目的：根据“肺合大肠”理论拟定治肺、治肠、肺肠同治方药，观察不同治法对脓毒症急性肺损伤大鼠肺组织MMP-9、TIMP-1及MMP-9/TIMP-1比值的变化，探讨“肺肠同治”法治疗脓毒症肺损伤的作用机制。方法将清洁级SD雄性大鼠50只随机分为假手术组、模型组、治肺组、治肠组、肺肠同治组，每组10只。以盲肠结扎穿孔（CLP）法制备脓毒症大鼠模型，观察CLP术后24h大鼠肺组织匀浆中MMP-9、TIMP-1及MMP-9/TIMP-1比值、肺湿/干重比（W/D）的情况。结果与假手术组比较，模型组、治肺组、治肠组、肺肠同治组大鼠肺湿/干重比均明显增大（P<0.01）；与模型组比较，治肺组、治肠组、肺肠同治组的大鼠肺湿/干重比均显著减小（P<0.01或P<0.05）。与假手术组比较，模型组、治肺组、治肠组、肺肠同治组的大鼠MMP-9、TIMP-1显著增高（P<0.01或P<0.05），TIMP-1/MMP-9比值显著下降（P<0.01或P<0.05）。与模型组比较，治肺组、治肠组、肺肠同治组大鼠MMP-9降低[（12.56±0.76）、（12.50±0.98）、（10.50±0.71）比（14.80±0.59），P<0.05]，TIMP-1显著下降[（14.10±1.12）、（14.30±1.30）、（10.90±0.53）比（17.70±1.06），P<0.05]，TIMP-1/MMP-9比值显著升高[（0.91±0.04）、（0.90±0.04）、（0.98±0.03）比（0.84±0.03），P<0.05]。结论“治肺”法、“治肠”法、“肺肠同治”法均可以下调肺损伤模型大鼠肺组织MMP-9基因与TIMP-1基因表达，从而减轻脓毒症大鼠的肺损伤，对肺脏有一定的保护作用，其中以肺肠同治法效果最好。%Objective According to the"Treat Lung and Colon Together"theory, we developed prescriptions for the treatment of lung, colon and both, respectively. This study aimed to observe the effectof these prescriptions on the level of metalloproteinase-9 (MMP-9), TIMP-1 (metallopeptidase inhibitor 1) and the ratio of MMP-9/TIMP-1 in lung tissue of rats with acute lung injury and to explore the underlying mechanism. Methods Fifty SD male rats were randomly divided into 5 groups with 10 in each group: sham operation group, model group, lung treat-ment group, colon treatment group, lung and colon treatment group. Cecal ligation and puncture (CLP) was used to generate sepsis in rats in all groups except sham operation group; the level of MMP-9 and TIMP-1 and the ratio of MMP-9/TIMP-1 in lung tissue and lung wet/dry weight ratio (W/D) were observed in 24h after CLP. Results Compared with sham operation group, the W/D ratio was increased in model group and lung, colon or lung and colon treatment groups (P<0.01); compared with the model group, the W/D ratio was decreasedin lung, colon or lung and colon treatment groups (P<0.01 or P<0.05). Compared with sham operation group, the level of MMP-9 and TIMP-1 wasregulated and the ration of TIMP-1/MMP-9 was decreased in treatment groups(P<0.01 or P<0.05);compared with model group, lung, colon or lung and colon treatment groups had lower levels of MMP-9 (12.56±0.76, 12.50±0.98, 10.50±0.71 vs 14.80±0.59) and TIMP-1(14.10±1.12, 14.30±1.30, 10.90±0.53 vs 17.70±1.06) and higher ration of TIMP-1/MMP-9(0.91±0.04, 0.90±0.04, 0.98±0.03 vs 0.84±0.03), with all P<0.05. Conclusion The prescriptions from the "Treat Lung and Colon Together" theory can reduce the level of MMP-9 and decrease TIMP-1 in rats with sepsis, which is benefit to ameliorating lung injury. The effect is more prominent in lung and colon treatment group.
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