中医辨证治疗对NAFLD大鼠血脂等影响的实验研究

Experimental Study on Effect of Traditional Chinese Medicine Dialectical Treating Blood-fat Index on NAFLD Rats

目的:探讨中医辨证治疗对非酒精性脂肪性肝病(NAFLD)大鼠各时期血脂等指标影响的作用机制,为临床防治NAFLD提供理论依据。方法:取SPF级Wistar大鼠72只,雌雄各半,随机分为正常组、模型组、对照药物治疗组、药物A方治疗组、药物B方治疗组、先A方后B方治疗组、先B方后A方治疗组、先空白后A方治疗组、先空白后B方治疗组,共9组。除正常组给予普通饲料外,其余各组均饲以高脂饲料。造模第4周后,模型组加用生理盐水灌胃;对照组加用对照药物灌胃;药物A方组加用治疗药物A方灌胃;药物B方组加用治疗药物B方灌胃;先A方后B方治疗组即4～8周用A方,8～12周用B方灌胃;先B方后A方治疗组即4～8周用B方,8～12周用A方灌胃;先空白后A方治疗组即先空白,第8～12周用A方灌胃;先空白后B方治疗组即先空白,第8～12周用B方灌胃。实验第12周时,测定大鼠血清TCH、TG、HDL、LDL、FFA、GSH-ST、TNF-α的值。结果:实验第12周时,先A方后B方治疗组(编号为6组)降低NAFLD后期大鼠血清TG、TCH、LDL、FFA、TNF-α及升高血清GSH-ST水平的疗效与其他治疗组相比尤为显著(P<0.01或P<0.05)。结论:在NAFLD的整个病程中,采取早期阶段运用疏肝健脾、活血化瘀、化痰利湿功效的治法,后期阶段运用化痰消瘀、清热利湿、补益肝肾功效的治法的治疗方案,对于降低大鼠血脂等指标及提高大鼠抗氧自由基的疗效显著优于其他治疗措施。

Objective： To explore the function mechanism of traditional Chinese medicine dialectical treating blood - fat index and so on in nonalcoholic fatty liver disease （NAFLD） rats＇various times, which provide the basis theory to prevent and cure the NAFLD in clinic. Methods ： Fetched 72 wistar rats＇level of SPF, females and males were half and half, were divided into 9 groups at random： Normal group, Model group, Comparison medicine treatment group, Medicine A treatment group, Medicine B treatment group, First Medicine A then Medicine B treatment group, First Medicine B then Medicine A treatment group, First blank then Medicine A treatment group, First blank then Medicine B treatment group. Except the normal group was fed ordinary diet, the other eight groups were fed by high fat and high Cholesterol diet. After 4 weeks, Model group rats were given physiological saline by intragastrie administration. Comparison medicine treatment group rats were given comparison medicine by intragastric administration. Medicine A treatment group rats were given Medicine A by intragastric administration. Medicine B treatment group rats were given Medicine B by intragastric administration. First Medicine A then Medicine B treatment group rats were given Medicine A from 4 weeks to 8 weeks and Medicine B from 8 weeks to 12 weeks by intragastric administration. First Medicine B then Medicine A treatment group rats were given Medicine B from 4 weeks to 8 weeks and Medicine A from 8 weeks to 12 weeks by intragastrie administration. First blank then Medicine A treatment group rats were given nothing from 4 weeks to 8 weeks and Medicine A from 8 weeks to 12 weeks by intragastric administration. First blank then Medicine B treatment group rats were given nothing from 4 weeks to 8 weeks and Medicine B from 8 weeks to 12 weeks by intragastric administration. At the end of the 12 weeks, we determined the blood serum value of TCH, TG, HDL, LDL, FFA, GSH - ST and TNF - α in rat. Results ： At the end of the 12 weeks, First Medicine A then Medicine B treatment group （the group number of 6） had better curative effect than other treatment groups at reducing the blood serum value of TCH, TG, LDL, FFA and TNF -α, and raising the blood serum value of GSH -ST in NAFLD later period rats（ P 〈0.01 orP 〈0.05）. Conclusion： In NAFLD entire course of disease, Treatment plan of applying therapy of dispersing the depressed liver - energy to invigorate the spleen, activating blood circulation to dissipate blood stasis and dissipating phlegm to decrease wet in early stage, using therapy of dissipating phlegm to dissipate blood stasis, clearing away heat evil to decrease wet and benefiting hepatorenal function in later stage, which had better curative effect than other remedial measures at reducing the index of blood - fat , and raising the counteract oxyradical capability in NAFLD rats.