摘要
背景:鹿角方由鹿角、补骨脂、淫羊藿、山萸肉、女贞子、沉香等纯中药组成。此方具有正性肌力、扩张血管和利尿等作用。目的:探讨鹿角方逆转压力负荷增加对大鼠左心室重构的作用。设计:随机对照实验。单位:解放军南京军区南京总医院中西医结合科,上海中医药大学附属曙光医院,河北医科大学博士后流动站。材料:实验于 1998-01/12在上海中医药大学实验室完成。选取 W istar雄性大鼠 153只。共做 5次试验,只有第 4次试验选择 9只大鼠,其余均选取 36只大鼠。方法:将每次试验所选取的 36只 W istar雄性大鼠随机分为假手术组、模型组和鹿角方组。将所有大鼠建成压力负荷增加的左室重构模型,模型组造模 4周后,双蒸水灌胃 15m L /kg,1次 /d,共 4周;假手术组只分离腹主动脉,不用银夹狭窄,4周后同模型组;鹿角方组造模 4周后,以鹿角方灌胃 15m L /kg,1次 /d,共 4周。观察左心室质量指数,采用免疫组织化学染色法观察心肌Ⅰ、Ⅲ型胶原的改变,采用 RT-PCR 方法观察心肌Ⅰ型胶原 m RNA 的表达,并采用放射免疫分析方法检测血浆和心肌血管紧张素Ⅱ和血清醛固酮水平。主要观察指标:观察左心室质量指数、心肌Ⅰ、Ⅲ型胶原的改变、心肌Ⅰ型胶原 m RNA 的表达,检测血浆和心肌血管紧张素Ⅱ和血清醛固酮水平。结果:153只大鼠均进入结果分析。在检测Ⅰ型胶原的积分吸光度试验中假手术组和鹿角方组各死亡 3只,模型组死亡 1只,最终纳入 29只大鼠。在检测Ⅲ型胶原的积分吸光度的实验中,假手术组和鹿角方组均死亡 3只,模型组又死亡 6只,最终纳入 26只大鼠。①左心室质量指数比较:假手术组和鹿角方组明显低于模型组 [(2.24±0.12)/1000,(2.60±0.44)/1000,(3.15±0.47)/1000,t=2.959-6.499,P <0.05]。②Ⅰ型胶原积分吸光度的改变 : 鹿角方组和假手术组明显低于模型组[(0.56±0.23,0.57±0.19,2.79±2.00),t=0.661-3.964,P <0.01]。③Ⅲ型胶原积分吸光度的改变:假手术组和鹿角方组明显低于模型组[(0.48±0.10,0.55±0.09,0.84±0.27),t=2.898-3.560,P <0.01]。④Ⅰ型胶原 m RNA 表达:鹿角方组和假手术组明显低于模型组 [(58.0±36.0)%,(79.1±18.6)%,(139.0±29.2)%,t=3.027,P <0.05]。⑤心肌血管紧张素Ⅱ改变:鹿角方组和假手术组明显低于模型组[(2.49±0.57,2.64±0.57,3.96±0.77)pg/m L,t=4.773-5.315,P <0.001]。⑥血清醛固酮改变:鹿角方组和假手术组明显低于模型组 [(501.6±94.6,476.6±85.7,647.8±72.2) ng/m L,t=4.256-5.292,P <0.001]。结论:Ⅰ型和Ⅲ型胶原的积分吸光度、Ⅰ型胶原 m RNA 的表达、心肌血管紧张素Ⅱ及血清醛固酮这些指标,均与左心室质量指数的改变一致。补肾为主的中药复方鹿角方具有逆转充血性心力衰竭心肌纤维化的作用及逆转左心室重构的作用。
BACKGROUND： The complex prescription of lujiao prescription is made up of antle, malytea scurfpea fruit, korean epimedium herb, dogwood, glossy privet fruit, and Chinese eaglewood wood. It is characterized by its positive myodynamia as well as promoting diuresis and expanding vessels.
OBJECTIVE： To observe the effect of lujiao prescription in reversing left ventricular remodeling in rats with pressure overload.
