敗血症的高死亡率一直是臨床上的難題，由於其病程發展快速，病理機轉複雜，在治療上實有其難以掌握之處。在過去的研究中發現「性別」對於敗血症的病程發展與預後是一個重要的影響因子。本研究嘗試以補充性荷爾蒙的方式，探討不同性別之敗血症大鼠，於敗血症造型前接受連續三天的補陰中藥地黃或雌激素後，其體內性荷爾蒙、細胞激素與存活率之間的關係。
本研究以盲腸結紮及穿孔（cecal ligation and puncture, CLP）作為引發敗血症之模型。實驗設計為12週齡成年之公、母大鼠隨機分為六組，分別於術前三天接受每天兩次口服2 ml低劑量地黃（5 mg/ml）、高劑量地黃（10 mg/ml）以及皮下注射1 ml低劑量雌激素（5 μg/ml）、高劑量雌激素（10 μg/ml），另有空白對照組及假手術組。
結果：不論公、母鼠給予連續三天的雌激素後，血中雌性素濃度上升且雄性素濃度下降，相對於空白對照組，其CLP術後三天存活率較高，細胞激素IL-6與IL-10濃度較低。而給予補陰中藥地黃後，血中性荷爾蒙濃度未發生改變，但是，相對於空白對照組，其CLP術後三天存活率有升高的趨勢，且對於細胞激素IL-6、IL-10濃度沒有影響。根據此結果，推論補陰中藥地黃可以降低敗血症的死亡率，其機轉尚須做更進一步的研究與探討。
The high mortality of sepsis is a difficult issue in clinical practice. It is hard to control in sepsis treatment due to its rapid progression and complicated pathogenesis. In previous study, gender is found to be an important factor of sepsis progression and outcome. Therefore, in this study we tried to adopt the method of sex hormone replacement, in order to explore the relationship among the sex hormones, cytokines and survival rate of the treatment in three consecutive days of Yin-supplement Chinese herb Di-Huang and estradiol before the animal model of sepsis in different gender rats.
In this study, we adopt cecal ligation and puncture (CLP) as an animal model of sepsis. 12-week-old adult male and female rats were randomly divided into six groups. Before CLP surgery, the rats accepted 2 ml of low dose (5 mg/ml), high dose (10 mg/ml) Di-Huang by oral administration twice a day and 1 ml of low dose (5 μg/ml), high dose (10 μg/ml) estradiol by subcutaneous injection within three consecutive days. In addition, the control group and sham-operation group.
Result: After receiving of estradiol for continuously three days, the concentration of estradiol increased and testosterone decreased, whether in male or female rats. Compared with the control group, the survival rates of sepsis rats were higher and the concentrations of cytokine IL-6 & IL-10 were lower. And after receiving Yin-supplement Chinese herb Di-Huang, the concentration of sex hormones didn’t changed but the survival rate of sepsis rats had a rise trend and there was no effect on cytokine IL-6 & IL-10. According to the result, Yin-supplement Chinese herb Di-Huang could reduce the mortality rate of sepsis rats but the mechanism should be further investigated.
