| 引用本文: |
叶嘉豪, 吴子政, 张垚, 孟骊冲, 胡志希.基于“以方测证”理论探讨腹主动脉缩窄术致慢性心力衰竭大鼠模型的中医证型[J].湖南中医药大学学报,2025,45(5):787-794[点击复制] |
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| 基于“以方测证”理论探讨腹主动脉缩窄术致慢性心力衰竭大鼠模型的中医证型 |
| 叶嘉豪,吴子政,张垚,孟骊冲,胡志希 |
| (湖南中医药大学, 湖南 长沙 410208) |
| 摘要: |
| 目的 观察4种中药注射液对腹主动脉缩窄术（AAC）致慢性心力衰竭（CHF）大鼠模型的疗效差异，基于“以方测证”理论探讨该模型的中医证候属性。方法 对100只SD大鼠行AAC，另设15只为假手术组，造模8周后验证CHF大鼠是否成模。将造模成功的68只AAC大鼠随机分为模型组、丹红注射液组、参麦注射液组、参附注射液组、黄芪注射液组和卡托普利组。丹红注射液组、参麦注射液组、参附注射液组和黄芪注射液组通过腹腔注射给予对应注射液6 mL/kg，并灌胃生理盐水4 mL/kg进行干预；卡托普利组每日灌胃卡托普利8.8 mg/kg，并腹腔注射生理盐水6 mL/kg进行干预；假手术组和模型组均腹腔注射并灌胃等量生理盐水；每组干预15 d。给药结束后，观察各组大鼠的一般情况；采用超声心动图检测大鼠心功能；ELISA检测血清N末端脑钠肽前体（NT-proBNP）、血管紧张素Ⅱ（AngⅡ）、血管紧张素1型受体（AT1R）含量；采用HE染色和Masson染色法检测心肌组织病理改变情况。结果 与假手术组对比，模型组大鼠出现皮肤和毛发枯燥无光泽，唇甲和腹部发绀、脱毛、易怒、活动能力下降等表现，左室射血分数（LVEF）和左心室短轴缩短率（LVFS）显著降低（P＜0.01），左心室舒张末期内径（LVIDd）值、左心室收缩末期内径（LVIDs）值、血清NT-proBNP、AngⅡ和AT1R含量、胶原容积分数（CVF）值显著升高（P＜0.01），心肌炎症浸润明显。与模型组比较，丹红注射液组、参麦注射液组、参附注射液组、黄芪注射液组和卡托普利组的大鼠反应较为灵敏，皮肤光泽度、唇甲和腹部颜色等均有所改善，LVEF值和LVFS值升高（P＜0.05，P＜0.01），LVIDd值、LVIDs值、血清NT-proBNP、AngⅡ和AT1R含量、CVF值降低（P＜0.05，P＜0.01），心肌炎症浸润情况有所改善。与丹红注射液组相比，参麦注射液组、参附注射液组、黄芪注射液组的LVEF值降低（P＜0.05)，LVIDd值、LVIDs值、血清NT-proBNP、AngⅡ和AT1R含量、CVF值升高（P＜0.05，P＜0.01），心肌炎症浸润较严重。结论 丹红注射液可有效提高AAC诱导CHF大鼠模型的心功能，降低炎症反应，抑制神经内分泌的过度激活，治疗效果优于其他3种注射液，基于“以方测证”理论，推测该模型的中医证型为心血瘀阻证。 |
| 关键词: 腹主动脉缩窄术 慢性心力衰竭 以方测证 丹红注射液 参麦注射液 参附注射液 黄芪注射液 |
| DOI：10.3969/j.issn.1674-070X.2025.05.002 |
| 投稿时间：2024-11-19 |
| 基金项目:国家自然科学基金面上项目（82274412）；湖南中医药大学校级研究生创新课题项目（2023CX01）。 |
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| Exploring the TCM pattern in the rat model of chronic heart failure induced by abdominal aortic constriction based on the theory of "pattern identification by formula" |
| YE Jiahao, WU Zizheng, ZHANG Yao, MENG Lichong, HU Zhixi |
| (Hunan University of Chinese Medicine, Changsha, Hunan 410208, China) |
| Abstract: |
| Objective To observe the therapeutic differences of four TCM injections on the rat model of chronic heart failure (CHF) induced by abdominal aortic constriction (AAC), and to explore the TCM pattern attributes of the model based on the theory of "pattern identification by formula". Methods AAC was performed on 100 SD rats, with additional 15 rats assigned to a sham-operation group. Eight weeks after modeling, the successful establishment of the CHF rat model was verified. A total of 68 AAC rats with successful modeling were randomly divided into model group, Danhong Injection group, Shenmai Injection group, Shenfu Injection group, Huangqi Injection group, and captopril group. The Danhong, Shenmai, Shenfu, and Huangqi Injection groups were intraperitoneally injected with the corresponding injections of 6 mL/kg, along with intragastric administration of saline at 4 mL/kg for intervention. The captopril group received daily intragastric administration of captopril at 8.8 mg/kg, combined with intraperitoneal injection of saline 6 mL/kg for intervention. Both the sham-operation and model groups received equivalent volumes of saline via intraperitoneal injection and intragastric administration. Each group underwent a 15-day intervention period. After the administration period, the general conditions of the rats in each group were observed. Echocardiography was used to assess cardiac function. ELISA was employed to determine serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), angiotensin Ⅱ (Ang Ⅱ), and angiotensin type 1 receptor (AT1R). HE staining and Masson's trichrome staining were both utilized to examine pathological changes in myocardial tissue. Results Compared with the sham-operation group, the model group rats exhibited dull skin and hair, cyanosis of the lips, nails, and abdomen, hair loss, irritability, and reduced activity. Left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) significantly decreased (P<0.01), while left ventricular internal diameter at end-diastole (LVIDd), left ventricular internal diameter at end-systole (LVIDs), serum levels of NT-proBNP, Ang Ⅱ, and AT1R, as well as collagen volume fraction (CVF) significantly elevated (P<0.01), with prominent myocardial inflammatory infiltration. In comparison to the model group, the Danhong, Shenmai, Shenfu, Huangqi Injection groups and captopril group demonstrated improved responsiveness, enhanced skin luster, and ameliorated cyanosis of the lips, nails, and abdomen. These groups exhibited increased LVEF and LVFS values (P<0.05, P<0.01), while LVIDd, LVIDs, serum NT-proBNP, Ang Ⅱ, AT1R levels, and CVF (P<0.05, P<0.01) decreased. with alleviated myocardial inflammatory infiltration. Compared with the Danhong Injection group, the Shenmai, Shenfu, and Huangqi Injection groups showed decreased LVEF values (P<0.05) and increased LVIDd, LVIDs, serum NT-proBNP, Ang Ⅱ, AT1R levels, and CVF (P<0.05, P<0.01), with more severe myocardial inflammatory infiltration. Conclusion The Danhong Injection effectively improves cardiac function, reduces inflammatory responses, and inhibits excessive neuroendocrine activation in the AAC-induced CHF rat model. Its therapeutic efficacy is superior to the other three injections. Based on the theory of "pattern identification by formula", it is hypothesized that the TCM pattern of this model corresponds to heart blood stasis pattern. |
| Key words: abdominal aortic constriction chronic heart failure pattern identification by formula Danhong Injection Shenmai Injection Shenfu Injection Huangqi Injection |
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