针刺对慢性心衰兔模型的实验研究

发布时间：2018-06-20 03:42

本文选题：针刺 + 慢性心力衰竭　；参考：《西南医科大学》2017年硕士论文

【摘要】：目的:通过研究针刺对慢性心力衰竭兔模型的影响,探讨针刺治疗慢性心力衰竭(chronic heart failure,CHF)可能的机制,为临床进一步开展和推广慢性心力衰竭的针刺治疗提供更加可靠的前期基础和依据。方法:将28只雄性新西兰大白兔按照随机数字表分为正常对照组(7只)、CHF模型组(7只)、贝那普利组(7只)和针刺治疗组(7只)。正常对照组和CHF模型组予以蒸馏水灌胃;贝那普利组予以盐酸贝那普利(3mg/kg/d)灌胃3个月;针刺治疗组予以针刺治疗和等量蒸馏水灌胃。评估实验前后实验兔的生理状况、血生化指标、超声心动图指标和心肌病理形态。干预前后,采用ELISA试剂盒测量实验兔血浆B型钠尿肽(B type natfiuretic peptide,BNP)、肾素(renin,REN)、血管紧张素II(angiotensinII,Ang II)、醛固酮(aldosterone,ALD)、去甲肾上腺素(norepinephrine,NE)水平,采用超声心动图测量左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左室收缩末期内径(left ventricular end systolic diameter,LVESD)、左室射血分数(left ventricular ejection fraction,LVEF);干预后,采用光镜观察心肌病理形态变化。结果:(1)造模后,CHF模型组、贝那普利组和针刺治疗组实验兔的体重[(1.84±0.10)kg、(1.90±0.09)kg、(1.81±0.08)kg比(2.03±0.08)kg,P0.05]比正常对照组减轻,心率加快[(233.86±5.52)次/分、(234.43±4.24)次/分、(235.29±5.62)次/分比(164.86±4.10)次/分,P0.05],血浆BNP[(1940.20±87.84)pg/ml、(1905.62±109.83)pg/ml、(2012.88±89.59)pg/ml比(1408.99±119.48)pg/ml,p0.05]、ren[(259.71±14.81)pg/ml、(253.75±11.06)pg/ml、(257.61±8.88)pg/ml比(183.31±22.25)pg/ml,p0.05]、ang-Ⅱ[(461.19±38.10)pg/ml、(455.20±28.30)pg/ml、(463.39±20.23)pg/ml比(311.38±13.40)pg/ml,p0.05]、ald[(487.86±73.01)pg/ml、(445.30±17.08)pg/ml、(457.21±21.14)pg/ml比(339.29±25.73)pg/ml,p0.05]、ne[(414.16±13.56)pg/ml、(408.01±22.11)pg/ml、(400.30±14.18)pg/ml比(305.66±13.49)pg/ml,p0.05]水平升高,lvef[(56.57±2.82)%、(56.29±2.69)%、(56.43±3.60)%比(77.00±2.83)%,p0.05]下降,lvedd[(13.49±0.44)mm、(13.60±0.40)mm、(13.58±0.36)mm比(10.51±0.46)mm,p0.05]、lvesd[(8.74±0.66)mm、(8.75±0.51)mm、(8.4±0.63)mm比(6.80±0.28)mm,p0.05]增加,差异有统计学意义,提示造模成功。(2)在干预终点,与正常对照组相比,贝那普利组和针刺治疗组的各观察指标均无明显差异,而chf模型组的体重[(2.64±0.09)kg比(3.14±0.08)kg、(3.08±0.08)kg、(3.06±0.09)kg,p0.05]较正常对照组、贝那普利组和针刺治疗组减轻,心率[(236.57±3.78)次/分比(174.00±4.28)次/分、(182.57±9.78)次/分、(181.29±8.08)次/分,p0.05]和血bnp[(1836.91±92.54)pg/ml比(1414.07±88.84)pg/ml、(1386.76±69.38)pg/ml、(1453.16±69.58)pg/ml,p0.05]、ren[(255.49±11.97)pg/ml比(182.00±17.49)pg/ml、(186.72±6.31)pg/ml、(189.27±10.41)pg/ml,p0.05]、ang-Ⅱ[(477.85±15.44)pg/ml比(315.12±35.11)pg/ml、(325.75±15.73)pg/ml、(323.87±15.08)pg/ml,p0.05]、ald[(484.66±47.6)pg/ml比(332.55±24.97)pg/ml、(328.14±19.00)pg/ml、(329.95±17.13)pg/ml,p0.05]、ne[(406.42±16.23)pg/ml比(335.84±16.22)pg/ml、(324.10±13.56)pg/ml、(327.06±20.38)pg/ml,p0.05]水平升高,LVEDD[(13.62±0.41)mm比(12.17±0.34)mm、(12.38±0.54)mm、(12.45±0.32)mm,P0.05]、LVESD[(11.40±0.41)mm比(9.97±0.30)mm、(10.35±0.57)mm、(10.26±0.18)mm,P0.05]增加,LVEF降低[(55.43±2.64)%比(77.43±2.76)%、(65.71±2.29)%、(67.00±2.58)%,P0.05]。(3)病理形态学改变上显示,正常对照组心肌未见明显的异常改变,而CHF模型组、贝那普利组和针刺治疗组的实验兔心肌均可见不同程度的损伤性改变,主要包括心肌细胞排列稀疏、紊乱,细胞水肿、坏死,心肌细胞核固缩、浓缩、裂解,横纹不清,心肌纤维组织增生,炎细胞浸润等。其程度由低到高为:贝那普利组、针刺治疗组和CHF模型组。结论:(1)针刺能降低慢性心力衰竭兔模型血浆BNP水平;(2)针刺能有效抑制慢性心力衰竭兔模型的肾素-血管紧张素-醛固酮系统(renin-angiotensin-aldosterone system,RAAS)和儿茶酚胺系统的激活,降低血浆REN、Ang-Ⅱ、ALD、NE水平;(3)针刺能改善慢性心力衰竭兔模型的心功能;(4)针刺可能对慢性心力衰竭兔模型的心肌重塑进程有改善作用。
[Abstract]:Objective: To explore the possible mechanism of acupuncture treatment for chronic heart failure (chronic heart failure, CHF) by studying the effect of acupuncture on the rabbit model of chronic heart failure, so as to provide a more reliable basis and basis for the further development and promotion of acupuncture treatment for chronic heart failure. Methods: 28 new Zealand white rabbits were used as a basis. The random number table was divided into the normal control group (7), the CHF model group (7), the Benner Pury group (7) and the acupuncture treatment group (7). The normal control group and the CHF model group were given the distilled water, and the Benner Pury group was treated with Benner Pury (3mg/kg/d) for 3 months; the acupuncture treatment group was treated with acupuncture and the same amount of distilled water was given to the stomach. Experimental rabbit's physiological status, blood biochemical index, echocardiography index and myocardial pathological form. Before