucosal epithelial cells was measured. Real-time quantitative PCR was used to measure the mRNA expression of tight junction proteins zonula occluden-1 (ZO-1), claudin, and occludin. Results Compared with the sham-operation group, the standard enteral nutrition group had significant reductions in the width of tight junctions between intestinal mucosal epithelial cells and the mRNA expression of ZO-1, claudin, and occludin in the small intestine (P<0.05). Compared with the standard enteral nutrition group, the TCM group had significant increases in the width of tight junctions between intestinal mucosal epithelial cells and the mRNA expression of ZO-1, claudin, and occludin in the small intestine (P<0.05). Conclusion Qihuang decoction can alleviate the damage of tight junctions between intestinal mucosal epithelial cells after gastrectomy, possibly by regulating the mRNA expression of ZO-1, claudin, and occludin.