艾灸对慢性心力衰竭大鼠心功能及心肌组织TNF-α、NF-κB表达水平的影响

Effect of Moxibustion on Cardiac Function and Expression of TNF-α and NF-κB in Chronic Heart Failure Rats

目的观察艾灸对慢性心力衰竭(chronic heart failure,CHF)大鼠心功能及心肌组织肿瘤坏死因子-α(TNF-α)mRNA、核因子-κB(NF-κB)表达水平的影响,探讨艾灸对CHF心肌保护作用机制。方法采用盐酸多柔比星隔日腹腔注射的方法构建CHF模型,将造模成功的28只大鼠随机分为模型组、艾灸组、西药组、灸药(艾灸加西药)组,每组7只。艾灸组给予温和灸双侧肺俞、心俞,每日1次,每次15 min;西药组灌服卡托普利混悬液(25 mg/kg),每日1次;灸药组给予卡托普利混悬液(25 mg/kg)灌服结合温和灸双侧肺俞、心俞,每日1次,各组均连续3周。检测大鼠心率(HR)、心输出量(CO)、左心室收缩压(LVSP)、左心室舒张末压(LVEDP)、左室内压最大上升或下降速率(±dp/dtmax)、心肌组织NF-κB活性及TNF-αmRNA表达水平。结果与正常大鼠比较,建模大鼠的行为体征改变明显,心功能指标明显异常(P<0.01),心肌组织HE染色结果符合CHF表现。与正常组比较,模型组大鼠HR、LVEDP升高,CO、LVSP、+dp/dtmax和-dp/dtmax降低(P<0.01),心肌组织TNF-αmRNA表达及NF-κB蛋白结合活性明显升高(P<0.01);与模型组比较,艾灸组、西药组及灸药组CO、LVSP、±dp/dtmax均升高,HR、LVEDP明显降低(P<0.01),TNF-αmRNA表达及NF-κB核蛋白DNA结合活性降低(P<0.01);与艾灸组和西药组比较,灸药组HR、LVEDP降低,CO、LVSP、±dp/dtmax升高明显(P<0.05),且TNF-αmRNA表达降低明显(P<0.05)。结论艾灸联合西药改善大鼠心功能指标,降低TNF-αmRNA表达方面优于单用艾灸及西药,可能通过降低TNF-αmRNA表达,抑制心肌组织NF-κB核蛋白的DNA结合活性,抑制免疫炎症反应,从而改善CHF症状。

Objective To observe the effect of moxibustion on cardiac function and expression of TNF-α and NF-κB in chronic heart failure（CHF） rats, and to explore its mechanism underlying improvement of CHF. Methods The CHF model was established by intraperitoneal injection of Adriamycin. After successful modeling, 28 rats were randomly divided into the model group, the moxibustion group, the Western medicine group,and the moxibustion ＋Western medicine group, 7 in each group. Rats in the mild moxibustion group recieved mild moxibustion on bilateral Feishu （BL13） and Xinshu （BL15） for 15 min. Rats in the Western medicine group were administered by gastrogavage with Captopril （25 mg/kg） ,While those in the moxibustion ＋ Western medicine group were administered with Captopril （25 mg/kg） and mild moxibustion. Once a day for 3 weeks. After treatment, heart failure（HR）, cardiac output（ CO）, left ventricular systolic pressure （ LVSP）, left ventricular end-diastolic pressure （ LVEDP）, maximal rate of the decrease/increase of left ventricular pressure（ ±dp/dtmax） and the expression of NF-KB and TNF-（x mRNA were observed respectively. Results In comparison with normal rats, characteristic behaviors and cardiac function were significantly different with modeling rats （P 〈0.01 ）. The results of HE stain in myocardium were in accordance with the performance of CHF. Compared with the normal group, HR and LVEDP increased, CO, LVSP and ±dp/dtmax decreased （P 〈0.01 ）, and the expression levels of NF-κB and TNF-α mRNA decreased significantly in the model group（P 〈0.01 ）. Compared with the model group, CO, LVSP and ±dp/dtmax increased, HR and LVEDP were decreased and the expression levels of NF-κB and TNF-α mRNA were decreased significantly in the other three treatments groups（P 〈0.01 ）. Compared with the moxibustion group and the Western medicine group, HR and LV- EDP decreased, CO, LVSP and ~dp/dtmax increased more obviously（P 〈0.05）, and the level of TNF-α mRNA was decreased in the moxibustion ＋ Western medicine group（P 〈0.05）. Conclusions Moxibustion combined with medication could better improve the heart function and down-regulate the expression of TNF-α mRNA than using moxibustion or Western medicine alone, and could suppress CHF induced down-regulation of using expression of myocardial TNF-α mRNA and NF-κB in rats, which may contribute to its effect in regulating the immune response and relieving myocardial injury.