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目的：观察中药合剂ＡＡ３在治疗重症胰腺炎（ＳＡＰ）肠粘膜屏障缺血性损害及对抗肠源性感染导致的二次打击中的机制。方法：ＳＤ大鼠随机分假手术组（ＳＯ）、ＳＡＰ组和ＡＡ３组。改良式激活剂胰被膜均匀浸润法制模；中药ＡＡ３以生大黄、丹参、生山栀为主。用ＦＩＴＣ标记大肠杆菌ＡＴＣＣ；检出肠系膜淋巴结、胰腺、肾脏、脾脏、肝脏标记菌；观察空肠细胞超微结构；进行回肠组织病理学检查。结果：各组间各被检脏器标记菌检出经统计学比较差异显著（ＳＡＰ组比ＳＯ组，Ｐ＜０．００１；ＳＡＰ组比ＡＡ３组，Ｐ＜０．０５）。ＳＡＰ组空肠上皮亚细胞结构损害，ＡＡ３组亚细胞结构基本完整、损害减轻。ＳＡＰ组回肠粘膜严重破坏，ＡＡ３组病理损害程度较ＳＡＰ组明显减轻。结论：“通里攻下、活血化瘀和清热解毒”治则治疗ＳＡＰ和降低死亡率的机制部分是通过保护肠粘膜屏障功能和减轻小肠缺血性损伤来实现的，中西医结合治疗ＳＡＰ能阻断其重症化过程
OBJECTIVE: To observe the mechanism of Chinese traditional medicine mixture AA3 in the treatment of ischemic injury of intestinal mucosal barrier in severe pancreatitis (SAP) and its secondary fight against enterogenous infection. Methods: SD rats were randomly divided into sham operation group (SO), SAP group and AA3 group. Modified activator pancreatic membrane uniform infiltration modeling; Chinese medicine AA3 rhubarb, Salvia, mainly Zhoushanzhi. E. coli ATCC was labeled with FITC; mesenteric lymph nodes, pancreatic, kidney, spleen and liver marker were detected; the ultrastructure of jejunum cells was observed; ileum histopathological examination was performed. Results: There were significant differences among the tested organs in each group (P <0.001 for SAP group, P <0.001 for SAP group, P <0.05 for AA group). SAP group jejunal epithelial subcellular structure damage, AA3 group subcellular structure is basically complete, lessening the damage. The ileal mucosa in SAP group was severely damaged, and the pathological damage in AA3 group was significantly less than that in SAP group. Conclusion: The mechanism of “Tongli attacking, promoting blood circulation to remove blood stasis and clearing heat and detoxifying” treatment of SAP and reduce mortality is partly through the protection of intestinal mucosal barrier function and relieve intestinal ischemic injury to achieve, SAP can treat SAP Block its critical process