Chen De-chang, Wang Lü
Department of Emergency and Critical Care Medicine, Changzheng Hospital, Second Military Medical University, China.
Chin J Traumatol. 2009 Dec;12(6):365-9.
It is proposed that gut-liver-lung axis plays an important role in the pathophysiologic development of the critical illness, and it induces excessive inflammatory response in vivo and multiple organ dysfunction syndrome. The mechanisms of therapeutic effects of rhubarb on critical patients are studied based on the theory of Chinese traditional medicine. Researches demonstrate that rhubarb can be used to protect gut barrier, maintain intestinal micro-ecological environment and prevent bacterial translocation. It also can be used to inhibit the release of inflammatory mediators by liver inflammatory-effector cells, reduce inflammatory reaction in the liver and protect hepatic cell functions. Furthermore, rhubarb can be used to reduce pulmonary vascular permeability and extenuate pulmonary edema, inhibit the release of neutrophil myeloperoxidase, and lower the level of inflammatory response and decrease inflammatory mediators in circulation. The above results indicate that rhubarb may interrupt or partly interrupt the gut-liver-lung axis after trauma and reduce the intensity of systemic inflammatory response syndrome. Therefore, rhubarb may obviously lower the incidence of multiple organ dysfunction syndrome and be used to prevent and treat systemic inflammatory response syndrome and multiple organ dysfunction syndrome after trauma.
研究表明，肠 - 肝 - 肺轴在危重病的病理生理发展中起重要作用，它可诱导体内过度的炎症反应和多器官功能障碍综合征。基于中医理论对大黄治疗危重病患者的作用机制进行了研究。研究表明，大黄可用于保护肠道屏障，维持肠道微生态环境并防止细菌移位。它还可用于抑制肝脏炎症效应细胞释放炎症介质，减轻肝脏炎症反应并保护肝细胞功能。此外，大黄可用于降低肺血管通透性，减轻肺水肿，抑制中性粒细胞髓过氧化物酶的释放，并降低炎症反应水平，减少循环中的炎症介质。上述结果表明，大黄可能在创伤后中断或部分中断肠 - 肝 - 肺轴，降低全身炎症反应综合征的强度。因此，大黄可能明显降低多器官功能障碍综合征的发生率，并可用于预防和治疗创伤后的全身炎症反应综合征和多器官功能障碍综合征。
