基于益气活血利水法探讨二参真武汤改善心肾阳虚型慢性心力衰竭大鼠的作用机制  

Mechanism of Ershen Zhenwu Decoction(二参真武汤)on Chronic Heart Failure Rats with Yang Deficiency of Heart and Kidney Based on Method of Invigorating Qi,Promoting Blood Circulation and Promoting Diuresis

作　　者：葛岚[1] 程丹[2] 朱振鹏 洪莉丽 程晓昱[1] 姚淮芳[1] GE Lan;CHENG Dan;ZHU Zhenpeng;HONG Lili;CHENG Xiaoyu;YAO Huaifang(The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,Anhui,China;The Third Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei 230031,Anhui,China;Anhui University of Chinese Medicine,Hefei 230012,Anhui,China)

机构地区：[1]安徽中医药大学第一附属医院,安徽合肥230031 [2]安徽中医药大学第三附属医院,安徽合肥230031 [3]安徽中医药大学,安徽合肥230012

出　　处：《中华中医药学刊》2023年第6期133-138,共6页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81373774,81473386);安徽省高等学校自然科学类科学研究重点项目(2022AH050507);安徽省中医药学术流派传承工作室建设项目(皖中医药发展秘〔2021〕30号);安徽省中医药领军人才培养对象建设项目(皖中医药发展秘〔2018〕23号);新安医学教育部重点实验室项目。

摘　　要：目的通过检测氧化应激损伤,研究二参真武汤改善心肾阳虚型慢性心力衰竭(CHF)大鼠心脏功能的作用机制。方法36只SD大鼠随机分为空白组、模型组、二参真武汤治疗组(二参真武汤低、中、高剂量组)及阳性对照组(贝那普利),每组6只。通过甲状腺切除后0.02%阿霉素注射造模。造模成功后分别给予二参真武汤(3.96、7.92、15.84 g/kg)及贝那普利(0.5 mg/kg)灌胃4周。给药结束通过多普勒超声检测大鼠舒张期左室内径(left ventricular in⁃ner diameter,LVIDd),三尖瓣和二尖瓣血流频谱比值(E/A峰),ELISA法检测血清生化指标氨基末端脑钠肽前体(NT-proBNP)、血清总三碘甲腺原氨酸(T3)、甲状腺素(T4)、超氧化物歧化酶(superoxide dismutase,SOD)、活性氧(reactive oxygen species,ROS)及丙二醛(malondialdehyde,MDA),醛固酮(aldosterone,ALD),血管紧张素Ⅱ(angiotensinⅡ,Ang-Ⅱ)含量。结果造模后大鼠血清NT-proBNP含量显著升高(P<0.01),T3、T4含量显著降低(P<0.001),提示模型建立成功;模型组LVIDd显著增加(P<0.01),E/A值显著降低(P<0.01);血清ALD(P<0.001),Ang-Ⅱ含量(P<0.001),ROS(P<0.001),MDA(P<0.001)显著升高,SOD(P<0.001)显著降低;二参真武汤显著降低NT-proBNP、ALD、Ang-Ⅱ、ROS、MDA含量和LVIDd显著升高E/A值,二参真武汤中剂量显著升高SOD含量。结论二参真武汤可通过温阳活血利水之功效,纠正大鼠RASS系统异常,降低氧化应激,改善心肾阳虚型CHF大鼠心脏功能。Objective To study the mechanism of Ershen Zhenwu Decoction(二参真武汤,ESZWD)on improving heart func⁃tion in chronic heart failure(CHF)rats with Yang deficiency of heart and kidney through oxidative stress damage.Methods Thir⁃ty-six SD rats were randomly divided into blank group(Control group),model group(Model group),ESZWD treatment groups(ESZWD low,medium and high dose groups)and positive control group(benazepril group),with 6 rats in each group.After thy⁃roidectomy,0.02%doxorubicin injection was used to create the model.After successful modeling,they were given ESZWD(3.96,7.92,15.84 g/kg)and benazepril(0.5 mg/kg)by gavage for four weeks.At the end of administration,the left ventricu⁃lar inner diameter(LVIDd),tricuspid valve and mitral valve blood flow spectrum ratio(E/A peak)of rats in diastole were measured by Doppler ultrasound.ELISA kit was used to detect serum biochemical indicators such as N-terminal pro brain natriuretic peptide(NT proBNP),total triiodothyronine(T3),thyroxine(T4),superoxide dismutase(SOD),reactive oxygen species(ROS),malondialdehyde(MDA),aldosterone(ALD),angiotensinⅡ(AngⅡ).Results The serum NT-proBNP content increased sig⁃nificantly after modeling(P<0.001),the contents of T3 and T4 were significantly reduced(P<0.001,P<0.001),indicating that the model was successfully established.The LVIDd of the model group was significantly increased(P<0.01),and the E/A value was significantly reduced(P<0.01).The contents of serum ALD,Ang-Ⅱ,ROS,and MDA were significantly increased(all P<0.001).SOD was significantly decreased(P<0.001).ESZWD significantly reduced the contents of NT-proBNP,LVIDd,ALD,Ang-Ⅱ,ROS,MDA,and ESZWD significantly increased E/A value,ESZWD medium dosesignificantly in⁃creased SOD content.Conclusion ESZWD can correct the abnormalities of the rats RASS system,reduce the levels of oxidative stress,improve the cardiac function of CHF rats with Yang deficiency of heart and kidney.

关 键 词：慢性心力衰竭 二参真武汤 氧化应激损伤 益气活血利水 

分 类 号：R285.5[医药卫生—中药学]