欧阳里知 王晶 刘惠娟 黄河 张彬彬 刘红华 邓加勤 常小荣

〔摘要〕 目的 觀察隔药饼灸对动脉粥样硬化（atherosclerosis， AS）兔血脂及胸主动脉G蛋白偶联胆汁酸受体5（takeda G-protein-coupled receptor 5， TGR5）含量的影响。方法 将40只新西兰雄性兔随机分为空白组、模型组、抗生素组、隔药饼灸组与阿托伐他汀组，每组8只。空白组用普通饲料喂养，采用高胆固醇饲料与丙基硫氧嘧啶[10 mg/（kg·d）]配合的方式制备AS模型。隔药饼灸组（取穴分为“巨阙”“天枢”“丰隆”和“心俞”“肝俞”“脾俞”两组，隔日交替施灸）每穴施灸30 min，每日1次。各组均连续干预12周，检测各组兔血清胆固醇（TC）、甘油三酯（TG）与高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）水平;100倍光学显微镜下观察兔胸主动脉血管壁结构;采用免疫组化法测定胸主动脉TGR5表达量。结果 干预后，与空白组比较，模型组兔血清TC、TG、HDL-C、LDL-C水平均升高（P<0.01），胸主动脉TGR5表达量下降（P<0.01）;与模型组相比，隔药饼灸组、抗生素组与阿托伐他汀组血清TC、TG、HDL-C、LDL-C水平均下降（P<0.01或P<0.05），胸主动脉TGR5表达量上升（P<0.01）;与空白组比较，模型组血管内壁形态结构明显损伤，隔药饼灸组与阿托伐他汀组血管内壁损伤较模型组轻微。结论 抗生素组、隔药饼灸组和阿托伐他汀组对AS模型兔血脂水平有良性调节作用;隔药饼灸组与阿托伐他汀组有效激活了TGR5的表达，对血管内壁损伤有修复作用。

〔关键词〕 动脉粥样硬化;隔药饼灸;抗生素;阿托伐他汀;G蛋白偶联胆汁酸受体5;血脂水平

〔中图分类号〕R245.8        〔文献标志码〕A       〔文章编号〕doi：10.3969/j.issn.1674-070X.2021.04.008

〔Abstract〕 Objective To observe the effects of herbal cake-separated moxibustion on lipid content of blood and G protein coupled bile acid receptor 5 （TGR5） in thoracic aorta of rabbits with atherosclerosis （AS）. Methods 40 New Zealand male rabbits were randomly divided into blank group， model group， antibiotic group， herbal cake-separated moxibustion group and atorvastatin group， with 8 rabbits in each group. The blank group was fed with normal diet， and the AS model was prepared by the combination of high cholesterol diet and propylthiouracil [10 mg/（kg·d）]. In herbal cake-separated moxibustion group [acupoints were divided into "Juque" （RN14）， "Tianshu" （ST25）， "Fenglong" （ST40） and "Xinshu" （BL15）， "Ganshu" （BL18）， "Pishu" （BL20）， alternated moxibustion on alternate days]， moxibustion was adopted on each point for 30 minutes， once a day. Serum cholesterol （TC）， triglyceride （TG）， high density lipoprotein （HDL-C） and low density lipoprotein （LDL-C） levels were detected in rabbits in each group after 12 weeks of intervention. The vascular wall structure of thoracic aorta was observed under 100 times light microscope. The expression of TGR5 in thoracic aorta was determined by immunohistochemistry. Results After intervention， compared with blank group， the levels of TC， TG， HDL-C and LDL-C in serum of model group were increased （P<0.01）， and the expression of TGR5 in thoracic aorta was decreased （P<0.01）. Compared with model group， the serum TC， TG， HDL-C and LDL-C levels of herbal cake-separated moxibustion group， antibiotic group and atorvastatin group were decreased （P<0.01 or P<0.05）， and the expression of TGR5 in thoracic aorta was increased （P<0.01）. Compared with the blank group， the morphology and structure of vascular inner wall of the model group was obviously damaged， and the vascular inner wall injury of the herbal cake-separated moxibustion group and the atorvastatin group was less than that of the model group. Conclusion The herbal cake-separated moxibustion group， antibiotic group and atorvastatin group had a benign regulation effect on the blood lipid level of AS model rabbits. The expression of TGR5 was effectively activated in the herbal cake-separated moxibustion group and the atorvastatin group， which had a repairing effect on the vascular inner wall injury.

〔Keywords〕 atherosclerosis; herbal cake-separated moxibustion; antibiotics; atorvastatin; G protein conjugated bile acid receptor 5; blood lipid level

动脉粥样硬化（atherosclerosis， AS）是一种由多因素引起的慢性疾病，是诱发心血管疾病（cardiovascular， CVD）的主要原因，而CVD是造成人类死亡的重要因素，AS主要病理特点是动脉血管壁上出现异常脂质堆积及炎性反应[1-2]。其发病机制至今未完全明确，但许多研究者发现炎症反应参与AS的发生发展过程，尤其对粥样斑块的稳定性起到至关重要的作用[3-5]。胆汁酸是一种体内的信号分子，其发挥相应生物学效应是在胆汁酸受体介导下进行的[6]，G蛋白偶联胆汁酸受体5（takeda G-protein-coupled receptor 5， TGR5），又称M-BAR、BG37等[7]。其表达于单核细胞及多种巨噬细胞中，单核-吞噬细胞能分泌多种炎性介质，在调控炎症反应中具有重要作用[8-9]。……