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目的评价调补肺肾三法对慢性阻塞性肺疾病(COPD)大鼠右心室重构的影响和远后效应。方法 120只大鼠随机分为对照组、模型组、补肺健脾组、补肺益肾组、益气滋肾组和氨茶碱组,每组20只。除对照组外其余各组采用香烟暴露联合细菌感染法制作COPD模型8周,于第9周起分别给予补肺健脾方、补肺益肾方、益气滋肾方及氨茶碱灌胃至第20周。于第20、32周分批取材,观察大鼠心肌组织超微结构,计算右心肥大指数(RVHI)和心肌组织细胞因子的表达。结果第20、32周时,各给药组及对照组大鼠RVHI均低于模型组(P<0.01);补肺健脾组、补肺益肾组、益气滋肾组大鼠RVHI较氨茶碱组显著降低(P<0.05或P<0.01)。第20、32周时,模型组大鼠肌节长度较对照组缩短(P<0.05),补肺健脾组较模型组增长(P<0.01)。第20、32周时,模型组大鼠心脏组织细胞因子表达高于其余各组(P<0.01);补肺健脾组、补肺益肾组、益气滋肾组大鼠内皮素-1(ET-1)表达较氨茶碱组明显降低(P<0.01)。结论调补肺肾三法可改善COPD右心室重构并有明显远后效应,其中以补肺健脾方和补肺益肾方尤为显著,其作用机制可能与调节细胞因子有关。
Objective To evaluate the effect and the long-term effect of Tiaoyu lungs and shuensan on right ventricular remodeling in chronic obstructive pulmonary disease (COPD) rats. Methods 120 rats were randomly divided into control group, model group, Bufei Jianpi group, Bufei Yishen group, Yiqi zishen group and aminophylline group, with 20 rats in each group. Except the control group, COPD model was made by cigarette exposure combined with bacterial infection for 8 weeks. From the 9th week, rats were given Bufei Jianpi Fang, Bufei Yishen Recipe, Yiqi Zishen Recipe and aminophylline respectively To the 20th week. At the 20th and 32nd week, the rats were sacrificed and the ultrastructure of the myocardium was observed. RVHI and the expression of cytokines were calculated. Results At the 20th and the 32nd week, the RVHI of rats in each administration group and the control group was lower than that in the model group (P <0.01). The RVHI of rats in Bufei Jianpi group, Bufei Yishen group and Yiqi zishen group were significantly lower than those in model group Aminophylline group was significantly lower (P <0.05 or P <0.01). At 20 and 32 weeks, the length of sarcomere in model group was shorter than that in control group (P <0.05). Bufei Jianpi group increased compared with model group (P <0.01). At week 20 and week 32, the expression of cytokines in heart tissue of model group was higher than that of the other groups (P <0.01). The levels of ET-1 in Bufei Jianpi group, Bufei Yishen group and Yiqi zishen group (ET-1) expression was significantly lower than aminophylline group (P <0.01). Conclusion tonifying the lung and kidney three methods can improve COPD right ventricular remodeling and obvious far-after effects, including Bufei Jianpi Prescription and Bufei Yishen Prescription, especially its mechanism may be related to the regulation of cytokines.