肾阳虚对肺主气功能的影响及其机制研究
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摘要
目的:本研究立足肺肾相关理论,以肌注氢化可的松建立的肾阳虚大鼠模型为研究平台,观察肾阳虚对模型大鼠“肺主气”的影响,以模型大鼠的呼吸指标探讨肾阳虚对“肺司呼吸”的影响,以AngⅡ、AT1R等指标探讨肾阳虚对“肺朝百脉”的影响,以AQP3、AQP4等指标探讨肾阳虚对“肺主通调水道”的影响,以TLR4、TRAF-6等指标探讨肾阳虚对“肺主卫外”的影响。同时运用温补肾阳的右归丸对模型大鼠进行干预,运用现代研究手段检测其肺内各种因子的表达,以初步阐明肾阳虚对“肺主气”功能影响的机制。
     方法:本课题采用6周龄Wistar大鼠60只,雄性,随机分为正常组、模型组、右归丸组,除正常组外,其余各组大鼠采用肌注氢化可的松建立肾阳虚大鼠模型。正常组大鼠每日上午8:00给予臀部肌肉注射生理盐水5ml/kg体重,连续15天,此后每天灌胃生理盐水10ml/kg体重,连续30天;模型组大鼠每日上午8:00给予臀部肌肉注射氢化可的松25mg/kg体重,连续15天,造模结束次日,每天灌胃生理盐水10ml/kg体重,连续30天;右归丸组大鼠每日上午8:00给予臀部肌肉注射氢化可的松25mg/kg体重,连续15天,造模结束次日,每天灌胃右归丸混悬液10ml/kg体重(药物浓度为0.243g/ml),连续30天。①造模结束次日及灌胃结束次日,所有实验大鼠取24小时尿液,腹主动脉采血后,检测24小时尿17-CS-OH及血清睾酮(T)含量;②造模结束次日及灌胃结束次日,用实验小动物肺功能测定仪测定用力肺活量(FVC)等呼吸功能指标;③免疫组化和Western Blot检测肺组织AngⅡ、AT1R蛋白的表达;④Western Blot检测肺组织AQP3、AQP4蛋白的表达,RT-PCR检测肺组织AQP3mRNA、AQP4mRNA基因的表达;⑤Western Blot检测肺组织TLR4、TRAF-6蛋白的表达,RT-PCR检测肺组织TLR4mRNA、TRAF-6mRNA基因的表达。
     结果:①实验大鼠尿17-OH-CS、血清T含量检测结果:第46天时,与正常组比较,模型组大鼠尿17-OH-CS、血清T含量降低,差异有统计学意义(P<0.05);与右归丸组比较,模型大鼠尿17-OH-CS和血清T含量较少,差异有统计学意义(P<0.05)。
     ②实验大鼠呼吸功能检测结果:与正常组比较,模型组大鼠FVC、FEV0.3均显著降低(P<0.05),动脉血PH、PaO2、SaO2显著降低,PaCO2显著升高(P<0.05);与模型组比较,右归丸组大鼠FVC、FEV0.3等显著降低,差异有统计学意义(P<0.05)。
     ③实验大鼠血液循环系统指标检测结果:免疫组化中AngⅡ、AT1R蛋白阳性反应产物呈现棕黄色,第46天时,与正常组比较,模型组大鼠肺组织AngⅡ表达减少,AT1R表达也减少,差异有统计学意义(P<0.05);与模型组比较,右归丸组大鼠肺组织AngⅡ和AT1R表达较多,差异有统计学意义(P<0.05)。
     ④实验大鼠水液代谢指标检测结果:Western Blot和RT-PCR分别检测出蛋白和基因的含量,与正常组比较,模型组大鼠肺组织AQP3、AQP4蛋白和基因表达明显减少,差异有统计学意义(P<0.05);与模型组比较,右归丸组大鼠肺组织AQP3、AQP4表达较多,差异有统计学意义(P<0.05)。
     ⑤实验大鼠免疫功能指标TLR4、TRAF-6检测结果:Western Blot和RT-PCR检测,与正常组比较,模型大鼠肺组织TLR4、TRAF-6的表达显著减少,差异有统计学意义(P<0.05);与模型组比较,右归丸组大鼠肺组织TLR4和TRAF-6的表达显著增加,差异有统计学意义(P<0.05)。
     结论:①采用氢化可的松建立肾阳虚大鼠模型,根据模型大鼠的一般状况,以及24小时尿液17-OH-CS和血清T含量显著降低的特点,提示肾阳虚模型建立成功。
     ②模型大鼠呼吸功能各项指标下降,血液生化指标异常,小气道阻力增加,气流受限,肺通气功能障碍,影响了血液生化指标的改变;而右归丸组大鼠各项呼吸功能指标及血液生化指标明显改善,表明肾阳虚可以影响模型大鼠肺的呼吸功能,温补肾阳名方--右归丸可以明显改善肾阳虚大鼠由于呼吸功能异常而引起的血液生化异常,从而缓解肾阳虚对“肺司呼吸”的影响。
     ③模型大鼠肺组织AngⅡ、AT1R的表达明显下降,表明肾阳虚大鼠体内血液循环受到影响;温补肾阳名方--右归丸可以通过增加模型大鼠肺组织AngⅡ和AT1R的表达,从而缓解肾阳虚对“肺朝百脉”的影响。
     ④模型大鼠肺组织AQP3、AQP4的表达明显下降,表明肾阳虚大鼠肺内水液代谢受到影响;温补肾阳名方--右归丸可以增加模型大鼠肺组织AQP3、AQP4的表达,从而缓解肾阳虚对“肺主通调水道”的影响。
     ⑤模型大鼠肺组织TLR4、TRAF-6的表达明显下降,表明肾阳虚大鼠免疫功能受到影响;温补肾阳名方--右归丸可以增加模型大鼠肺组织TLR4、TRAF-6的表达,从而缓解肾阳虚对“肺主卫外”的影响。
     本课题率先从“肺司呼吸”、“肺主通调水道”、“肺朝百脉”、“肺主卫外”等方面解释了“肺主气”的理论内涵;用氢化可的松注射方法成功建立出了肾阳虚大鼠模型,模型大鼠存在“肺司呼吸”、“肺主通调水道”、“肺朝百脉”、“肺主卫外”等方面的异常变化,其肺组织存在AngⅡ、AQP、TLR4低表达的病理状态,右归丸具有提高模型大鼠“肺司呼吸”、“肺主通调水道”、“肺朝百脉”、“肺主卫外”等方面功能的作用,推测其作用机制可能是通过增强其AngⅡ、AQP、TLR4的表达而实现的。
