基于肾虚血瘀理论探讨艾灸对实验性类风湿性关节炎家兔抗炎镇痛的作用机制  

Mechanism of Moxibustion on Experimental RA Rabbit Anti-inflammation and Analgesia Based on Theory of Kidney Deficiency and Blood Stasis

作　　者：白玉 熊燕 李媛[3] 廖晨希 代静杨 周旻庆 陈白露 武平[4] BAI Yu;XIONG Yan;LI Yuan;LIAO Chenxi;DAI Jingyang;ZHOU Minqing;CHEN Bailu;WU Ping(Department of Rehabilitation Medicine,Jiangyou Municipality the Second People's Hospital,Jiangyou 621700,Sichuan,China;Dazhou Central Hospital,Dazhou 635099,Siehuan,China;Teaching Hospital of Chengdu University of TCM,Chengdu 610075,Siehuan,China;Chengdu University of Chinese Medicine,Chengdu 610075,Siehuan,China;Hospital(TCM)Affiliated to .Southwest Medical University,Luzhou 646000,Gansu,China)

机构地区：[1]江油市第二人民医院康复医学科,四川江油621700 [2]达州市中心医院,四川达州635099 [3]成都中医药大学附属医院,四川成都610075 [4]成都中医药大学针灸推拿学院,四川成都610075 [5]西南医科大学附属中医医院,四川泸州646000

出　　处：《中华中医药学刊》2019年第1期85-88,I0004,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81373738);四川省科技计划项目(2017JY0016)

摘　　要：目的:观察艾灸"肾俞""足三里"对实验性类风湿性关节炎(Rheumatoid arthritis,RA)家兔滑膜组织中TGF-β1、NF-κBp65、VEGF含量和TGF-β1/NF-κB通路的影响;基于肾虚血瘀理论探讨艾灸治疗RA的抗炎镇痛作用机制。方法:将30只日本大耳白兔(简称"家兔"),随机分为空白组、对照组、治疗组,每组10只。对照组、治疗组用0.5 mL/kg弗氏完全佐剂(FCA)法造模,空白组不作任何处理。在造模后第7天,用艾炷灸治疗组家兔双侧"肾俞""足三里"各5壮,1次/d,两侧交替进行,共治疗3个疗程18 d,两疗程之间休息1 d,空白组和对照组不进行艾灸治疗。治疗后第21天,取膝关节滑膜组织和滑膜液。采用免疫组化染色法进行滑膜组织染色并测定组织中TGF-β1、NF-κBp65、VEGF蛋白基因表达水平。结果:与空白组比较,对照组家兔滑膜组织中TGF-β1、NF-κBp65、VEGF蛋白含量均明显升高,具有显著的统计学意义(P<0.01)。治疗后,与对照组相比,治疗组RA家兔滑膜组织TGF-β1、NF-κBp65、VEGF蛋白含量均降低,具有显著的统计学意义(P<0.01)。结论:艾灸"肾俞""足三里"能降低RA家兔滑膜组织TGF-β1、NF-κBp65的蛋白含量,下调VEGF的表达,从而抑制血管新生和血管翳形成,缓解滑膜炎症,提示艾灸可能是通过调肾活血治法发挥抗炎镇痛之效。Objective: To observe the influence of moxibustion at "Shenshu(BL23)","Zusanli(ST36)" on TGF-β1,NF-κBp65,VEGF and NF-κB/TGF-β1 pathway in the synovial tissue of rheumatoid arthritis(RA)rabbits based on the theory of kidney deficiency and blood stasis and discuss the mechanism of anti-inflammation and analgesic effect of moxibustion on RA.Methods: A total of 30 rabbits(Japanese Big-ear White species)were randomly divided into blank control group(hereinafter referred to as the "blank"), RA model group(hereinafter referred to as the "model"), moxibustion treatment group(hereinafter referred to as the "moxibustion")with 10 cases in each.RA model and moxibustion groups were established by injection of Freund's Complete Adjuvant(FCA, 0.5 mL/kg)into the animals' bilateral joint cavities.On the 7th day after modeling, moxibustion was applied to bilateral "Shenshu(BL23)" and "Zusanli(ST36)", 5 cones every time, once a day(except Sundays), 18 days altogether.The "blank" and "model" did not make any treatment.After treatment for 21 days,synovial was obtained and dyed immunohistochemically to measure the TGF-β1,NF-κBp65 and VEGF protein gene expression levels in the synovial tissue.Results: Compared with "blank",the TGF-β1,NF-κBp65 and VEGF protein levels were obviously enhanced in RA model group(P<0.01).After treatment,while compared with "model", those in "moxibustion" decreased considerably(P<0.01).Conclusion: Moxibustion at "Shenshu(BL23)" and "Zusanli(ST36)" can reduce the TGF-β1 and NF-κBp65 protein levels, regulate the VEGF expression and stop the vascular and pannus formation, and thus improving synovial inflammation.It is suggested that moxibustion may play an anti-inflammatory and analgesic effect by regulating the kidney and activating blood.

关 键 词：艾灸 转化生长因子-Β1 核转录因子-ΚB 肾虚血瘀 抗炎镇痛 

分 类 号：R245.81[医药卫生—针灸推拿学] R593.22[医药卫生—中医临床基础]