[目的]观察通腑泻肺法对急性肺损伤(ALI)/急性呼吸窘迫综合征(ARDS)大鼠免疫炎症损伤的影响,探讨肺与大肠相表里理论的生物学基础。[方法]将健康wistar大鼠随机分为5组,正常对照组、模型组、治肺组、治肠组和肺肠同治组,采用尾静脉注射油酸加内毒素方法造成大鼠ALI/ARDS模型,观察大鼠血中D-乳酸、丙二醛(DAO)、肿瘤坏死因子-α(TNF-α)、白介素IL-1β(IL-1β)、白介素-6(IL-6)、白介素-10(IL-10)及肺、肠组织分泌型免疫球蛋白A(sIgA)含量。[结果]通腑泻肺法可以有效降低大鼠全身炎性因子TNF-α、IL-1β、IL-6、IL-10表达水平,降低血浆D-乳酸、DAO及肺肠组织sIgA含量。[结论]1)通腑泻肺法能够明显减轻ALI/ARDS大鼠免疫炎症及肠黏膜屏障损伤,其保护作用较单纯用泻肺法或通腑法效果更有优势;2)泻肺法、通腑法和通腑泻肺法对ALI/ARDS大鼠血清炎性因子作用靶点不同,其作用机制与抑制炎性因子合成分泌及调节肠道免疫功能有关。
[Objective] To observe the effect of Tongfu Xiefei therapy on the immune inflammatory damage in ALI/ARDS rats and to investigate the biological basis of the interior-exteriorly related theory of lung and the large intestine.[Methods] The health Wistar rats were divided the health Wistar rats into 5 groups: control group,model group,lung treatment group,large intestine treatment group and lung-large intestine treatment group.The ALI/ARDS in rats was established by intravenous injecting oleic acid plus endotoxin in caudal vein,and the D-Lactate,DAO,TNF-α,IL-1β,IL-6,IL-10 in blood,sIgA in lung and large intestine were observed.[Results] Tongfu Xiefei therapy could effectively reduce the expression of systemic inflammatory factors in rats,such as TNF-α,IL-1β,IL-6,IL-10;and reduced the D-Lactate,DAO and sIgA in lung and large intestine organs.[Conclusion] 1)Tongfu Xiefei therapy can effectively reduce the immune inflammation and the intestinal mucosal barrier injury in rats with ALI/ARDS.The combined method is superior than either single method of Xiefei therapy or Tongfu therapy;2)The action targets of Xiefei therapy,Tongfu therapy and Tongfu Xiefei therapy on inflammatory factors in ALI/ARDS rats are different,and the mechanism may be related with inhibiting the synthesis and secretion of inflammatory factors and regulating the immune function of the intestines.