雀啄灸对湿热痹阻型类风湿关节炎大鼠滑膜抗瓜氨酸化蛋白抗体免疫复合物表达的影响  

Effect of sparrow-pecking moxibustion on the expression of anti-citrullinated protein antibodies-immune complex in the synovium of rats with rheumatoid arthritis of damp heat stasis pattern

作　　者：邓慧榕 岳婷 杨东宇 刘煜 王煜 杨吉勃 赵中亭[1] 严兴科[1] 朱田田[1] DENG Huirong;YUE Ting;YANG Dongyu;LIU Yu;WANG Yu;YANG Jibo;ZHAO Zhongting;YAN Xingke;ZHU Tiantian(Gansu University of Chinese Medicine,Lanzhou 730000,China;Gansu Provincial Hospital of TCM,Lanzhou 730000,China)

机构地区：[1]甘肃中医药大学,兰州730000 [2]甘肃省中医院,兰州730000

出　　处：《上海针灸杂志》2025年第4期482-489,共8页Shanghai Journal of Acupuncture and Moxibustion

基　　金：国家自然科学基金地区基金项目(82060892,81560791);甘肃省科技厅省自然基金项目(20JR10RA313);甘肃省重点人才项目(2024年)。

摘　　要：目的 观察雀啄灸对湿热痹阻型类风湿关节炎(rheumatoid arthritis, RA)大鼠滑膜抗瓜氨酸化蛋白抗体免疫复合物(anti-citrullinated protein antibodies-immune complex,ACPA-IC)表达的影响,探究灸法干预早期RA的免疫机制及灸治热证的现代生物学机制。方法 从72只雌性Sprague-Dawley(SD)大鼠中随机抽取18只作为空白组,其余54只采用胶原诱导性关节炎结合风、湿、热环境刺激复合造模法进行湿热痹阻型RA大鼠病证结合的模型制备,并采用关节炎指数(arthritis index, AI)结合热和痛的证候特征指标对模型进行评价。将造模成功的大鼠随机分为模型组、药物组和雀啄灸组,每组18只。药物组大鼠采用甲氨蝶呤混悬液进行灌胃治疗,雀啄灸组大鼠进行雀啄灸干预。干预结束后采集4组大鼠AI评分、关节表面温度和足底热痛阈值;采用透射电镜技术观察4组大鼠滑膜细胞超微结构;采用酶联免疫吸附测定法检测大鼠双侧膝关节滑膜白细胞介素-1(interleukin-1, IL-1)和肿瘤坏死因子-α(tumor necrosis factor-α, TNF-α)水平;采用蛋白印迹法检测大鼠滑膜ACPA-IC的表达。结果 与空白组比较,模型组大鼠病变关节足底热痛阈值降低(P<0.05);滑膜细胞出现水肿,细胞核和线粒体出现炎性改变;AI评分、关节表面温度以及滑膜IL-1、TNF-α和ACPA-IC水平均升高(P<0.05)。与模型组比较,药物组和雀啄灸组大鼠足底热痛阈值升高(P<0.05);滑膜细胞水肿减轻,细胞核和线粒体炎性病变改善;AI评分、关节表面温度以及滑膜IL-1、TNF-α和ACPA-IC水平均降低(P<0.05)。与药物组比较,雀啄灸组大鼠足底热痛阈值升高(P<0.05),滑膜IL-1、TNF-α和ACPA-IC水平降低(P<0.05)。结论 雀啄灸可改善湿热痹阻型RA大鼠滑膜细胞炎性损伤,减轻热和痛的关节外部表现,调节滑膜ACPA-IC水平,降低滑膜IL-1和TNF-α水平。Objective To observe the effect of sparrow-pecking moxibustion on the expression of anti-citrullinated protein antibodies-immune complex(ACPA-IC)in the synovium of rats with rheumatoid arthritis(RA)of damp heat stasis pattern and to discover the immune mechanism of moxibustion intervening in early-stage RA and the modern biological mechanism of moxibustion treating heat patterns.Method Eighteen rats were randomly selected from 72 female Sprague-Dawley(SD)rats as a blank control group,and the other 54 rats were prepared to be disease-pattern-combined RA models of damp heat stasis pattern using a combo modeling method(collagen-induced arthritis plus environmental stimuli,including wind,damp,and heat).The model was assessed using the arthritis index(AI)and indicators of heat and pain patterns.The successful rat models were randomized into a model group,a medication group,and a sparrow-pecking moxibustion group,with 18 rats in each group.Rats in the medication group received methotrexate suspension via gavage,and rats in the sparrow-pecking moxibustion group received sparrow-pecking moxibustion.When the intervention finished,the AI score,joint surface temperature,and plantar thermal pain threshold value were collected from each group.The ultrastructure of synovial cells of the four groups of rats was observed using transmission electron microscopy;the levels of interleukin-1(IL-1)and tumor necrosis factor-α(TNF-α)in the synovium of bilateral knee joints were detected using the enzyme-linked immunosorbent assay(ELISA);the expression of synovial ACPA-IC was determined using Western blotting.Result Compared to the blank control group,the plantar thermal pain threshold of the diseased joint side declined in the model group rats(P<0.05);the model group also presented synovial cell swelling,inflammatory changes in the nucleus and mitochondria,and increased AI scores,joint surface temperatures,and synovial IL-1,TNF-α,and ACPA-IC levels(P<0.05).Compared to the model group,rats in the medication and sparrow-pecking moxibus

关 键 词：灸法 艾条灸 雀啄灸 关节炎 类风湿 湿热痹阻 特异性免疫复合物 大鼠 

分 类 号：R2-03[医药卫生—中医学]