文献类型：期刊文献

中文题名：敦煌灸法对RA模型大鼠血清炎症因子和MMPs的影响

英文题名：Effect of Dunhuang Moxibustion on Serum Inflammatory Factors and MMPs in RA Model Rats

作者：姚小强[1,2];周亚婕[3];郑先丽[1,2];李鼎鹏[4];高佳星[3];徐影杰[3];火琳嵛[3]

第一作者：姚小强

机构：[1]甘肃中医药大学附属医院,甘肃兰州730000;[2]甘肃省皇甫谧针灸医院,甘肃兰州730000;[3]甘肃中医药大学,甘肃兰州730000;[4]甘肃省第二人民医院,甘肃兰州730000

第一机构：甘肃中医药大学第二附属医院

年份：2023

卷号：40

期号：3

起止页码：16

中文期刊名：中医药信息

外文期刊名：Information on Traditional Chinese Medicine

基金：甘肃省自然科学基金项目(20JR5A167);甘肃省高等学校创新能力提升项目(2019A-081);敦煌医学与转化教育部重点实验室开放课题(DHYX20-01);甘肃省针灸临床医学研究中心(18JR2FA002)。

语种：中文

中文关键词：类风湿关节炎;艾灸;敦煌医学;少阳主骨

外文关键词：Rheumatoid arthritis;Moxibustion;Dunhuang medicine;Shaoyang governing bone

摘要：目的:通过敦煌灸疗选穴组悬钟、风市穴和常规艾灸选穴组足三里、肾俞,验证敦煌灸法疗效并探讨其作用机制。方法:将40只SPF级SD大鼠随机分为空白组、模型组、西药组、常规灸组和敦煌灸组。除空白组外,其余各组大鼠制备风寒湿型类风湿关节炎(RA)模型。造模成功后,西药组给予1 mg/kg甲氨蝶呤腹腔注射;常规灸组在大鼠后三里(双)、肾俞(双)艾灸;敦煌灸组在悬钟(双)、风市(双)艾灸。于造模前、实验第21、31天测量大鼠足趾厚度并记录。第21、31天对各组大鼠进行关节炎指数(AI)评分。治疗结束后,用ELISA法检测大鼠血清中IL-2、TNF-α、IL-4、IL-10、MMP-3和MMP-9的含量。每组大鼠取左后足踝关节滑膜,HE染色,200倍镜下观察组织病理学变化。结果:实验第21、31天,与空白组比较,模型组大鼠足趾厚度、AI评分升高(P<0.01);第31天,与模型组比较,西药组、常规灸组、敦煌灸组大鼠足趾厚度、AI评分降低(P<0.01),与常规灸组比较,敦煌灸组大鼠足趾厚度、AI评分降低(P<0.05)。实验第31天,与空白组比较,模型组血清IL-2、TNF-α含量升高(P<0.01),IL-4、IL-10含量下降(P<0.01),血清MMP-3、MMP-9含量明显增多(P<0.01);与模型组比较,西药组、常规灸组、敦煌灸组大鼠血清IL-2、TNF-α含量均下降(P<0.01,P<0.05),IL-4、IL-10含量均上升(P<0.01,P<0.05),MMP-3、MMP-9含量均明显减少(P<0.01);与常规灸组比较,敦煌灸组大鼠血清IL-2、TNF-α含量降低(P<0.05),IL-4、IL-10含量升高(P<0.05),MMP-3、MMP-9含量均下降(P<0.05)。结论:敦煌灸疗可明显降低RA大鼠AI评分,降低大鼠足趾肿胀度,减少大鼠滑膜组织增生、炎性浸润,减轻滑膜细胞水肿,减少血管增生。其机制与敦煌灸疗能降低血清IL-2、TNF-α含量,增加IL-4、IL-10含量,抑制MMP-3、MMP-9表达水平,动态调节炎症平衡,缓解关节炎症,减少软骨破坏有关。敦煌灸治疗效果优于常规灸组,提示在RA早期从“少阳主骨”出发选穴治疗更优。
Objective:To verify the curative effect of Dunhuang moxibustion and to explore its mechanism by comparing Dunhuang moxibustion on Xuanzhong(GB39)and Fengshi(GB31)with common moxibustion on Zusanli(ST36)and Shenshu(BL23)in treatment of rheumatoid arthritis(RA).Methods:40 SPF SD rats were randomly divided into the blank group,the model group,the western medication group,the routine moxibustion group and the Dunhuang moxibustion group,with 8 rats in each group.Chicken typeⅡcollagen and complete Freund’s adjuvant combined with wind,cold and wet environment stimulation were used to prepare RA rat model.After successful modeling,the western medication group was given Methotrexate intraperitoneal(1 mg/kg)injection;the routine moxibustion group was treated with moxibustion on ST36(bilateral)and BL23(bilateral),and the Dunhuang moxibustion group was treated with moxibustion on GB39(bilateral)and GB31(bilateral).Toe thickness was measured and recorded before modeling,after 21 days and 31 days of treatment.The arthritis index(AI)scores of rats in each group were performed on the 21st and 31st days.After the treatment,the serum contents of IL-2,TNF-α,IL-4,IL-10,MMP-3 and MMP-9 were detected by ELISA.The synovial membrane of the left hind foot ankle joint of each group was taken and stained with HE,and the histopathological changes were observed under 200-fold microscope.Results:On the 21 st and 31 st day of the experiment,the toe thickness and AI score were increased in the model group compared with those in the blank group(P<0.01).On the 31 st day of the experiment,the toe thickness and AI score were decreased in the western medication group,the routine moxibustion group,the Dunhuang moxibustion group compared with those in the model group(P<0.01);the toe thickness and AI score were decreased in the Dunhuang moxibustion group compared with those in the routine moxibustion group(P<0.05).On the 31 st day of the experiment,the serum contents of IL-2 and TNF-αwere increased(P<0.01),the serum contents of IL-4 and IL-10 were decreased(P<0.01),and the serum contents of MMP-3 and MMP-9 were significantly increased in the model group compared with those in the blank group(P<0.01).Compared with those in the model group,the serum contents of IL-2 and TNF-αwere decreased(P<0.01,P<0.05),the serum contents of IL-4 and IL-10 were increased(P<0.01,P<0.05),and the serum contents of MMP-3 and MMP-9 were significantly decreased in the western medication group,the routine moxibustion group and the Dunhuang moxibustion group(P<0.01).Compared with those in the routine moxibustion group,the serum contents of IL-2 and TNF-αwere decreased(P<0.05),the serum contents of IL-4 and IL-10 were increased(P<0.05),and the serum contents of MMP-3 and MMP-9 were decreased in the Dunhuang moxibustion group(P<0.05).Conclusion:Dunhuang moxibustion can significantly reduce the AI score of RA rats,reduce the swelling degree of toes,reduce the hyperplasia and inflammatory infiltration of synovial tissue,relieve synovial cell edema and reduce vascular hyperplasia.Its mechanism may be that Dunhuang moxibustion can reduce the serum contents of IL-2 and TNF-α,increase the serum contents of IL-4 and IL-10,inhibit the expressions of MMP-3 and MMP-9,dynamically adjust the inflammatory balance,alleviate joint inflammation and reduce cartilage damage.The therapeutic effect of Dunhuang moxibustion is better than that of routine moxibustion,which suggests that choosing points based on‘Shaoyang governing bone’is better in treatment of RA at early stage.