不同组合穴位涂敷对大鼠佐剂性关节炎的疗效比较

Comparison of the Therapeutic Effects of External Application of "Arthritis-Ⅲ" to Different Acupoint Groups in Experimental Arthritis Rats

目的 :为临床应用“关节炎Ⅲ号”穴位贴敷治疗类风湿性关节炎时选择最佳配穴处方提供依据。方法 :大鼠足跖皮内注射福氏完全佐剂诱导关节炎模型 ,观察自制“关节炎Ⅲ号”不同组合穴位涂敷对模型大鼠关节炎指数、左右后肢跖围的动态变化和关节的病理变化 ,以及血清、脾、关节浸液中的白细胞介素 1 β(IL 1 β)与前列腺素E2 (PGE2 )的浓度变化的影响。结果 :各治疗组大鼠的关节炎指数、跖围与模型组大鼠比较均有显著降低 ,其中系统取穴组见效最快 ,远道取穴组次之 ,局部取穴组见效最慢。造模后大鼠关节有明显的病理改变 ,经治疗各组炎症级别有所下降 ,以系统取穴组最明显。造模后大鼠各样本的IL 1 β浓度均上升 ,各治疗组IL 1 β浓度与模型组比较有一定差异 ,但以关节浸液中的IL 1 β浓度的降低为明显 ,并以远道取穴的效果较好 ;不同组合穴位涂敷均能降低模型大鼠关节浸液中升高的PGE2 浓度 ,以局部取穴为好。结论 :“关节炎Ⅲ号”穴位涂敷对大鼠佐剂性关节炎有效与对IL 1 β和PGE2 的调节有关 ;不同组合的穴位涂敷表现出不同的疗效 ,其中整体疗效以系统取穴最佳 ,远道取穴免疫调节作用较强 。

Objective:To observe the therapeutic effects of external application of 'Arthritis-Ⅲ' (a Chinese medicinal herbal ointment ) to different acupoint groups in the treatment of adjuvant arthritis in the rat. Methods:Arthritis rats model was established by subcutaneous injection of complete Freund's adjuvant (CFA, 0.1 mL) into the right paw. Fifty SD rats were randomly divided into remote + local acupoint group, remote acupoint group, local acupoint group, model group, and normal control group , with 10 cases in each one. Self-prepared 'Arthritis-Ⅲ' ointment containing Leigongteng (Tripterygium Wilfordii) etc. was applied to 'Dazhui' (GV 14), 'Shenshu' (BL 23) and 'Taixi '(KI 3) for 5 min every time, twice daily, continuously for 14 days. Arthritis index (AI) was tested using Wood's method, and the plantar circumference of the hind legs of the rats was measured from the 19th day on after injection, once every 3 days. The anatomical changes of rats' paw tissues were observed based on Mosakazu's method after staining with HE technique. IL-1β and Prostaglandin (PG) E 2 concentrations in the serum and spleen and joint fluid were assayed separately. Results: On the 33rd day after injection of CFA, AI values of the 3 acupoint groups, particularly that of remote +local acupoint group, were significantly lower than that of model group (P<0.05～0.01). From the 22nd day to 31st day after injection of CFA, the plantar circumference values (right limb) of the normal control group and the 3 treatment groups (in remote acupoint group, from 25th day on, and in local acupoint group, from 31st day on) were all markedly lowered than those of model group (P<0.05～0.01). The inflammation degree of the 3 treatment groups, especially that of remote+ local acupoint group, was significantly lighter than that of model group (P<0.05). IL-1β concentrations in serum, spleen supernate and the left joint infusion of model group were higher than those of normal control group, and majority of those of the 3 treatment groups were considerably lower than those of model group (P<0.05～0.01); only those of remote acupoint group were close to those of control group (P>0.05). PGE 2 concentration value of serum in model group was considerably lower than that of normal control group, and those of the 3 treatment group were higher or apparently higher than that of model group (P<0.05). On the contrary, PGE 2 concentration value in the joint infusion of model group was markedly higher than that of control group, and those of the 3 treatment groups were all significantly lower than that of model group (P<0.01), only PGE 2 levels (serum and joint infusion) of the local acupoint group were close to those of normal control group (P>0.05). Conclusion: External application of 'Arthritis-Ⅲ' to acupoints is effective in relieving symptoms and signs of arthritis, reducing inflammation reaction, and regulating IL-1β and PGE 2 levels of the tissues. Among them, the effects of improvement of symptoms and signs and pathological changes in remote +local acupoint group are the best, the effect of immunoregulation in remote acupoint group is stronger, and the anti-inflammation action of local acupoint group is better.