养肝利胆颗粒治疗胆囊炎作用机理探究.docVIP

养肝利胆颗粒治疗胆囊炎作用机理探究 　作者：高建平，金若敏，朱培庭，吴耀平，沈伟，陈艳艳 【摘要】 　　目的观察养肝利胆颗粒的溶石和抗菌作用。方法采用体外溶石实验观察该药的溶石作用；采用豚鼠胆色素结石模型观察口服养肝利胆颗粒对动物的成石率和胆汁成分的影响；采用体外试管法研究药物的直接抑菌作用以及含药血清和含药胆汁的抑菌作用。结果养肝利胆颗粒体外能溶解胆色素型、胆固醇型和混合型结石;体内能降低模型豚鼠的成石率，升高胆汁中总胆汁酸的量，降低总胆红素和游离胆红素含量；药物对痢疾杆菌、变形杆菌、大肠杆菌等有直接抑制作用；含药血清和含药胆汁对大肠杆菌、痢疾杆菌等有较强的抑菌作用。结论养肝利胆颗粒治疗胆囊炎主要的作用机理是其具有溶石和抗菌作用。 【关键词】 养肝利胆颗粒； 胆囊炎； 溶石； 抗菌； 作用机理 　　Abstract:ObjectiveTo investigate the effect of Yang-Gan-Li-Dan Granule (YGLDG) on litholysis and bacteriostasis. MethodsThe effect of the granule on litholysis was tested in vitro. The model of bile pigment calculus in guinea pigs was established,and the effect of the granule on anti-lithogenesis and on bile components was also observed in vitro. By adding the granule dilution, the drug contained serum and bile, which were prepared from the rats given the granule per os, directly into the culture medium, the anti-bacteria effect of the granule was evaluated.ResultsIn vitro, YGLDG solution could increase the litholytic effect on human bile pigment calculus, chelecsterol calculus and combined calculus. In vitro, it could inhibit lithogenesis in guinea pigs, elevate the level of total bile acid and reduce the levels of total and free bilirubin. In vitro, YGLDG showed the bacteriostatic effect for Bacillus dysteriae, Escherichia coli, Staphylococcus aureus etc. The drug-contained serum and bile had the obvious bacteriostatic effect on Escherichia coli, Bacillus dysteriae etc.ConclusionThe results show that the main mechanisms of YGLDG on treating cholecystitis are related to its effects on litholysis and bacteriostasis. 　　Key words:Yang-Gan-Li-Dan Granule (YGLDG); Cholecystitis; Litholysis; Bacteriostasis; Mechanism 胆囊炎是胆道系统常见疾病，其发生和发展的主要原因多与胆囊结石和细菌感染等有关［1～3］。养肝利胆方是上海中医药大学附属龙华医院名中医朱培庭教授多年的临床经验方，主要由白芍、首乌等中药组成，适用于属于肝阴不足之证的胆道感染和胆石症。临床实验显示该方对于胆囊炎和胆石症治疗的总有效率达90%以上［4］。已有研究证实养肝利胆颗粒具有抗炎、镇痛、解痉以及保肝利胆等作用［5，6］，证明该方对胆囊炎的常见临床症状和病理生理异常具有改善作用。为进一步探讨其治疗胆囊炎的作用机理，笔者对养肝利胆颗粒溶石防石和抗菌等作用进行了研究。结果报道如下。 　　1 材料与仪器 　　1.1 试剂和药物 　　养肝利胆颗粒（干膏粉），四川美大康药业