基于慢性心衰大鼠模型的苓桂术甘汤和肾气丸“同病异治”作用比较研究

Comparative Study of Treating Same Disease with Different Formulae Linggui Zhugan Decoction and Shenqi Pill Treating Rats with Cardiac Diseases

目的:观察苓桂术甘汤和肾气丸对慢性心衰(CHF)模型大鼠的干预作用是否有差异,探讨"同病异治"的内涵。方法:取30只健康SD大鼠,腹主动脉缩窄法建立CHF大鼠模型,另取10只行假手术。2周后将模型大鼠随机分为苓桂术甘汤组、肾气丸组、模型组,并开始给予中药灌胃,持续4周,假手术组与模型组以纯净水灌胃。4周后,检测各组大鼠动脉血气、肺功能、血流动力学参数。结果:与假手术组比较,模型组大鼠FVC、FEV_1/FVC均降低(P<0.05),动脉血PaO_2、pH、SaO_2均降低(P<0.05),PaCO_2升高(P<0.05),+dp/dtmax、HR明显降低(P<0.05),LVEDP明显升高(P<0.05)。与模型组比较,肾气丸组、苓桂术甘汤组大鼠FVC均升高(P<0.05),动脉血pH、PaO_2、SaO_2均升高(P<0.05),PaCO_2降低(P<0.05)苓桂术甘汤组+dp/dtmax、HR明显升高(P<0.05),LVEDP明显降低(P<0.05);肾气丸组LVSP、HR、+dp/dtmax明显升高(P<0.05)。苓桂术甘汤组与肾气丸组大鼠动脉血气、血流动力学参数、肺功能比较(P>0.05)。结论:苓桂术甘汤和肾气丸均可改善CHF模型大鼠的心功能,且两方效果差异不显著,即"同病-同证-异治"这一"同病异治"的内涵是可能存在的。

Objective:To observe the intervention effect of Linggui Zhugan Decoctin and Shenqi Pills on rats with chronic cardiac failure.Method:Thirty healthy SD rats,by abdominal aortic banding method,were established models with chronic cardiac failure.Then another 10 rats were given sham operations.Three weeks later, these rats models were randomly divided into Shenqi Pill group,Linggui Zhugan Decoction group and model group.Chinese materia medica was injected into the stomach for 4 weeks and water into the stomach of those rats in model group and sham operation group.Four weeks later, we tested the pulmonary function and arterial blood and Qi of those rats in each group.Results:Compared with the sham operation group, FVC and FEV1/FVC of the model group all went lower(P<0.05), and pH, PaO2 and SaO2 of arterial blood were all lower(P<0.05)while PaCO2 higher.The HR and+dp/dtmax were significantly decreased(P<0.05),while the LVEDP was significantly increased.It signified that the model rats had cardiac dysfunction.Compared with model group, rats in Linggui Zhugan Decoction and Shenqi Pill groups had improvement in pulmonary functions and arterial blood and Qi(P<0.05).There was no obvious difference of the pulmonary functions and arterial blood and Qi of Linggui Zhugan Decoction and Shenqi Pill(P>0.05).The HR and+dp/dtmax in Linggui Zhugan Decoction group were significantly increased(P<0.05), while LVEDP was significantly decreased(P<0.05).HR,LVSP and+dp/dtmax in Shenqi Pill group were significantly increased(P<0.05).It signified that both of these two formulae could improve cardiac functions of rats with cardiac failure which meant they could treat shortness of breath and there was no obvious difference of functions by these two formulae.Conclusion: Linggui Zhugan Decoction and Shenqi Pill both could improve the cardiac functions of rat model with chronic heart failure with no differences.That is to say, we can have various treatments to the same disease(P<0.05).