目的：研究利胆汤对急性重症胆管炎的大鼠所致肝损伤的作用机制。方法：选择健康的Wistar大鼠60只，3月龄，雄性，随机分组为对照组、模型组、胆宁片组、利胆汤低剂量组、中剂量组和高剂量组6组，每组10只。分别于术后立刻、术后6 h、术后12 h、术后24 h 4个时间点收集大鼠胆汁，以及检测大鼠胆总管压力；对照组和模型组灌胃给予0.9%的氯化钠；胆宁片组灌胃给予胆宁片 0.5 g/(kg·d)；各利胆汤剂量组：6，12和24 g/(kg·d)，灌胃给药3天后处死大鼠。HE染色观察大鼠肝病理形态；ELISA检测的方法大鼠血清中的细胞因子IL-6，TNF-α水平；Q-PCR法检测大鼠肝脏巨噬细胞移动抑制因子(migration inhibitory factor，MIF)和Toll样受体4(Toll-like receptor 4，TLR4)基因的表达。结果：利胆汤能明显的降低血清细胞因子IL-6(P<0.05)、TNF-α的表达(P<0.01)，并且明显抑制MIF和TLR4的表达(P<0.01)。结论：利胆汤能够改善大鼠急性重症胆管炎所致的肝损伤，作用机制可能通过抑制MIF和TLR4的表达和下调IL-6，TNF-α的表达水平实现的。
Lidantang attenuates severe acute cholangitis induced hepatic injury
Objective: To investigate the mechanism of lidantang for treatment of hepatic injury induced by severe acute cholangitis. Methods: Sixty male Wistar rats were randomly divided into Control group (0.9% NaCl), Model group (0.9% NaCl), Danningpian group (0.5 g/kg), and lidantang group [6, 12, 24 g/(kg·d)]. At 0, 6, 12, 24 h post-surgery, the rat bile was collected, and the pressure of duct were measured. After 3 days of intragastric administration and all rats were killed, pathological morphologic change were observed by HE staining, ELISA was used to assess the levels of serum cytokines IL-6, TNF-α, macrophage migration inhibitory factor (MIF) and Toll-like receptor 4 (TLR4) was assessed by Q-PCR. Results: Lidantang could decrease the level of serum TNF-α (P<0.01) and reduce the level of serum IL-6 (P<0.05), moreover, lidantang could also decrease the expression of MIF (P<0.01) and TLR4 (P<0.01). Conclusion: Lidantang can attenuate severe acute cholangitis induced hepatic injury via down-regulate the serum of IL-6, TNF-α and inhibit the expression of MIF, TLR4 in the liver.