摘要
目的 探讨中药方剂和复方磺胺甲基异恶唑（SMZCO）针剂联合治疗卡氏肺孢子菌肺炎大鼠模型的疗效.方法 选用SD大鼠,设置正常对照组4只,利用地塞米松注射法,复制SD大鼠卡氏肺孢子菌肺炎模型并按随机数字法分为：卡氏肺孢子菌肺炎模型组9只,SMZCO治疗组9只,中药方剂治疗组9只,中药方剂联合SMZCO治疗组9只.酶联免疫分析法检测各组大鼠肺泡灌洗液中白细胞介素8（IL-8）、肿瘤坏死因子α（TNF-α）和血清乳酸脱氢酶（LDH）含量;六胺银染色观察肺组织印片肺孢子菌包囊,光镜和电镜观察肺组织病理学和超微结构变化.结果 5组间肺泡灌洗液的IL-8、TNF-α水平总体方差分别为8.97、10.23,P值为0.038、0.031,其总体差异有统计学意义.在治疗组中,中药方剂治疗组IL-8水平较高[（476±45） μg/L],中药方剂联合SMZCO治疗组最低[（302±18） μg/L],差异有统计学意义（P＜0.05）.5组间LDH水平总体差异有统计学意义（P =0.036）.同SMZCO治疗组比较,中药方剂治疗组LDH水平[（184 ±56） U/L]较高,中药方剂联合SMZCO治疗组[（96±35） U/L]最低,差异有统计学意义（均P＜0.05）.SMZCO治疗组、中药方剂治疗组、中药方剂联合SMZCO治疗组的肺孢子菌包囊减少率分别为85.5％、15.2％和90.3％,差异有统计学意义（P＜0.05）.与SMZCO治疗组比较,中药方剂联合SMZCO治疗组肺间质炎性细胞浸润明显减少,肺泡及间隔修复基本完整,肺组织结构接近正常,肺孢子菌包囊明显减少.电镜观察模型组的肺组织可见肺泡上皮细胞变性脱落,基底膜暴露,间质胶原纤维增生,肺泡腔内蛋白渗出增多.肺孢子菌虫体与肺泡上皮细胞紧密接触.结论 中药方剂对卡氏肺孢子菌肺炎大鼠模型的虫体、炎性因子等有一定抑制作用,可改善肺泡上皮损伤,与SMZCO联合使用有较好疗效.
Objective To investigate the therapeutic effect of integrated Chinese medicinal formulae with sulfamethoxazole （SMZCO） injection on pneumocystis carinii pneumonia （PCP） rat model.Methods The PCP Sprague-Dawley （SD） rat models were reproduced by the dexamethasone injection method,and the models were randomly divided into follow groups：normal control group （4 rats）,group B （PCP model,9 rats）,SMZCO treatment group（9 rats）,Chinese medicinal formulae treatment group （9 rats）,combination with Chinese medicinal formulae and SMZCO treatment group（9 rats）.The concentrations of interleukin （IL）-8,tumor necrosis factor （TNF）-alpha in bronchoalveolar lavage fluid （BALF） and serum lactate dehydrogenase （LDH） were measured by enzyme-linked immunosorbent assay （ELISA）.The Pneumocystis cysts were calculated by silver stain method.The pathology and ultrastructural changes were observed by light microscope after hematoxylin-eosin staining stain and electronic microscope.Results There were statistical significances of IL-8 and TNF-α concentrations in five groups.The F values were 8.97,10.23 respectively ; P values were 0.038,0.031 respectively.The IL-8 value in Chinese medicinal formulae treatment group（9 rats） was the highest （476 ±45） μg/L and the IL-8 value in group E was the lowest （302 ± 18） μg/L.There was a statistical significance of serum LDH concentration in the five groups （P =0.036）.Compared with serum LDH value in Chinese medicinal formulae treatment group,the LDH value in Chinese medicinal formulae treatment group was the highest [（184 ± 56） U/L] ; the value in combination with Chinese medicinal formulae and SMZCO treatment group was the lowest [（96 ± 35） U/L].The differenceswere statistically significant （P 〈 0.05）.The decrement rates among the treatment group were 85.5%,15.2% and 90.3% respectively,and the differences were statistically significant （P 〈 0.05）.Compared with the pathological observation in Chinese medicinal
出处
《中国医药》
2014年第2期168-172,共5页
China Medicine
基金
浙江省中医药普通课题（2007CA088）
关键词
卡氏肺孢子菌
卡氏肺孢子菌肺炎
复方磺胺甲基异恶唑
中药方剂
Pneumocystis carinii
Pneumocystis carinii pneumonia
Compound sulfamethoxazole
Chinese medicinal formulae