Objective:This study is based on the theory of lung relation to kidney,kidneyyang deficiency rat model with hydrogenation cortisone replication as to beresearch platform, to observe the effects of kidney yang deficiency on "lungmains qi" of rat model,to explore the influence of kidney yang deficiencyon"Lung dominates breathing" through respiratory index of kidney yangdeficiency rats,the effects on "Hundreds of vessels run toward lung" with AngⅡ、 AT1R,the effects on "lung dominates water channels" withAQP3,AQP4,and the effects on "lung defenses wild bad things to protect body" with TLR4, TRAF-6.At the same time we use Yougui Pill which couldincrease and warm kidney yang to intervene in model rats, through modernresearch methods to detect the expression of various factors of lung, to clarifythe mechanism that kidney yang deficiency affects on "lung mains qi".
     Methods:This study was performed at6weeks of age,60Wistar rats,male,which were randomly divided into the normal control group, the model group,the Yougui Pill group.All rats were intramuscular injected in hydrocortisone tocopy kidney yang deficiency models, except the normal control group. Thenormal control group rats daily at8:00am were given intramuscular injectionof physiological saline5ml/kg,for15consecutive days, then filled the stomachwith physiological saline every10ml/kg, for30consecutive days; The modelgroup rats daily at8:00Am were given intramuscular injection ofhydrocortisone25mg/kg,for15consecutive days,from the first day afterfinishing making models,filled the stomach with physiological saline10ml/kg, for30consecutive days; The Yougui Pill group rats daily at8:00Am weregiven intramuscular injection of hydrocortisone25mg/kg, for15consecutivedays, from the first day after finishing making model,filled the stomach withgastric perfusion of Yougui Pill suspension10ml/kg (drug concentration was0.243g/ml),for30consecutive days.①On the first day after finishing makingmodels and stomach perfusion, all rats were taken their24h urine, abdominalaorta,24hours urinary17-CS-OH and serum testosterone(T) content;②On thefirst day after finishing making models and stomach perfusion, test respiratoryfunction indexes just like forced vital capacity(FVC) and so on by theexperimental small animal pulmonary function measured instrument;③Detectthe expression of Ang Ⅱ, AT1R protein with immunohistochemical andWestern Blot;④D etect the expression of AQP3、AQP4protein in lung tissuewith the Western Blot, and the expression of AQP4mRNA、AQP3mRNA geneof lung by RT-PCR;⑤Detect the expression of TLR4、TRAF-6protein byWestern Blot,and the expression of TLR4mRNA、TRAF-6mRNA gene byRT-PCR.