DESIGN： A randomized controlled trial.
SETTING： Department of Integrated Traditional Chinese Medicine and Western Medicine, Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA： Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine; Postdoctor Institute of Hebei Medical University.
MATERIALS： The experiment was conducted at the Laboratory of Shanghai University of Traditional Chinese Medicine from January to December 1998. Totally 153 male Wistar rats were provided by the Experimental Animal Center of Shanghai Medical College. There were five experiments with 36 rats selected for each experiment except 9 rats for the fourth one.
METHODS： Totally 36 Wistar male rats selected for each experiment were randomly divided into sham operation group, model group and lujiao prescription group. Sham-operation group： The rats＇ abdominal aortas were separated, but not narrowed by silver clip. After four weeks, the rats were treated with twice-distilled water （15 mL/mg, ig）, once a day for 4 consecutive weeks. Model group： Four weeks after modeling, the rats were treated with twice-distillod water （15mL/mg, ig） once a day for 4 consecutive weeks, Lujiao prescription group： Four weeks after rat modeling, the rats were given orally liquid decoction of lujiao prescription （15 mL/mg, ig）, once a （lay for 4 weeks. Observations on left ventrieular mass index （LV= MI）： Collagen type Ⅰ and Ⅲ was measured by immunohistochemistry. mRNA expression of collagen type Ⅰ and Ⅲ was measured by RT-PCR. Ang Ⅱ, ANF and ALD were measured hy radioimmunoassay.
MAIN OUTCOME MEASURES： LVMI, left ventficular myocardium collagen type Ⅰ and Ⅲ, mRNA expression of collagen type Ⅰ and Ⅲ, and changes of plasm, myocardlum Ang Ⅰ, plasm ANF and serum aldosterone.
RESULTS： Totally 153 rats entered the final analysis, During the detection of mRNA expression of collagen type 1 , 3 rats in sham-operation group died and 1 in lujiao prescription group died. The other 29 rats entered the final analysis. During the detection of mRNA expression of collagen type Ⅲ, 3 rats in sham-operation group died, 3 in lujiao prescription group died, and 6 in model group died. The other 26 rats entered the final analysis. All rats were lost because of operation injury. （1） LVMI： It was lower in sham-operation group and lujiao prescription group than in model group [（2.24±0.12）/1 000, （2.60±0.44） /1 000, （3.15±0.47）/1 000, t=2.959-6.499, P 〈 0.05]. （2） Changes of absorbency of collagen type Ⅰ ：It was lower in sham-operation group and lujiao prescription group than in model group [（0.56±0,23, 0.57±0.19, 2.79±2.00）, t=0.661-3.964, P 〈 0.01]. （3） Changes of absorbency of collagen type Ⅲ： It was lower in sham-operation group and lujiao prescription group than in model group [（0.48±0.10,0.55±0.09,0.84±0.27）, t=2.898-3.560, P 〈 0.01]. （4） mRNA expression of collagen type Ⅰ ： It was lower in sham-operation group and lujiao prescription group than in model group [（58.0±36.0）%, （79.1±18.6）%, （139.0±29.2）%, t=3.027, P 〈 0.05]. （5） Changes of myocardium Ang Ⅱ ： It was lower in sham-operation group and lujiao prescription group than in model group [（2.49±0.57, 2.64±0.57,3.96±0.77） pg/mL, t=4.773-5.315, P 〈 0.001]. （6） Changes of serum aldosterone： It was lower in sham-operation group and lujiao prescription group than in model group [（501.6±94.6, 476.6±85.7, 647.8±72.2） ng/mL, t=4.256-5.292, P 〈 0.001].
CONCLUSION： Indexes of integrating absorbency of myocardial collagen type Ⅰ and type Ⅲ, mRNA expression of collagen type Ⅰ , myocardial Ang Ⅱ and serum aldosterone ale all similar to the changes LVMI. Lufiao prescription can revere left ventricular remodeling and myocardial fibrosis.
出处
《中国临床康复》
CSCD
北大核心
2006年第3期177-179,共3页
Chinese Journal of Clinical Rehabilitation
