目的:观察多器官功能障碍综合征(MODS)大鼠小肠深部肌间神经丛神经一胃肠道Cajal间质细胞(ICC)-平滑肌网络结构的形态学改变和大承气汤对其的修复作用,探讨大承气汤治疗MODS的机制。方法:将50只Wistar大鼠随机分为对照组、MODS组和大承气汤治疗组;采用免疫荧光双标记、激光扫描共聚焦显微镜和透射电镜观察MODS大鼠小肠深部肌间神经丛胆碱能神经-ICC-平滑肌网络结构损伤和大承气汤对其的修复作用。结果:MODS组小肠深部肌间神经丛胆碱能神经-ICC-平滑肌网络连接结构不完整,神经纤维末梢、ICC、平滑肌超微结构以及相互之间的联系结构明显损伤。大承气汤治疗组小肠神经-ICC-平滑肌网络结构比较完整,神经纤维末梢、ICC、平滑肌超微结构无明显损伤,相互之间联系结构较为完好。结论:大承气汤能通过修复MODS大鼠小肠神经-ICC-平滑肌网络结构损伤,改善胃肠运动障碍,治疗MODS。
Objective: To observe the repairing effects of Dachengqi decoction (大承气汤) on the damage in the network of cholinergic nerve -interstitial cells of Cajal (ICC)-smooth muscle network of enteric deep muscular plexuses in rats with multiple organ dysfunction syndrome (MODS). Methods: Fifty Wistar rats were randomly divided into control group, MODS group and Dachengqi decoction group. The network of cholinergic nerve - ICC - smooth muscle network of deep muscular plexuses of small intestine was observed by using c -Kit and vesicular acetylcholine transtorter (VAChT) immunohistochemical double -staining with whole -mount preparation technique and confocal laser scanning microscopy and transmission electron microscope. Results: Compared with control group, the distribution and density of cholinergic nerves and ICC in the deep muscular plexuses (ICC - DMP) of intestine in MODS group were significantly decreased (P〈0. 01), the network of cholinergic nerve -ICC -smooth muscle was disrupted; and the ultra -structural features of ICC- DMP, nerve, smooth muscle ceils were severely damaged. After treatment with Dachengqi decoction, the network of cholinergic nerve - ICC - smooth muscle was significantly recovered. Compared with MODS group, the distribution and density of cholinergic nerves and ICC -DMP in treatment group were significantly increased (Pal0. 01) ; and the ultra -.structural features of ICC - DMP, nerve, smooth muscle ceils were significantly recovered. Conclusion : Dachengqi decoction can improve the gastrointestinal motility in MODS and the mechanism may be related to its effects on the distribution and the connection of the network of cholinergic nerve - ICC - smooth muscle of deep muscular plexuses in the intestine of rats with MODS.