刺山柑果风湿止痛贴结合艾灸治疗对类风湿性关节炎大鼠TNF-α、IL-1β、VEGF和滑膜组织MMP-9表达的影响

Effect of Capparis spinosa fruits pain gel paste combined with moxibustion on TNF-α,IL-1β,VEGF and MMP-9 expression in synovial tissue of rats with rheumatoid arthritis

目的观察刺山柑和艾灸对类风湿性关节炎大鼠血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1β)和血管内皮生长因子(VEGF)含量,以及滑膜组织中基质金属蛋白酶-9(MMP-9蛋白)表达的影响。方法将60只大鼠随机分为正常组、模型组、阳性药组、刺山柑组、艾灸组和综合组,采用足跖皮下注射完全弗氏佐剂建立类风湿性关节炎模型。阳性药组和刺山柑组分别用伤湿止痛膏和刺山柑果风湿止痛贴外敷,艾灸组进行温和灸肾俞、足三里,综合组进行联合治疗,各组均治疗3个疗程(21d)。观察大鼠AI指数、足爪容积和热痛阈,大鼠血清TNF-α、IL-1β、VEGF水平和滑膜组织MMP-9蛋白表达。结果各组大鼠的AI指数和足爪容积明显高于正常组,热痛阈明显低于正常组(P<0.01)。经治疗后,各组的AI指数和足爪容积明显降低,热痛阈明显升高(P<0.05或P<0.01),尤其是艾灸组和综合组的AI指数、刺山柑组的足爪容积和艾灸组的热痛阈均在第1疗程就有显著性改善(P<0.05或P<0.01)。刺山柑组、艾灸组、综合组的TNF-α、IL-1β、VEGF水平和MMP-9表达均降低(P<0.05)。结论艾灸和刺山柑均有抗炎消肿止痛的作用,刺山柑消肿方面起效迅速,艾灸止痛见效更快,且二者均能下调TNF-α、IL-1β、VEGF水平和MMP-9蛋白表达。

Objective To observe the effects of Capparis spinosa and moxibustion on the levels of serum tumor necrosis factor-α(TNF-α),interluekin-1(IL-1β),vascular endothelial growth factor(VEGF)and the expression of matrix metalloproteinases-9(MMP-9)in synovial tissue of rats with rheumatoid arthritis.Methods 60 rats were randomly divided into normal group,model group,positive drug group,Capparis spinosa group,moxibustion group and comprehensive group.The rheumatoid arthritis model was established by subcutaneous injection of Freund’s complete adjuvant into the sole of the foot except normal group.Positive drug group and Capparis spinosa group were treated with Shangshi Zhitong Ointment and Capparis spinosa Fruits Pain Gel Paste respectively.Moxibustion group was treated with warm moxibustion of Shenshu(BL23)and Zusanli(ST36),comprehensive group was treated with combined therapy.Each group was treated for 3 courses.ApoptosisIndex(AI),paw volume and thermal pain threshold,serum levels of TNF-α,IL-1β,VEGF and expression of matrix metalloproteinases-9(MMP-9)in synovial tissue were observed.Results Compared with normal group,the AI index and foot volume of rats in each group were significantly higher than normal group,and the heat pain threshold was significantly lower than normal group(P<0.01).After treatment,the AI index and foot volume of each group decreased significantly,and the heat pain threshold increased significantly(P<0.05 orP<0.01);the levels of TNF-α,IL-1β,VEGF and the expression of MMP-9 in Capparis spinosa group,moxibustion group and comprehensive group decreased(P<0.05).Conclusion Both moxibustion and Capparis spinosa have anti-inflammatory,anti-swelling and analgesic effects.Capparis spinosa has a rapid effect on anti-swelling and analgesic effect.Both of them can down-regulate the levels of TNF-α,IL-1β,VEGF and the expression of MMP-9 protein.