(1天津市塘沽区天津市永久医院普外科天津300450)(2天津市塘沽中医医院天津300450)【摘要】目的 观察中药联合早期肠内营养对胃大部切除术后大鼠肠屏障功能的影响。方法 30只雄性Wistar大鼠随机分为PN组，EEN组和中药+EEN组，每组10只。从术后1d起连续营养支持7d，各组等氮、等热卡。观察术前1d，术后1d、4d、7d大鼠血浆D-乳酸和内毒素水平变化；术后7d大鼠空肠粘膜组织形态学变化。结果 3组D-乳酸水平在术后均有升高，中药+EEN组在术后7d其水平已基本恢复正常。3组内毒素水平在术后均明显升高，EEN组和中药+EEN组在7d时较PN组明显回落，这两组间回落幅度无统计学差异。3组的肠粘膜形态学都呈损伤改变，中药+EEN组较另2组数据显示损伤恢复最好。结论 中药联合EEN较单纯EEN及PN对胃大部切除术后大鼠肠屏障功能的恢复更有效。【关键词】早期肠内营养; 内毒素; D-乳酸;大承气汤 【项目基金】本课题受天津市塘沽区科委科技兴区专项资金资助(项目编号2009XQ12-08)【中国分类号】R656【文献标识码】B【文章编号】1004-5511(2012)04-0116-02 【Abstract】Objective To evaluate the influence of combination of “Dachengqi Decotion” and early enteral nutrition on intestinal mucosal barrier function after subtotal gastrectomy. Methods Subtotal gastrectomy was performed in thirty male Wistar rats and then the raats were divided randomly into three groups with ten animals in each group: parenteral nutrition group(PN group), early enteral nutrition group (EEN group) and treatment group (DCQD+EEN group). The rats received isocaloric and isonitrogenous nutrition support for seven days. The plasma levels of D-lactic acid ang endotoxemia were measured. The pathological morphology of jejural mucosa were detected after seven days. Result The levels of D-lactic acid in DCQD+EEN group were significantly lower than those in the other groups(P<0.05). The levels of endotoxemia in PN group were significantly higher than those in the other groups(P<0.05). The pathological morphology of jejural mucosa in DCQD+EEN group were best in the three groups. Conclusion “Dachengqi Decotion” combined with early enteral nutrition may effectively decrease the intestinal mucodsal permeability of the subtotal gastectomy rats and improve the intestinal mucosal barrier function.【Key words】early enteral nutrition ......