针药并用对子宫内膜异位症疼痛大鼠CLEC5A、NLRP3和IL-1β表达的影响  

Effects of the combination of acupuncture and medicines on the expression of CLEC5A,NLRP3 and IL-1bin rats with endometriosis pain

作　　者：胡佳玮 吴楚婷 徐丹丹 高源 李云翼 李铭旸 李语然 张春雁[1,3] HU Jiawei;WU Chuting;XU Dandan;GAO Yuan;LI Yunyi;LI Mingyang;LI Yuran;ZHANG Chunyan(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Meilong Community Health Center,Minhang District,Shanghai 201108,China;Yiwu Traditional Chinese Medicine Hospitalt,Yiwu 322000,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437 [2]上海市闵行区梅陇社区卫生服务中心,上海201108 [3]义乌市中医医院,义乌322000

出　　处：《上海针灸杂志》2025年第3期355-365,共11页Shanghai Journal of Acupuncture and Moxibustion

基　　金：上海市“科技创新行动计划”启明星培育-扬帆专项(22YF1444200);上海市“科技创新行动计划”科技成果转化服务体系建设项目(23ZC2520700);国家自然科学基金青年项目(82405565);上海市东方英才计划青年项目;上海市卫生健康委员会卫生行业临床研究专项(202240054);金华市科学技术局重点项目(2024-3-140);上海中医药大学“杏林学者”;上海申康医院发展中心促进市级医院临床技能与临床创新能力三年行动计划项目(SHDC2020CR3093B)。

摘　　要：目的观察针药并用对子宫内膜异位症疼痛大鼠CLEC5A、NLRP3和IL-1β表达的影响,探讨针药并用缓解子宫内膜异位症疼痛的作用机制。方法从48只大鼠随机选取8只进行假手术作为假手术组,剩余40只进行子宫内膜异位症造模,模型建立后根据异位囊肿总体积再区组随机分为模型组、布洛芬组、针灸组、中药组和针药组,每组8只。假手术组、模型组固定并给予等量0.9%生理盐水灌胃,布洛芬组固定并给予布洛芬和0.9%生理盐水混悬液灌胃,针灸组给于固定针灸干预,中药组固定并给予加味没竭片和0.9%生理盐水混悬液灌胃,针药组给予固定针灸和加味没竭片0.9%生理盐水混悬液灌胃。造模后和干预后测量并计算子宫内膜异位症大鼠异位囊肿体积,并测量6组大鼠痛阈。干预后检测6组内膜组织C型凝集素结构域家族5成员A(C-type lectin domain family 5 member A,CLEC5A)、NLR家族Pyrin域蛋白3(NOD-like receptor family pyrin domain containing protein 3,NLRP3)、白细胞介素-1β(interleukin 1β,IL-1β)蛋白和m RNA表达水平。结果针灸组、针药组干预后异位囊肿体积减少值和痛阈增加值均优于模型组(P<0.05)。模型组在位及异位内膜组织中CLEC5A、NLRP3、IL-1β蛋白表达水平高于正常子宫内膜组织(P<0.05)。针灸组、针药组在位及异位内膜组织中CLEC5A和NLRP3蛋白表达水平及异位内膜组织中IL-1β蛋白表达水平低于模型组(P<0.05),针灸组在位内膜IL-1β表达显著低于模型组(P<0.05)。针药组在位内膜组织CLEC5A蛋白表达水平低于布洛芬组和中药组(P<0.05),NLRP3蛋白表达水平低于布洛芬组(P<0.05);异位内膜组织CLEC5A蛋白表达水平低于针灸组、布洛芬组和中药组(P<0.05),NLRP3蛋白表达水平低于布洛芬组和中药组(P<0.05),IL-1β蛋白表达水平显著低于布洛芬组(P<0.05)。模型组在位和异位内膜CLEC5A m RNA水平高于假手术组子宫内膜(P<0.05),模型组在位内Objective To observe the effects of the combination of acupuncture and medicines on the expression of CLEC5A,NLRP3 and IL-1bin rats with endometriosis pain,and to explore the mechanism of acupuncture and medicines in relieving endometriosis pain.Method Eight rats were randomly selected from 48 rats for sham operation as the sham operation group,and the remaining 40 rats were modeled for endometriosis.After the model was established,according to the total volume of the ectopic cysts,they were randomly divided into the model group,the ibuprofen group,the acupuncture-moxibustion group,the traditional Chinese medicines group,and the acupuncture plus medicines group,with 8 rats in each group.The sham-operated group and model group were fixed and given an equal amount of 0.9%saline by gavage,the ibuprofen group was fixed and given ibuprofen+0.9%saline by gavage,the acupuncture-moxibustion group was given fixed acupuncture-moxibustion intervention,the traditional Chinese medicines group was fixed and given Jiawei Mojie tablets+0.9%saline by gavage,and the acupuncture plus medicines group was given fixed acupuncture-moxibustion and Jiawei Mojie tablets+0.9%saline by gavage.The volume of ectopic cysts in rats with endometriosis was measured and calculated after modeling and intervention,and the pain thresholds of rats in the six groups were measured.The endometrial tissues of the six groups were examined for C-type lectin domain family 5 member A(CLEC5A),NOD-like receptor family pyrin domain containing protein 3(NLRP3),interleukin 1b(IL-1b)protein and mRNA expression levels.Result The values of volume reduction of ectopic cysts and increase in pain threshold after intervention in the acupuncture-moxibustion and acupuncture plus medicines groups were better than those in the model group(P<0.05).The protein expression levels of CLEC5A,NLRP3,and IL-1bwere higher than those of normal endometrial tissues in both in situ and ectopic endometrial tissues of the model group(P<0.05).The protein expression levels of CLEC5A and NLRP3

关 键 词：针药并用 子宫内膜异位症 疼痛 C型凝集素结构域家族5成员A NLR家族Pyrin域蛋白3 白细胞介素-1β 大鼠 

分 类 号：R2-03[医药卫生—中医学]