艾灸调控TLR/MyD88免疫信号通路对CHF心室重塑影响机制研究

To elaborate the mechanism of chronic heart failure and ventricular remodeling with immunity inflammation theory is the newest and the hottest research field of heart failure. Moxibustion is good in adjusting the immune system and the cardiovascular system, but the previous studies of chronic heart failure in traditional Chinese medicine mainly focused on internal use of Chinese herbal, and most of the researches were based on rennin- angiotensin - aldosterone system. Only few of them studied the moxibustion's effects on chronic heart failure and ventricular remodeling. This study started from the moxibustion's regulation of the chronic heart failure's signal path, and took aorta abdominalis half-constriction method to reproduce the chronic heart failure rat models. The study divided the rats into six groups, which are: normal group, model group, pseudo-surgical group, western medicine group, moxibustion group and moxibustion& western medicine group. After being treated separately for three weeks, the heart function, ventricular structure, cardiac muscle ultrastructure, the mast cells at the moxibustion point, and the immune materials which are closely related to the immune signal pathway such as MyD88, NF-ΚB， TNF-α，IL-6 should be examined to find out the changes. This thesis studied the moxibustion's effects on chronic heart failure and ventricular remodeling by comparing the differences between these groups, and elaborated the moxibustion's regulation of the chronic heart failure's immune system. It also revealed the mechanism of treating chronic heart failure and ventricular remodeling with moxibustion, and laid an experimental foundation for the clinical application of treating chronic heart failure and ventricular remodeling with moxibustion.

免疫炎症学说阐述慢性心衰心室重塑发生机制是心衰研究的最新进展，亦是当今研究的热点。艾灸对于免疫系统、心血管系统具有较好的调整作用，但目前中医药治疗慢性心衰的研究主要集中在中药内服上，且多围绕肾素－血管紧张素－醛固酮系统开展研究，从免疫炎症角度研究艾灸对慢性心衰心室重塑影响者甚少。本项目在前期工作基础上，从研究艾灸对慢性心衰免疫信号通路的调控入手，采用腹主动脉半缩窄术复制慢性心衰大鼠模型，将大鼠分为正常组、模型组、伪手术组、西药组、艾灸组以及艾灸加西药组，分组处理三周后，检测各组大鼠心功能、心室结构、心肌超微结构以及与免疫信号通路密切相关的免疫物质MyD88、NF－КB、TNF-α、IL-6 和穴区肥大细胞变化，分析比较各组差异，探讨艾灸对慢性心衰心室重塑的影响，阐明艾灸对慢性心衰免疫系统的调控作用，揭示艾灸治疗慢性心衰心室重塑的相关机制，为艾灸治疗慢性心衰心室重塑的临床运用奠定实验基础。

慢性心衰（CHF）多见于各种心血管疾病后期，严重影响患者的健康和生活质量。在CHF进展过程中，心室重塑是影响病变的重要因素。近年来，免疫炎症学说阐述慢性心衰心室重塑发生机制是心衰研究的最新进展，亦是当今研究的热点。艾灸对于免疫系统、心血管系统具有较好的调整作用，但目前中医药治疗慢性心衰的研究主要集中在中药内服上，且多围绕肾素－血管紧张素－醛固酮系统开展研究，从免疫炎症角度研究艾灸对慢性心衰心室重塑影响者甚少。本项目从研究艾灸对慢性心衰免疫信号通路的调控入手，采用阿霉素腹腔注射法复制慢性心衰大鼠模型，将大鼠分为正常组、模型组、西药组、艾灸组以及艾灸加西药组，分组处理三周后，检测各组大鼠心功能、心室肥厚指数、心肌病理变化以及心肌组织中与免疫信号通路密切相关的免疫物质MyD88、NF－КB、Caspase3 mRNA、TNF-αmRNA、IL-6 mRNA变化，结果显示，模型组大鼠心功能下降、心室肥厚以及心肌细胞坏死明显加重，心肌组织MyD88、NF－КB、Caspase3 mRNA、TNF-αmRNA、IL-6 mRNA水平明显上升；艾灸组、西药组及艾灸加西药组能明显改善心功能、心室肥厚以及心肌细胞坏死状况，显著降低心肌组织MyD88、NF－КB、Caspase3 mRNA、TNF-αmRNA、IL-6 mRNA水平，且艾灸加西药能发挥协同效应，作用更加明显。研究表明艾灸肺俞、心俞可能通过下调MyD88、NF-КB、Caspase3 mRNA、TNF-αmRNA以及IL-6 mRNA表达，调控免疫信号传导通路，抑制免疫炎症反应，从而减轻CHF心室重塑状况，改善心功能。.本项目初步阐明艾灸对慢性心衰免疫系统的调控作用，揭示艾灸治疗慢性心衰心室重塑的相关机制，艾灸治疗慢性心衰心室重塑的临床运用奠定了实验基础。