基于胃肠动力调节与透皮吸收探讨中药外用制剂消胀贴膏治疗肝硬化腹水的作用机制

摘要

基于“消胀贴膏”敷脐促进肝硬化腹水减退的临床疗效，及该药促进患者排气与减轻腹胀的作用特点，结合胃肠动力影响肝硬化腹水的研究进展，探讨消胀贴膏调节胃肠动力促进肝硬化腹水消退的作用机制及效应物质。首先观察药物敷贴对肝硬化腹水动物胃肠动力、腹内压、肾血流与腹水量的影响及其相关关系；分析药物对模型动物胃肠激素、血管活性因子及胃肠动力调节关键细胞-Cajal间质细胞数量与功能的作用。继之，观察药物对离体胃肠组织平滑肌收缩、对Ca-jal间质细胞SCF/c-kit信号通路等的影响。最后，分析消胀贴膏的整体动物与离体皮肤透皮入血成分，并评价其影响小肠平滑肌收缩的活性。最终验证“消胀贴膏主要通过促进胃肠动力，从而降低腹内压，增加肾血流量，促进腹水减退，并且具有透皮吸收的效应成分”的科学假说，部分诠释中医“气行则水行”的科学内涵，阐明消胀贴膏外用治疗肝硬化腹水主要作用原理，提高中医药外治法的基础研究水平。%Chinese herbal cataplasm Xiaozhang Tie showed good adjuvant effect on patients of cirrhotic ascites by means of promo-ting the gas passing and releasing abdominal distension. This study will focus on the mechanism of Xiaozhang Tie on cirrhotic asci-tes and its active components based on the gastrointestinal motility. Firstly we will observe the effect of Xiaozhang Tie on gastroin-testinal motility, abdominal pressure, renal blood flow and ascites as well as their relationships in rats with cirrhotic ascites. Sec-ondly we will assess their gastrointestinal hormones, rennin and angiotensin, in particular, viability and functions of Cajal intersti-tial cell relating to stem cell factor ( SCF)/c-kit signal pathway will be investigated. At last, the active components in the blood by transdermal absorption will be detected. The scientific hypotheses of Xiaozhang Tie serving good acceleration effect on cirrhotic as-cites by means of promoting gastrointestinal motility to release abdominal distension and raise renal blood flow as well as its main active components by percutaneous absorption will be verified. Furthermore, Xiaozhang Tie′s action mechanism will be clerified and the basic research levels of TCM extrenal treatment would be improved.