目的：研究加味四逆散（JWSNS）对模型大鼠胃粘膜超微结构、胃排空率及小肠推进比的影响，探讨JWSNS 干预应激性胃肠功能障碍的机制。方法：大鼠随机分为正常组，模型组，加味四逆散大、中、小剂量组，西沙比利组，采用慢性心理性应激方法建立应激性胃溃疡大鼠模型，经JWSNS 等干预后，采用透射电镜法观察腺胃区胃粘膜组织细胞及细胞间连接的超微结构改变，并检测胃肠动力变化。结果：电镜观察显示正常组大鼠胃粘膜上皮细胞间连接紧凑，胞膜完整，细胞器均匀分布，且形态正常，胞核形态及大小正常，核膜完整，无染色质浓缩、边集等异常；模型组大鼠胃粘膜上皮细胞间连接松解，胞膜结构部分缺失，胞质中细胞器崩解，基质透明，内质网扩张，线粒体肿胀，胞核形态极不规则，大量畸形核，部分核溶解，染色质明显边集、浓缩或均一化分布；其余治疗组均较模型组不同程度好转。与模型组比较，各治疗组及正常组胃排空率及小肠推进比均明显升高（P<0.05~0.01）；与西沙比利组比较，加味四逆散大剂量组胃排空率升高不明显（P>0.05），而小肠推进比升高明显（P<0.05）；与加味四逆散小剂量组比较，加味四逆散中、大剂量组胃排空率及小肠推进比升高明显（P<0.05~0.01）。结论：JWSNS可显著改善慢性心理应激胃溃疡模型大鼠胃粘膜组织细胞的微观病理形态，并可改善胃肠功能。

This study was aimed to establish a chronic rat model of acute stress ulcer, and observe effect of Jia-Wei -Si -Ni -San (JWSNS) on gastric emptying rate and small intestinal propulsion ratio, gastric mucosal ultrastructure of rat model. The mechanism of JWSNS on the treatment of stress-induced gastrointestinal dysfunction was studied. Rats were randomly divided into the normal group, model group, JWSNS large dosage, medium dosage and small dosage group, Cisapride group. Stress gastric ulcer rat model was made by chronic psychological stress method. After JWSNS intervention, the gastrointestinal motility of rats was detected. The gastric mucosa tissue cells of glandular stomach region and intercellular junctions ultrastructural alterations were observed with transmission electron microscopy method. The results showed that the normal rats gastric mucosa epithelial cells connect compactly under electron microscope observation, the cell membrane integrity, cell organelles are distributed uniformly, the morphology is normal, nuclear shape and size is regular, the nuclear membrane is integrity, no chromatin is condensate, edge set and other abnormal; model rats gastric mucosa epithelial intercellular connection release, cell membrane structure deletion partially, cytoplasmic organelles in the matrix disintegration, transparent, dilation of endoplasmic reticulum, mitochondria swell, nuclear are quite irregular in shape, large number of deformities, part of nuclear are in dissolution, chromatin are in obvious edge set, concentrated or uniform distribution; the rest of the treatment groups were different degree better than those in the model group. Compared with the model group, the gastric emptying rate and small intestinal propulsion ratio of the treatment groups and the normal group were significantly higher (P < 0.05 ~ 0.01). Compared with Cisapride group, the gastric emptying rate of JWSNS high dosage group were not significantly higher (P > 0.05), and the small intestinal propulsion ratio increased significantly (P < 0.05). Compared with JWSNS small dosage group, the gastric emptying rate and small intestinal propulsion ratio are increased significantly in the high and medium dosage group (P < 0.05 ~ 0.01). It was concluded that JWSNS can significantly improve gastric ulcer gastric mucosa cell microscopic pathologic morphology of the chronic psychological stress rat models. It can also improve the gastrointestinal function.

湖北省教育厅科学研究计划重大项目(Z20092901)：加味四逆散对身心应激大鼠胃肠功能的影响，负责人：谢慧臣；湖北民族学院博士科研启动基金项目（20110112）：加味四逆散对身心应激模型大鼠胃粘膜保护作用的实验研究，负责人：谢慧臣。