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[目的]探讨促胃肠动力西药联合理气中药对糖尿病大鼠胃排空延迟的影响及其机制。[方法]70只7周龄雄性SD大鼠随机分为两组:正常组(A组,n=10),模型组(n=60)。模型组大鼠首先通过腹腔内注射四氧嘧啶建立糖尿病模型,造模成功大鼠随机分为4组:对照组(B组,n=15)、理气中药治疗组(C组,n=15)、伊托必利治疗组(D组,n=14)、伊托必利联合理气中药治疗组(E组,n=14)。依照各组要求,每日予以相应药物灌胃,饲养24周后,全部大鼠行13C胃固体半排空实验,记录胃半排空时间,处死大鼠并取材,进行苏木-伊红(HE)和神经元型一氧化氮合酶(n NOS)免疫组化染色,观察胃壁病理改变。[结果]1)与A组大鼠相比,B组、C组、D组、E组大鼠胃固体半排空时间明显延长(P<0.01)。2)C组、D组、E组大鼠胃排空时间较对B组明显减少(P<0.05);E组大鼠胃排空时间较D组及C组大鼠明显减少(P<0.01)。3)HE染色结果表明,与A组大鼠相比,B组、C组、D组、E组大鼠胃环肌及纵肌变薄,肌间神经丛数量减少,免疫组化n NOS表达明显减少(P<0.05)。4)D组大鼠肌间神经丛数目较B组明显增加(P<0.05),而C组及E组大鼠肌间神经丛数目明显高于D组(P<0.05),且E组大鼠n NOS阳性神经丛数明显高于D组(P<0.05)。[结论]规律应用理气中药,可明显促进糖尿病大鼠胃排空,且和伊托必利联合应用,可获得更佳效果。实验结果表明其对平滑肌及肌间神经丛有一定保护作用,并可促进n NOS的表达,此可能是其的作用机制。
[Objective] To investigate the effect and mechanism of gastrointestinal motility combined with western medicine on gastric emptying delay in diabetic rats. [Methods] Seventy 7-week-old male SD rats were randomly divided into two groups: normal group (group A, n = 10) and model group (n = 60). Rats in model group were induced by intraperitoneal injection of alloxan to establish diabetic model. The rats were randomly divided into 4 groups: control group (B group, n = 15), TCM group (n = 15) , Itopride treatment group (group D, n = 14) and Itopride combined with qi treatment group (group E, n = 14). According to the requirements of each group, the rats were given the corresponding drugs daily. After 24 weeks of feeding, all the rats were subjected to 13C gastric emptying test, the gastric emptying time was recorded, the rats were killed and taken for hematoxylin and eosin HE) and neuronal nitric oxide synthase (nNOS) immunohistochemical staining to observe the gastric wall pathological changes. [Results] 1) Compared with group A, gastric emptying time in group B, group C, group D and group E was significantly prolonged (P <0.01). 2) The gastric emptying time of rats in group C, group D and group E was significantly lower than that of group B (P <0.05); The gastric emptying time of group E was significantly lower than that of group D and group C (P <0.01) ). 3) The results of HE staining showed that compared with group A, the gastric muscle and longitudinal muscle of rats in group B, C, D and E became thinner, the number of myenteric plexus decreased and the expression of nNOS in immunohistochemistry Significantly reduced (P <0.05). 4) The number of myenteric plexus in group D was significantly higher than that in group B (P <0.05), while the number of myenteric nerve plexus in group C and group E was significantly higher than that in group D (P <0.05) The number of NOS positive neurons in rats was significantly higher than that in D group (P <0.05). [Conclusion] The regular application of qi medicine can obviously promote the gastric emptying in diabetic rats, and combined with itopride, better results can be obtained. Experimental results show that it has some protective effect on smooth muscle and myenteric plexus, and can promote the expression of nNOS, which may be its mechanism of action.