研究增味小承气汤对梗阻性黄疸大鼠腹部切口愈合程度的影响。

将SD大鼠随机分为对照组、假手术组、梗阻性黄疸＋中药组和梗阻性黄疸组，每组10只，梗阻性黄疸＋中药组和梗阻性黄疸组大鼠建立梗阻性黄疸模型，建模前1 d至建模后第7天，梗阻性黄疸＋中药组大鼠每日以增味小承气汤灌胃2次，同时给予其他各组大鼠等量蒸馏水灌胃。模型建立后第3、5、7天自大鼠尾静脉取血，测定直接胆红素水平；术后第8天处死大鼠，留取标本，行皮肤切口抗张力实验、腹壁切口抗张力实验，皮肤切口行HE染色、Masson染色，免疫组化法检测α-平滑肌激动蛋白（SMA）。

与梗阻性黄疸组相比，梗阻性黄疸＋中药组大鼠精神状态好转，活动量有所增加；建立模型后第3、5、7天留取的血清检查发现，梗阻性黄疸＋中药组和梗阻性黄疸组血清直接胆红素水平较对照组、假手术组均程度明显升高，说明模型建立成功。与梗阻性黄疸组相比，梗阻性黄疸＋中药组大鼠皮肤切口所抗张力程度明显提高（F=127.4，P<0.05），腹壁切口抗张力程度明显提高（F=101.9，P<0.05）；皮肤切口组织HE染色可见，与梗阻性黄疸组比较，梗阻性黄疸＋中药组大鼠切口愈合较好，Masson染色可见梗阻性黄疸＋中药组胶原纤维分布均匀紧密；各组皮下α-SMA表达量有差异，差异具有统计学意义（F=16.59，P<0.05），与梗阻性黄疸组相比，梗阻性黄疸＋中药组皮下α-SMA表达量增加，差异具有统计学意义（t=5.245，P<0.05）。

增味小承气汤明显加快了梗阻性黄疸大鼠腹部切口纤维化的形成，增加了切口的抗张力程度，促进了腹部切口的愈合。

To observe the effect of modified Xiaochengqi decoction on skin incision healing in rats with obstructive jaundice (OJ).

Healthy male rats were randomly divided into a control group, sham group, OJ+ traditional Chinese medicine (OJ+ M) group, and OJ alone group, each of which contained ten animals. The control group was not treated surgically; the sham group underwent separation of the common bile duct using laparotomy instruments, followed by abdominal closure; both the OJ+ M and OJ groups received laparotomy and separation of the common bile duct, which was ligated near the porta hepatis, followed by abdominal closure. From the day before modeling to the 7 th day after modeling, intragastric administration of modified Xiaochengqi decoction was performed in the OJ+ M group twice a day (in the morning and evening, respectively), while equal amount of distilled water was intragastrically administered in all other groups. All rats were killed on the 8 th day after modeling with specimens collected. The rats were observed in terms of general conditions, serum direct bilirubin, and incision healing. The general conditions of each group, such as activity level, mental state, and defecation, were recorded. Blood was collected via the caudal vein on the 3 rd, 5 th, and 7 th days after modeling, followed by centrifugation to obtain the serum, which was then stored at -20 ℃ for subsequent detection. Rat skin incision and abdominal incision were reserved for skin incision anti-tension test, abdominal incision anti-tension test, HE staining, Masson staining, and immunohistochemical detection of α-smooth muscle actin (α-SMA) expression to observe the effect of modified Xiaochengqi decoction on abdominal incision healing in OJ rats.

Compared with the OJ group, the rats of the OJ+ M group exhibited improved mental state and increased activity level. On the 3 rd, 5 th, and 7 th days after modeling, the levels of serum direct bilirubin in the OJ+ M and OJ groups were significantly higher than those in the control group and sham group, suggesting successful establishment of an OJ model. Compared with the OJ group, the OJ+ M group was featured by significantly increased tension resistance on the skin incision (F=127.4, P<0.05) and abdominal incision (F=101.9, P<0.05). HE staining demonstrated that the incision was better healed in the OJ+ M group, and Masson staining showed evenly and closely distributed collagen fibers at a higher content in the latter group (t=5.241, P<0.05). Immunohistochemical detection of α-SMA expression in the OJ+ M group indicated that the subcutaneous distribution of α-SMA was wider and significantly increased around the incision (t=5.245, P<0.05).

Modified Xiaochengqi decoction increases the formation of fibrosis significantly, improves the degree of tension resistance on the skin incision and abdominal incision, and promotes the healing of abdominal incision.