     Results:
     ①D etection of urinary17-OH-CS,serum T content:On the forty-sixth day,compared with the normal group,the urinary17-OH-CS and serum T contentof the model group rats were decreased, the difference was statisticallysignificant (P <0.05),compared with the Yougui Pill group,the rats' urinary17-OH-CS and serum T were lower,the difference has statistical significance(P <0.05).
     ②Respiratory function testing: compared with the normal controlgroup,FVC、FEV0.3of the model group rats were significantly decreased(P<0.05), arterial blood PH,PaO2,SaO2decreased significantly,PaCO2increased significantly (P <0.05), compared with the Yougui Pill group,themodel group rats' FVC,FEV0.3were lower than the Yougui pill group, the difference was statistically significant (P<0.05).
     ③Detection of blood circulation system indexes: immunohistochemistryof Ang Ⅱ, AT1R protein positive reaction product is brown, on the forty-sixthday, compared with the normal group, Ang Ⅱ expression in lung tissue of themodel group rats decreased, the expression of AT1R also reduced, comparedwith the Yougui Pill group, more Ang Ⅱ and AT1R expressed in rat lungtissue, the difference was statistically significant (P<0.05).
     ④Detection of water metabolism indexes: Western blot and PCR wereused to detect the content of protein and gene, compared with the normalcontrol group,AQP3,AQP4protein and gene expression significantly reducedin lung tissue of the model group rats, compared with the Yougui Pillgroup,AQP3,AQP4in lung tissue of the model group rats were less,thedifference was statistically significant (P<0.05).
     ⑤T he immune function indexes of TLR4,TRAF-6detection: by Westernblot and PCR,compared with the normal group,the lung TLR4, TRAF-6expression of the model group rats reduced,the Yougui Pill group comparedwith the model group,the expression of TLR4and TRAF-6increased,therewas significant difference between the two groups(P<0.05).
     Conclusion:
     ①Using hydrocortisone to make rats the kidney yang deficiency modelrats,the general condition of rats,and24hour urine17-OH-CS and serum Tcontent changing proved that the kidney yang deficiency model wassuccessfully reproduced.
     ②The indexes of respiratory function of the model rats alldecreased,blood biochemical abnormalities,small airway resistance of modelrats increased,airflow was limited, pulmonary ventilation dysfunction, whichaffected the changes of blood biochemical index; while the Yougui Pill grouprats respiratory function and blood biochemical indexes were all improved, showed that kidney yang deficiency can affect the respiratory function of ratlung,the prescription for increasing and warming kidney Yang-Yougui Pill canobviously improve the biochemical abnormalities of kidney yang deficiencyrats blood respiratory dysfunction that caused by kidney yang deficiency,so asto relieve the influence to"Lung dominates breathing".
     ③P ulmonary Ang Ⅱexpression of the model rats significantlydecreased,and AT1R expression also decreased,which prompts that thekidney yang deficiency rats blood circulation is affected;the prescription forincreasing and warming kidney Yang-Yougui Pill can increase the expressionof Ang Ⅱand AT1R,so as to relieve the effect of kidney yang deficiency onthe "Hundreds of vessels run toward lung".
     ④AQP3,AQP4expression in the lungs of the rats decreasedsignificantly,the results suggest that the lung water metabolism in kidney yangdeficiency rats is affected;the prescription for increasing and warming kidneyYang-Yougui Pill can increase the expression of AQP3,AQP4,and alleviatethe effect of kidney yang deficiency of "lung dominates water channels".
     ⑤T LR4,TRAF-6expression in the lungs of the rats decreasedsignificantly,suggesting that the immune function of kidney yang deficiencyrats is affected;the prescription for increasing and warming kidneyYang-Yougui Pill can increase the expression of TLR4, TRAF-6,and alleviatethe effect of kidney yang deficiency of "lung defenses wild bad things toprotect body".
     This is the first time to propose the "lung main gas" theoreticalconnotation that "lung can breathe","lung can regulate channel","lung canpromote blood circulation","lung can resist the evil". By hydrocortisoneinjection method we successful simulated the model of kidney yangdeficiency rats, the model rats appear the abnormal symptoms changes of"lung can breathe","lung can regulate channel","lung can promote blood circulation","lung can resist the evil",pathological state of Ang Ⅱ, AQP,TLR4low expression in the lung tissue.Yougui Pill can improve the functionthat "lung can breathe","lung can regulate channel","lung can promote bloodcirculation","lung can resist the evil" through enhanced the expression of AngⅡ, AQP, TLR4.
引文
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