and after intervention, ELISA kit was used to measure B type natriuretic peptide (B type natfiuretic peptide, BNP), renin (renin, REN), angiotensin II (angiotensinII, Ang), aldosterone, norepinephrine. Ine, NE) level, using echocardiography to measure left ventricular end diastolic diameter (left ventricular end diastolic diameter, LVEDD), left ventricular end systolic diameter (left ventricular end systolic), left ventricular ejection fraction (left ventricular ejection fraction). Results: (1) after the model, the body weight of the rabbits in the CHF model group, benazepril group and the acupuncture treatment group were (1.84 + 0.10) kg, (1.90 + 0.09) kg, (1.81 + 0.08) kg ratio (2.03 + 0.08) kg, P0.05] compared with the normal control group, and the heart rate was faster [(233.86 + 5.52) / sub, (234.43 + 4.24) / sub, (234.43 + 0.09) / sub / fraction, P0.05], and plasma BNP[( 1940.20 + 87.84) pg/ml, (1905.62 + 109.83) pg/ml, (2012.88 + 89.59) pg/ml ratio (1408.99 + 119.48) pg/ml, p0.05], ren[(259.71 + 14.81) pg/ml, (253.75 + 11.06) pg/ml, p0.05] pg/ml, p0.05]. (487.86 + 73.01) pg/ml, (445.30 + 17.08) pg/ml, (457.21 + 21.14) pg/ml ratio (339.29 + 25.73) pg/ml, p0.05], ne[(414.16 + 13.56) pg/ml, (408.01 + 22.11) pg/ml, (400.30 + 22.11) pg/ml, p0.05] level, lvef[ ) mm, (13.60 + 0.40) mm, (13.58 + 0.36) mm ratio (10.51 + 0.46) mm, p0.05], lvesd[(8.74 + 0.66) mm, (8.75 + 0.51) mm, (8.4 + 0.63) mm ratio (6.80 + 13.58) mm, p0.05] increased, the difference was statistically significant, indicating the success of the model, compared with the normal control group, the observation of benazepril group and the acupuncture treatment group had no significant differences, The weight of the CHF model group was (2.64 + 0.09) kg ratio (3.14 + 0.08) kg, (3.08 + 0.08) kg, (3.06 + 0.09) kg, p0.05] compared with the normal control group, and the benazepril group and the acupuncture treatment group were relieved, heart rate [(236.57 + 3.78) / sub / fraction (174 + 4.28) / sub, (182.57 +) secondary / sub, p0.05] and bnp[(0.08) pg/ml ratio. (88.84) pg/ml, (1386.76 + 69.38) pg/ml, (1453.16 + 69.58) pg/ml, p0.05], ren[(255.49 + 11.97) pg/ml ratio (182 + 17.49) pg/ml, (186.72 + 6.31) pg/ml, p0.05], ang- II. Pg/ml, (328.14 + 19) pg/ml, (329.95 + 17.13) pg/ml, p0.05], ne[(406.42 + 16.23) pg/ml ratio (335.84 + 16.22) pg/ml, (324.10 + 13.56) pg/ml, (327.06 + 20.38) pg/ml, p0.05] level rising, LVEDD[mm ratios. (10.26 + 0.18) mm, P0.05] increased, LVEF decreased [(55.43 + 2.64)%, 77.43 + 2.76)%, (65.71 + 2.29)%, (67 + 2.58)%, and P0.05]. (3) pathological changes showed that no obvious abnormal changes were found in the normal control group, while the myocardium in the CHF model group, the bainpril group and the acupuncture treatment group showed varying degrees of damage change in the experimental rabbit myocardium. Mainly including sparse, disorder, edema, necrosis, myocardial cell nuclear condensation, concentration, lysis, transverses, myocardial fibrosis, inflammatory cell infiltration and so on. The degree from low to high is: Benner Pury, acupuncture treatment group and CHF model group. (1) acupuncture can reduce plasma BNP level in rabbit model of chronic heart failure; (2) Acupuncture can effectively inhibit the activation of the renin angiotensin aldosterone system (renin-angiotensin-aldosterone system, RAAS) and catecholamine system in the rabbit model of chronic heart failure, and reduce the plasma REN, Ang- II, ALD, NE level; (3) acupuncture can improve the cardiac function of the rabbit model of chronic heart failure; (4) acupuncture may be on the rabbits with chronic heart failure. The model can improve the remodeling process of myocardium.
【学位授予单位】：西南医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R245;R-332

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