电针丰隆及足三里穴对非酒精性脂肪性肝炎大鼠的干预效应

Interventional effects of electro-acupuncture at Zusanli and Fenglong acupoints in rats with non-alcoholic steatohepatitis

目的:近年来,中医药在防治非酒精性脂肪性肝病方面显示了优势和发展前景。观察电针丰隆、足三里对非酒精性脂肪性肝炎大鼠模型血脂、肝功及肝组织形态学的影响。方法:实验于2003-11/2004-05在广州中医药大学实验动物中心及暨南大学医学院病理生理教研室、中心实验室完成。实验材料:选择SPF级SD大鼠30只,由广州中医药大学实验动物中心提供,雌雄各半,体质量(200±20)g,按随机数字表法分为正常对照组、模型组和电针组,每组10只。实验方法:正常对照组喂养基础饲料,其他两组喂养高脂高糖饲料。高脂高糖饮食造模第3天开始对电针组大鼠进行电针丰隆、足三里干预。10周后测定大鼠血脂四项、肝功能三项,光镜、电镜下行肝组织形态学观察。实验过程中对动物处置符合动物伦理学标准。结果:30只大鼠均进入结果分析。①模型组大鼠低密度脂蛋白胆固醇、总胆固醇均较正常对照组升高(P<0.01)。电针组大鼠血清胆固醇、低密度脂蛋白胆固醇、总胆红素、丙氨酸氨基转移酶含量均较模型组下降(P<0.01,P<0.05)。②模型组大鼠肝细胞增大,胞浆内脂肪滴大小不一,呈中重度脂肪变性,且100%存在汇管区炎症和小叶内炎症,未发现碎屑样坏死,大多出现灶性纤维增生,但其中2只出现桥接坏死;与模型组比较,电针组脂肪变性程度和炎症活动度均明显减轻(P<0.01,P<0.05),但仍有2只出现桥接坏死。③模型组大鼠肝细胞内出现大量脂肪滴,可见散在糖原颗粒,线粒体肿胀,嵴排列紊乱,内织网肿胀。电针组肝细胞内均可见多少不等的脂肪滴,其超微结构改变介于模型组和正常对照组之间。结论:①电针具有保护肝细胞、减轻炎症反应、改善肝功能作用。②血脂和血清酶学检查结果与肝组织病理形态学检测结果并不完全一致,检测肝组织活检更有意义。。

AIM： Recently, traditional Chinese medicine has shown advantage and developed perspective in preventing and treating non-alceholic fatty liver disease （NAFLD）. This article is aimed to study the effects of serum lipid, hepatic function and pathological changes of liver tissues in rats with non-alcoholic steatohepatitis （NASH） by electro-acupuncture at Zusanli （ST 36） and Fenglong （ST 40） acupoint. METHODS： The experiment was conducted in the Animal Experimental Center of Guangzhou University of Traditional Chinese Medicine and Biochemical Laboratory, Central Laboratory of Jinan University between November 2003 and May 2004. Thirty SPF SD rats of either sex （half and half） with the body mass of （200±20） g were offered by Animal Experimental Center of Guangzhou University of Traditional Chinese Medicine. All rats were randomly divided into three groups （n =10）. Rats in the normal control group received basic feed, and rats of the other groups received high-lipid high-glucese feed. The rat models were induced by high fat and sucrose diets at day 3 before the rats of acupuncture group were given electro-acupuncture at Zusanli and Fenglong acupoint. The contents of serum cholesterol （CHOL）, tdglyeride （TG）, total bilirubin （TB）, high density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol （LDL-C）, alanine aminotransferase （ALT）, aspartate aminotransferase （AST） were detected 10 weeks later, while the pathological changes of liver tissues were observed under light and scanning electron microscope. Animals were treated according to animal ethical standard. RESULTS. Thirty rats all entered the result analysis. ①Compared with normal control group, the contents of serum CHOL and LDC-C in model group were significantly increased （P 〈 0.01）. Compared with model group, the contents of serum CHOL, LDL-C, TB and ALT in electro-acupuncture group were significantly decreased （P 〈 0.01, P 〈 0.05）.②In model group, light microscope observation revealed swelling of hepatocytes, and different sizes of lipid droplets inside the cytoplasm, fatty degeneration from medium to server degrees in hepatocytes. In filtration of inflammatory cells and much focal proliferation fiber were also shown in the portal area of model rats. Portal area and hepatic Iobules had inflammatory cell infusion in model group. No piecemeal necrosis was found in rats of the model group, but bridging necrosis could be found in 2 rats. Compared with the model group, fatty degeneration and infiltration of inflammatory cells decreased significantly in the electro-acupuncture group （P 〈 0.01, P 〈 0.05）. But bridging necrosis could be found in 2 rats of the electro-acupuncture group too. ③A great deal of lipid droplets swelling of mitochondria and endoplasmic reticulums in hepatocytes and glycogen granule and disordered cristae arrangement could be observed in the model group. A little lipid droplets swelling of mitochondria and endoplasmic reticulums could be found in the electro-acupuncture group. The change of ultrastructure in the electro-acupuncture group was intervenient between the model group and the normal control group. CONCLUSION：①The method of electro-acupuncture at Zusanli and Fenglong acu-point can prevent hepatic cells, relieve inflammatory reaction and ameliorate hepatic function.② Findings of serum and serum enzyme labeled compound assay are not completely coincident as that of hepatic tissue pathomorphology assay. But liver biopsy is the most effective method.