临床误诊误治

目的探讨中药吊石苣苔对慢性支气管炎大鼠肺组织Toll样受体4(toll-like receptors 4,TLR4)mRNA的影响。方法选择50只SD雄性大鼠,按照随机数字表法分为空白对照组、模型组、阳性对照组、吊石苣苔水提取液低剂量组、吊石苣苔水提取液高剂量组,每组各10只。除空白对照组外,其余4组均建立慢性支气管炎模型,从造模结束第2天开始给药。低、高剂量组分别予吊石苣苔水提取液2 g/kg、8 g/kg灌胃,阳性对照组予桂龙咳喘宁1 g/kg灌胃,空白对照组及模型组以等体积0.9%氯化钠注射液灌胃,连续给药28 d。观察大鼠肺组织病理形态学改变和TLR4 mRNA表达情况。结果模型组见肺内支气管上皮空泡、变性、坏死、脱落,管壁结构破坏、充血、水肿,纤毛柱状上皮变性、坏死、脱落,大量炎性细胞浸润,腔内炎性渗出物填塞,肺泡大量融合;阳性对照组管腔轻度变形,管壁轻度增厚,上皮细胞少量脱落,部分纤毛脱落;吊石苣苔水提取液高、低剂量组肺泡壁增厚改善,炎性细胞增生缓解,管腔内分泌物减少。与空白对照组比较,模型组、阳性对照组、吊石苣苔水提取液高、低剂量组TLR4 mRNA表达量均上升,差异有统计学意义(P<0.05);与模型组比较,阳性对照组、吊石苣苔水提取液高、低剂量组TLR4 mRNA表达量下降,差异有统计学意义(P<0.05)。结论中药吊石苣苔可影响TLR4 mRNA的表达水平,显著改善大鼠慢性支气管炎症状,抑制气道炎性反应。

Objective To study the effect of L. Pauciflorus on the expression of toll-like receptors 4(TLR4)mRNA in lung tissues of rats with chronic bronchitis(CB). Methods Fifty male SD rats were randomly divided into 5 groups,blank control group(n = 10),CB model group(n = 10),positive control group(n = 10),low-dose water extracts from L. Pauciflorus treatment group(low-dose group,n = 10) and high-dose water extracts from L.Pauciflorus treatment group(high-dose group,n = 10) according to random number table. Except the blank control group,a model of CB was established in the other four groups. The medicine was administered the day after successful modeling. The low and high-dose groups were given 2 g/kg and 8 g/kg water extracts from L. Pauciflorus by gastric gavage respectively. The positive control group was given Guilong Kechuanning by gastric gavage for 1 g/kg,while blank control group and CB model group were given isopyknic 0. 9% sodium chloride injection by gastric gavage. The drugs were administered for 28 d consecutively. Pathological changes of lung tissues and the expression of TLR4 mRNA were observed. Results Vacuolar degeneration,necrosis and shedding of bronchial epithelium of the lung were seen in the model group. In addition,there was destruction of wall structure,hyperemia and edema,destruction of ciliated columnar epithelium,necrosis,shedding,massive inflammatory cell infiltration,inflammatory exudate obstruction in the lumen,and the alveolar mass fusion. In positive control group,there was mild deformation of the lumen,slight thickening of bronchial tube,and exfoliated epithelial cells and cilia. In low and high-dose group,there was improved alveolar wall thickening,relieved inflammatory cell hyperplasia,and reduced secretions of lumen.Compared with normal control group,the expression of TLR4 mRNA was increased in the model group,positive control group,low-dose group and high-dose group,suggesting significant differences(P < 0. 05). Compared with the model group,expression of TLR4 mRNA was reduced in positive control group,low-dose group and high-dose group(P < 0. 05). Conclusion L. Pauciflorus can affect the expression level of TLR4 mRNA,significantly improve the symptoms of CB in rats,and inhibit the airway inflammatory response.