悬灸与直接灸治疗类风湿关节炎小鼠的对比研究  

Comparative Study of Suspended Moxibustion and Direct Moxibustion in the Treatment of RA in Mice

作　　者：李尊元 李晓燕 赵创[1,2] 陈春兰 李淼[3] 谭倩 梁薇[1,2] 刘志丹[1,2] LI Zunyuan;LI Xiaoyan;ZHAO Chuang;CHEN Chunlan;LI Miao;TAN Qian;LIANG Wei;LIU Zhidan(Shanghai Baoshan Hospital Integrated of Chinese and Western Medicine,Shanghai 201999,China;Shuguang Hospital Affiliated to Shanghai University of TCM,Shanghai 201999,China;Yueyang Hospital Affiliated to Shanghai University of TCM,Shanghai 200437,China;Nanjing University of Chinese Medicine,Nanjing 210046,China)

机构地区：[1]上海市宝山区中西医结合医院,上海201999 [2]上海中医药大学附属曙光医院宝山分院,上海201999 [3]上海中医药大学附属岳阳中西医结合医院,上海200437 [4]南京中医药大学,江苏南京210046

出　　处：《针灸临床杂志》2018年第9期68-73,共6页Journal of Clinical Acupuncture and Moxibustion

基　　金：国家自然科学基金青年科学基金项目;编号:81403465;国家自然科学基金项目院内培育基金;编号:GZRPYJJ-201706;上海市宝山区卫生青年医学人才培养项目;编号:bswsyq-2017-A02;上海市宝山区中西医结合医院优秀青年医学人才培养项目(2016年)

摘　　要：目的:比较悬灸与直接灸对类风湿关节炎小鼠治疗作用的异同。方法:DBA/1J小鼠36只随机分为正常组、模型组、不治疗组、悬灸组、直接灸组和安慰治疗组。复制Ⅱ型胶原诱导的小鼠类风湿关节炎模型并予以艾灸治疗,观察悬灸与直接灸对关节肿胀、关节滑膜病理表现的影响,流式细胞术分析Th17、Treg细胞变化,ELISA检测相关细胞因子IL-1β/IL-6/IL-10/IL-17/TGF-β的含量。结果:经两次免疫后,小鼠足踝关节及脚掌、足趾关节出现红肿,CIA模型成功建立。治疗15天后,悬灸组小鼠关节肿胀有明显消退,关节评分低于模型组、不治疗组、直接灸组、安慰治疗组(P <0. 05)。病理表现上,悬灸组小鼠病变关节面粗糙较前缓解,滑膜层较治疗前变厚,与正常组病理表现较为接近;直接灸组关节面有一定恢复,但较悬灸组差;不治疗组及安慰治疗组无明显变化。ELISA检测发现CIA模型小鼠脾脏中IL-1β、IL-6、IL-17等致炎细胞因子表达增高、抑炎因子IL-10、TGF-β表达降低(均P <0. 01);悬灸和直接灸治疗后致炎因子含量与模型组比较相应降低、抑炎因子含量明显提高(均P <0. 01),且两组之间无统计学差异(均P> 0. 05)。流式细胞术显示:与正常小鼠相比,CIA模型小鼠调节性T细胞下降,而Th17细胞则上升(均P <0. 01);治疗后悬灸组Treg细胞的数量显著上升、Th17细胞的数量显著下降(均P <0. 01);而直接灸组、不治疗组、安慰治疗组Treg细胞、Th17数量与模型组比较无显著统计学差异(P> 0. 05)。结论:悬灸、直接灸均能减轻CIA小鼠关节滑膜病变、下调炎症因子和上调抗炎细胞因子含量;但与悬灸治疗比较,直接灸治疗对CIA小鼠关节肿胀度和脾Treg/Th17细胞失衡状态无显著作用。直接灸治疗CIA小鼠的疗效及作用机理还需进一步研究。Objective： To compare the effect difference between suspended moxibustion and direct moxibustion in mice with rheumatoid arthritis（ RA）. Methods： 36 DBA/1 J mice were randomly divided into the normal group,the model group,the non-treatment group,the suspended moxibustion group,the direct moxibustion group,and the placebo group. RA model was induced by injecting typeⅡ collagen. Moxibustion treatment was given to RA mice,the ankle swelling was evaluated by RA scale. The pathological changes of articular cavity and synovial membrane were observed by HE analysis. Flow cytometry was applied to evaluate the changes of Treg and Th17. Expressions of IL-1β,IL-6,IL-10,IL-17 and TGF-β were analyzed by ELISA method. Results： RA model was successfully established by the injection of typeⅡ collagen. The joint swelling of RA mice partly recovered in the suspended moxibustion group,the joint score was lower than that in the other RA groups（ P〈0. 05）. The joint synovial layer in RA mice was rougher and thinner than that of the normal mice,the synovial layer was smoother and thicker in the suspended moxibustion group after the treatment; Similar changes were observed in the direct moxibustion group,but they were less than those in the suspended moxibustion group; no changes were seen in the non-treatment group and the placebo group. IL-1β,IL-6,and IL-17 these inflammation related cytokines were increased and anti-inflammatory related cytokines,such as IL-10 and TGF-β were decreased in RA mice（ P〈0. 01）. The rise of IL-1β,IL-6,IL-17 and the decline of IL-10 and TGF-β were observed in the suspended moxibustion group and the direct moxibustion group（ P〈0. 01）,but no difference was observed between the two groups（ P〈0. 05）. Treg cells were decreased and Th17 cells were increased in RA mice（ P〈0. 01）; with the suspended moxibustion intervention,Treg cells were increased and Th17 cells were decreased（ P〈0. 01）; however,no difference was observed in the other groups（ P〈0. 05）.

关 键 词：类风湿关节炎 艾灸 悬灸 直接灸 小鼠 

分 类 号：R246.2[医药卫生—针灸推拿学]