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目的:比较不同针法对类风湿关节炎(rheumatoid arthritis,RA)模型家兔尿液代谢物的影响,探讨“热补针法”治疗RA的特异性机制。方法:40只清洁级青紫蓝家兔随机分为正常组、模型组、平补平泻组、捻转补法组、热补针法组,每组8只。除正常组外,余组以卵蛋白诱导法和低温冷冻法复制RA寒证模型。平补平泻组、捻转补法组、热补针法组于“足三里”分别施以平补平泻、捻转补法、“热补针法”针刺,留针30min,每日1次,共7d。干预结束后收集24h尿液,处死家兔,剥取各组家兔膝关节滑膜组织进行组织形态学观察,采用液相色谱-质谱联用仪技术(LC-Q/TOF-MS)检测尿液代谢物,利用主成分分析(PCA)和偏最小二乘方判别分析(PLS-DA)对数据进行统计分析。结果:与正常组比较,模型组尿液代谢物变化主要体现在亮氨酸代谢相关物质降低(P<0.05),嘌呤代谢、色氨酸代谢相关物质增高(P<0.05)。与模型组比较,各针刺组尿液代谢物变化主要体现在亮氨酸代谢相关物质增高(P<0.05),色氨酸代谢、嘌呤代谢相关物质降低(P<0.05),且热补针法组亮氨酸代谢相关物质明显高于平补平泻组和捻转补法组(P<0.05)。结论:平补平泻、捻转补法及“热补针法”针刺可调控RA家兔体内亮氨酸代谢(能量代谢)、嘌呤代谢(氧化损伤)、色氨酸代谢(免疫调控)通路,而热补针法治疗RA的特异性可能体现在对亮氨酸代谢(能量代谢)的调控方面。
Objective: To compare the effects of different acupuncture methods on urinary metabolites in rabbits with rheumatoid arthritis (RA) and to explore the specific mechanism of heat-acupuncture in treating RA. Methods: Forty clean-grade blue-purple rabbits were randomly divided into normal group, model group, Pingbu-diarrhea group, twirling-supplementation group and hot-fill-acupuncture group, with 8 in each group. In addition to the normal group, the remaining group to replicate the RA cold syndrome model with ovalbumin induction and cryogenic freezing. Supplement and flatulence group, twirling and supplementation group, hot fill acupuncture group in “Zusanli”, respectively, to make up for diarrhea, twisting fill method, “hot fill needle ” acupuncture, needle 30min, each Day 1, a total of 7d. Urine was collected 24h after the intervention, rabbits were sacrificed, the synovial tissue of rabbits in each group was removed and histomorphology was observed. The urine samples were collected by LC-Q / TOF-MS Liquid metabolites, the data were statistically analyzed by Principal Component Analysis (PCA) and Partial Least Squares Discriminant Analysis (PLS-DA). Results: Compared with normal group, the changes of urinary metabolites in the model group were mainly reflected in the decrease of leucine metabolism-related substances (P <0.05), purine metabolism and the increase of tryptophan metabolism related substances (P <0.05). Compared with the model group, the changes of urinary metabolites in each acupuncture group were mainly reflected in the leucine metabolism-related substances (P <0.05), tryptophan metabolism and purine metabolism-related substances decreased (P <0.05) Law group leucine metabolism related substances were significantly higher than the flat and flat group and twist make up group (P <0.05). CONCLUSION: The effects of “Pingbianxiaozai”, “Twister” and “Hot Acupuncture Method” acupuncture can regulate leucine metabolism (energy metabolism), purine metabolism (oxidative damage), tryptophan metabolism Regulation) pathways, and the specificity of heat-acupuncture in the treatment of RA may be reflected in the regulation of leucine metabolism (energy metabolism).