“火郁发之”法火针对大鼠急性痛风性关节炎NALP3炎性体的影响

Effect of Fire Needle on NALP3 Inflammasome of Rats with Acute Gouty Arthritis under the Guidance of Fire Stagnation Requiring Dissipation

目的在前期课题组成员广东省中医药局基金课题"基于NALP3的"火郁发之"法火针治疗急性痛风性关节炎的研究"(项目编号20161201)中发现,火针疗法对急性痛风性关节炎模型大鼠的NALP3炎性体有明显影响,由此进一步探讨火针疗法治疗急性痛风性关节炎的作用机制。研究火针疗法对大鼠急性痛风性关节炎的疗效及机制。方法 60只雄性Wistar大鼠随机分为正常组、模型组、火针组、针刺组及秋水仙碱组各12只。除正常组外,其他四组采用氧嗪酸钾联合Coderre方法[1]造模,模拟人体以高尿酸血症为基础引起的内环境变化诱发的急性痛风性关节炎,除正常组及模型组外,另3组分别予火针、针刺及秋水仙碱干预治疗,通过分析各组血尿酸及关节滑膜嗜中性粒细胞碱性磷酸酶3(NALP3)、白细胞介素-1β(IL-1β)水平变化,评估火针治疗急性痛风性关节炎的疗效,探讨火针治疗急性痛风性关节炎的可能作用机制。结果高尿酸血症(HUA)造模后,除正常组外,其他各组血尿酸均较正常组升高(P<0.05),疗程结束后,各组血尿酸水平均与正常组相当(P>0.05),且组间比较差别不大(P>0.05)。HUA造模后,除正常组外,各组关节滑膜IL-1β、NALP3水平均升高(均P<0.05);急性痛风性关节炎(AGA)造模后,3个干预组的IL-1β、NALP3水平明显低于模型组(P<0.05),但总体来说各组的IL-1β、NALP3水平仍较高。疗程结束后,3个干预组的IL-1β水平均明显下降(P<0.05),且水平与正常组相当,而模型组的IL-1β水平仍居高不下。疗程结束后,除模型组外,3个干预组的NALP3水平均较干预治疗前明显下降,但仍高于正常组的NALP3水平(P<0.05);火针组、针刺组及秋水仙碱组3组间疗程结束后的NALP3水平比较差别不大(P>0.05)。结论火针具有抑制NALP3的活化及IL-1β分泌的作用,效果与针刺及秋水仙碱相当,对大鼠急性痛风性关节炎有一定疗效,有一定临床参考价值。

Objective： To study the effect and mechanism of fire needle therapy on acute gouty arthritis in rats. Methods： 60 male Wistar rats were randomly divided into 5 groups,including the normal group,the model group ,fire needle group, acupuncture group and colchicine group. Except the normal group, the other four groups used potassium oxazine combined with Coderre to make models,and to induce acute gouty arthritis by internal environment changes based on hyperuricemia. Except the normal group and the model group,other three groups received intervention therapy with fire needle,acupuncture and colchicine,respeetively. The effect of fire needle on acute gouty arthritis was evaluated, and the possible mechanism was investigated by analyzing blood uric acid and the changes of NALP3 and IL-1β levels in synovium of joint of each group. Results： After the successful modelling of hyperuricemia （HUA） ,the blood uric acid in all the other groups was higher than that of the normal group （P〈0.05）. After the course of treatment,the level of blood uric acid in each group was equal to that of the normal group（P〉 0.05 ）, and there was no significant difference between the groups （P〉 0.05 ）. After the successful modelling of hyperuricemia （HUA）,the level of IL-1β and NALP3 in synovium of joint of each group increased significantly （P〈 0.05）. After the modelling of acute gouty arthritis （AGA）,the levels of IL-1β and NALP3 in the three intervention groups were significantly lower than those in the model group, and the statistical analysis was different （P〈0.05）,but in general,the levels of IL-1β and NALP3 in each group were still high. After the end of treatment, IL-1β levels in three intervention group were significantly decreased,and was equal to those of the normal group （P〈 0.05）,and IL-1β levels of the model group was still high. After the end of treatment,except the model group, NALP3 levels of three intervention groups were significantly lower than those before intervention treatment,but NALP3 level of the four group Was still higher than those of the normal group,and the difference was statistically significant （P〈 0.05）. But there was no significant difference in NALP3 levels among fire needle group, acupuncture group and colchicine group after treatment（P〉 0.05）. Conclusion： Fire needle has an inhibition effect on the activation of NALP3 and the secretion of IL-1β, and the effect is equal to that of acupuncture and colchicine. It has certain therapeutic effect on acute gouty arthritis in rats and has certain clinical reference value.