严氏温阳化瘀利水方对心肌梗死后心力衰竭大鼠心功能及肾脏水通道蛋白2表达的影响研究  

Impact of YAN’s Wenyang-Huayu-Lishui Prescription on Cardiac Function and Expression of Aquaporin-2 in Kidney in Rats with Heart Failure Caused by Myocardial Infarction

作　　者：俞瑞群 乔亮 吴凤珠 张家美 YU Ruiqun;QIAO Liang;WU Fengzhu;ZHANG Jiamei(Bengbu Medical College,Bengbu 233030,China;Shanghai Integrated Chinese and Western Medicine Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200082,China)

机构地区：[1]蚌埠医学院,安徽省蚌埠市233030 [2]上海中医药大学附属上海市中西医结合医院,上海市200082

出　　处：《实用心脑肺血管病杂志》2019年第4期38-41,46,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：上海市卫生和计划生育委员会科研课题(20164Y0229);上海市虹口区“国医强优”三年行动计划中医药科研基金项目(HGY-KY-2018-23);蚌埠医学院研究生科研创新计划项目(Byycx1727)

摘　　要：背景严氏温阳化瘀利水方是全国名中医严世芸教授研制的心力衰竭经验方,其治疗心力衰竭的临床疗效确切,但具体作用机制尚未完全明确。目的探讨严氏温阳化瘀利水方对心肌梗死后心力衰竭大鼠心功能及肾脏水通道蛋白2(AQP2)表达的影响。方法 2018年6-9月完成实验。将60只14周龄SPF级SD大鼠随机分为A组(制备模型,n=45)和B组(假手术,n=15),采用冠状动脉结扎法制备心肌梗死后心力衰竭大鼠模型,然后将心肌梗死后心力衰竭制备成功的28只大鼠随机分为A1组(n=9)、A2组(n=10)、A3组(n=9)。A2组大鼠给予坎地沙坦溶液灌胃,A3组大鼠给予严氏温阳化瘀利水方常规煎煮后灌胃,B组和A1组大鼠给予等体积蒸馏水灌胃;4组大鼠均连续灌胃8周。采用超声心动图检测各组大鼠左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)、左心室短轴缩短率(LVFS),采用酶联免疫吸附试验检测各组大鼠血浆氨基末端脑钠肽前体(NT-proBNP)水平,采用蛋白印记法检测各组大鼠肾髓质AQP2表达水平,采用实时荧光定量聚合酶链反应检测各组大鼠肾髓质AQP2 mRNA表达水平。结果(1)灌胃8周后,B组、A1组、A2组、A3组大鼠LVEDD、LVEF比较,差异无统计学意义(P>0.05);B组、A2组、A3组大鼠LVESD短于A1组,LVFS高于A1组(P<0.05);A1组、A2组、A3组大鼠血浆NT-proBNP水平高于B组,A2组、A3组大鼠血浆NT-proBNP水平低于A1组,A3组大鼠血浆NT-proBNP水平高于A2组(P<0.05)。(2)灌胃8周后,A1组、A2组、A3组大鼠AQP2、AQP2 mRNA相对表达量高于B组,A3组大鼠AQP2、AQP2 mRNA相对表达量低于A1组(P<0.05)。结论严氏温阳化瘀利水方能有效改善心肌梗死后心力衰竭大鼠左心室收缩功能,下调肾脏AQP2表达,与坎地沙坦治疗效果相似,但其较坎地沙坦对心力衰竭严重程度的改善效果略差。Background YAN’s Wenyang-Huayu-Lishui prescription is proved recipe for heart failure developed by professor YAN Shiyun(a renowned TCM physician in China);although the efficacy of YAN’s Wenyang-Huayu-Lishui prescription is definite,the specific mechanism of action is not fully clear. Objective To investigate the impact of YAN’s Wenyang-Huayu-Lishui prescription on cardiac function and expression of aquaporin-2 in kidney in rats with heart failure caused by myocardial infarction. Methods The experiment was carried out from June to September 2018. A total of 60 14-week-old SPF SD rats were randomly divided into A group(preparation for model,n=45)and B group(treated with sham-operation,n=15). Rats in A group was prepared by coronary artery ligation,and then 28 successfully prepared rats were randomly divided into A1 group(n=9),A2 group(n=10)and A3 group(n=9). Rats in A2 group received gavage of solution of candesartan cilexetil tablet,rats in A3 group received gavage of regular decoction of YAN’s Wenyang-Huayu-Lishui prescription,while rats in B group and A1 group received gavage of equivoluminal distilled water;all the rats were intervened for 8 weeks.Echocardiography was performed to measure the LVEDD,LVESD,LVEF and LVFS,ELISA was used to detect the plasma NT-proBNP level,Western blotting was adopted to detect the expression of AQP2 in renal medulla,and RT-qPCR was used to detect the expression of AQP2 mRNA in renal medulla. Results(1)After 8 weeks of intervention,no statistically significant difference of LVEDD or LVEF was found in B group,A1 group,A2 group and A3 group(P>0.05);LVESD in B group,A2 group and A3 group was statistically significantly shorter than that in A1 group,respectively,while LVFS in B group,A2 group and A3 group was statistically significantly higher than that in A1 group,respectively(P<0.05);plasma NT-proBNP in A1 group,A2 group and A3 group was statistically significantly higher than that in B group,respectively,meanwhile plasma NTproBNP in A2 group and A3 group was statistically si

关 键 词：心肌梗死 心力衰竭 严氏温阳化瘀利水方 心功能 水通道蛋白2 大鼠 

分 类 号：R542.22[医药卫生—心血管疾病] R541.6[医药卫生—内科学]