基于慢性心力衰竭大鼠模型的苓桂术甘汤和肾气丸“同病异治”之内涵研究

Connotation research on 'treating same disease with different methods' of Linggui Zhugan Decoction and Shenqi Pill based on CHF rat model

目的:从作用环节角度探讨苓桂术甘汤和肾气丸改善慢性心力衰竭(以下简称心衰)之"同病异治"的内涵。方法:取30只健康SD大鼠,采用腹主动脉缩窄法建立心衰大鼠模型,另取10只行假手术。2周后将模型大鼠随机分为模型组、苓桂术甘汤组、肾气丸组,并开始给予相应药物灌胃,持续4周。4周后,检测各组大鼠尿量、尿中AQP2含量,血清中PRA、AngⅡ、ALD、IL-1β、IL-6、IL-18、IL-10、CRP含量。结果:与假手术组比较,模型组大鼠尿量显著减少(P<0.05),尿中AQP2含量显著升高(P<0.05);动脉血PRA、AngⅡ、ALD含量均显著升高(P<0.05);血清中IL-6、IL-18、IL-10、TNF-α、IL-1β、CRP含量均显著升高(P<0.05)。与模型组比较,苓桂术甘汤组、肾气丸组大鼠尿量显著增多(P<0.05),肾气丸组大鼠尿中AQP2含量显著降低(P<0.05);苓桂术甘汤组、肾气丸组大鼠血清中PRA、ALD含量均显著降低(P<0.05);苓桂术甘汤组大鼠血清中IL-6、IL-18、IL-10、IL-1β含量均显著降低(P<0.05),肾气丸组大鼠血清中IL-6、IL-10、IL-1β显著降低(P<0.05)。与苓桂术甘汤组比较,肾气丸组大鼠血清中ALD含量显著降低(P<0.05),血清中IL-10、IL-18含量显著升高(P<0.05)。结论:苓桂术甘汤和肾气丸均能改善慢性心衰,即"同病-同证-异治"这一"同病异治"的解读是可能存在的,其内涵之一可能是两方作用于慢性心衰的不同病理环节。

Objective:To explore the connotation of‘treating same disease with different methods’of Linggui Zhugan Decoction and Shenqi Pill in improving chronic heart failure from the perspective of action sites.Methods:A total of 30 health SD rats were selected and the chronic heart failure models were established by coarctation of abdominal aorta.Ten rats were taken sham operations.Two weeks later,rats model were divided randomly into model group,Linggui Zhugan Decoction group,Shenqi Pill group and give them corresponding drug lavage for Four weeks.Four weeks later,to detect the content of urine volume,AQP2 in the urine and content of PRA,Ang II,ALD,IL-1β,IL-6,IL-18,IL-10,CRP in serum of rats in each group.Results:Compared with sham surgery group,the urination of rats in model group decreased(P<0.05),the content of AQP2 in the urine increased(P<0.05);the content of PRA,Ang II,ALD in arterial blood increased(P<0.05);the content of IL-6,IL-18,IL-10,TNF-α,IL-1β,CRP in serum increased(P<0.05).Compared with model group,the urine volume of rats in Linggui Zhugan Decoction group and Shenqi Pill group increased(P<0.05),the content of AQP2 in the urine of rats in Shenqi Pill group decreased(P<0.05);the content of PRA,ALD in serum of rats in Linggui Zhugan Decoction group and Shenqi Pill group decreased(P<0.05);the content of IL-6,IL-18,IL-10,IL-1βin serum of rats in Linggui Zhugan Decoction group decreased(P<0.05),the content of IL-6,IL-10,IL-1βin the serum of rats in Shenqi Pill group decreased(P<0.05).Compared with Linggui Zhugan Decoction group,the content of ALD in serum of rats in Shenqi Pill group decrease(P<0.05),while the content of IL-10,IL-18 increased(P<0.05).Conclusion:Linggui Zhugan Decoction and Shenqi Pill can improve chronic heart failure,the interpretation of‘same disease-same syndrome-different methods’means‘treating same disease with different methods’may exist,and one of its connotations maybe that two formulas act on different pathology links of chronic heart failure.