针刺腧穴“降压方”对自发性高血压大鼠血管重构的影响

Effects of acupuncture at acupoint ‘Jiangya Fang’ on the ultrastructure of aorta in SHRs

目的:探讨针刺腧穴“降压方”降压及改善血管重构的可能机制。方法:将30只10~11周龄的雄性自发性高血压大鼠(SHR)按随机数表分为模型组、针刺组和药物组,每组10只。10只同周龄的雄性WKY大鼠作为空白组。针刺组通过针刺人迎、曲池、足三里穴(腧穴“降压方”)进行干预;药物组予以氯沙坦进行灌胃治疗,共治疗8周。光镜下观察主动脉病理形态学变化;Masson染色观察主动脉形态变化;透射电镜下观察主动脉管壁超微结构的变化;ELISA法检测血清中炎症因子基质金属蛋白酶9(MMP-9)及基质金属蛋白酶抑制剂-1(TIMP-1)的变化;用免疫组化法检测主动脉组织中Profilin-l表达含量。结果:与模型组比较,药物组和针刺组大鼠主动脉管腔内径(LD)增大(P<0.05),中膜厚度(MT)及MT/LD比值显著减小(P<0.01,P<0.05)。与模型组比较,药物组和针刺组主动脉弹性纤维排列整齐,分布均匀,胶原蛋白纤维没有明显增生;主动脉组织Profilin-1表达显著降低(P<0.01)。主动脉电镜超微结构显示,与模型组比较,针刺组、药物组内皮损伤均明显改善,其中药物组内皮细胞轻度变性,内皮细胞下层的胶原纤维和弹性纤维结构基本完整;针刺组内皮部分肿胀,平滑肌细胞轻微肥大增生,胶原纤维增多,粗细不一。与模型组比较,药物组和针刺组血清MMP-9含量显著降低(P<0.05),针刺组TIMP-1含量显著升高(P<0.05)。结论:针刺腧穴“降压方”可改善SHR内皮肿胀、胶原纤维与弹力纤维分布,进而影响血管舒缩及血压调节。

Objective: To explored the possible mechanism of reducing blood pressure and improving vascular remodeling by acupuncture at ‘Jiangya Fang’. Methods: A total of 30 male SHRs aged 10~11 weeks were divided into three groups: model group, acupuncture group and drug group, 10 rats in each group. Another 10 male WKY rats with same age as blank control group. The acupuncture group was treated with acupuncture at Renying(ST 9), Quchi(LI 11) and Zusanli(ST 36)points(prescription ‘Jiangya Fang’), and the drug group was given gavage therapy of Losartan for 8 weeks. The pathological morphology of aorta under light microscope was observed;the morphological changes of aorta was observed by Masson staining;the changes of aortic wall structure was observed by transmission electron microscope;the expression levels of serum inflammatory factors MMP-9 and TIMP-1 were detected by ELISA;the positive expression level of Profilin-1 in aortic tissue was detected by immunohistochemical method. Results: Compared with the model group, the LD of the drug group and the acupuncture group was increased(P<0.05), the MT and MT/LD ratio were decreased(P<0.01, P<0.05);Compared with the model group, the elastic fibers of the aorta of the drug group and the acupuncture group are well arranged and evenly distributed, and there is no obvious proliferation of collagen fibers, the expression of Profilin-1 in the aorta of the drug group and the acupuncture group was significantly reduced(P<0.01). By comparing with the model group, ultrastructure of aorta under transmission electron microscope showed a significant improvement of the endothelial injury in drug group and the acupuncture group. Within the drug group, the endothelial cells were slightly degenerated. And the collagen fibers and elastic fibers under the lower layer of endothelial cells were basically intact;Within the acupuncture group, endothelium were partially swollen. The smooth muscle cells were slightly hypertrophic and proliferated, and the collagen fibers were increased with different thicknesses. Compared with the model group, the expression of MMP-9 in the drug group and the acupuncture group was significantly reduced(P<0.05), the expression of TIMP-1 in the acupuncture group was significantly elevated(P<0.05).Conclusion: Acupuncture at acupoint ‘Jiangya Fang’ can effectively improve the endothelium swollen, collagen fibers and elastic fibers distribution in SHR, and then affect vasomotion and blood pressure regulation.