基于“心受气于脾”理论探讨“从脾论治”心病的疗效机制  

Study on Mechanism of Treating Heart Diseases from Spleen Based on Theory of "Heart Affected by Spleen Qi"

作　　者：王佳楠 刘仕利[2] 英哲铭 徐宁阳[1] 李航[1] 王琪格 张哲[1] 杨关林[1] 刘悦[2] WANG Jianan;LIU Shili;YING Zheming;XU Ningyang;LI Hang;WANG Qige;ZHANG Zhe;YANG Guanlin;LIU Yue(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Affiliated Hosiptal of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《中华中医药学刊》2021年第6期68-72,I0020,共6页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金(81703970);辽宁中医药大学中医脏象理论及应用国家教育部重点实验室开放基金(zyzx1607)。

摘　　要：目的基于"心受气于脾"理论探讨"从脾论治"心病的疗效机制。方法 SPF级SD大鼠30只随机分为正常组、模型组和中药治疗组,每组10只。采用劳倦过度法联合饮食失节法建立脾气虚大鼠动物型,中药治疗组给予四君子汤灌胃,正常组和模型组给予生理盐水。通过大鼠的证候学特征和进食量、前肢抓力进行模型评价;采用酶联免疫吸附试验法(ELISA)检测大鼠脾细胞和心肌细胞complex V活性;利用RT-PCR法检测大鼠脾细胞和心肌细胞Na-K-ATP酶活性;通过HE染色观察脾脏组织和心脏组织的结构变化。结果脾气虚大鼠进食量、前肢抓力显著低于正常组(P<0.01),中药治疗组进食量、前肢抓力显著高于脾气虚大鼠(P<0.01)。在脾脏组织中,脾气虚大鼠complex V、Na-K-ATP酶活性明显降低(P<0.05),中药治疗组complex V、Na-K-ATP酶活性明显升高(P<0.05)。在心脏组织中,脾气虚大鼠complex V、Na-K-ATP酶活性降低,中药治疗组complex V、Na-K-ATP酶活性升高。脾气虚大鼠脾脏内结缔组织增生,脾小梁增厚,红髓区域变小,脾脏中央小动脉增生;中药治疗组较模型组恢复。脾气虚大鼠心肌细胞排列不整齐,少许炎症细胞浸润;中药治疗组较模型组恢复正常。结论劳倦过度法联合饮食失节法成功建立脾气虚大鼠动物模型,线粒体能量代谢的调控可能是"从脾论治"心病的疗效机制。Objective Based on the theory that "heart is affected by spleen Qi", the mechanism of treating heart diseases from spleen was discussed. Method Thirty SPF SD rats were randomly divided into normal group, model group and traditional Chinese medicine treatment group, with 10 rats in each group. The rat model of spleen Qi deficiency was established by the method of over food intake and excessive fatigue. The traditional Chinese medicine treatment group was administered with Sijunzi Decoction(四君子汤), and the normal group and model group were given normal saline. Model evaluation was performed based on the rats’ syndrome characteristics, food intake and forelimb grasping force. The enzyme-linked immunosorbent assay(ELISA) was used to detect the activity of complex V of rats splenocytes and cardiomyocytes. RT-PCR was used to detect rat spleen Na-K-ATPase activity of cells and cardiomyocytes. The structural changes of spleen and heart tissue were observed by HE staining. Result The food intake and forelimb grip of rats with spleen Qi deficiency were significantly lower than those of the normal group(P<0.01), and the food intake and forelimb grip of the traditional Chinese medicine treatment group were significantly higher than those of spleen Qi deficiency(P<0.01). In the spleen tissue, the complex V and Na-K-ATPase activities of the spleen Qi deficiency rats were significantly reduced(P<0.05), and the complex V and Na-K-ATPase activities of the traditional Chinese medicine group were significantly increased(P<0.05). In heart tissues, the complex V and Na-K-ATPase activities of the spleen Qi deficiency rats were decreased, while the complex V and Na-K-ATPase activities of the traditional Chinese medicine group were increased. The connective tissue hyperplasia, spleen trabecula thickening, red pulp region became smaller and the central spleen arterial hyperplasia were increased in the spleen Qi deficiency rats. The myocardial cells of the spleen Qi deficiency rats were not aligned, and there was a little inflamm

关 键 词：脾气虚 线粒体 四君子汤 健脾益气 心 

分 类 号：R259.41[医药卫生—中西医结合]