【作者】 沈菁；

【导师】 常小荣；

【作者基本信息】 湖南中医药大学 ， 针灸推拿学， 2005， 硕士

【摘要】 目的:观察隔药饼灸对兔高脂血症（hyperlipemia,HLP）合并动脉粥样硬化（artherosclerosis,AS）总胆固醇（cholesterol,TC）、甘油三酯（glyceryl trioleate,TG）、高密度脂蛋白胆固醇（high densitylipoprotein,HDL）、低密度脂蛋白胆固醇（low density lipoprotein,LDL）、载脂蛋白A（apolipoprotein A,Apo-A）、载脂蛋白B（apolipoprotein B,Apo-B）、血浆血栓素B₂（Thromboxane A₂,TXB₂）、6-酮-前列腺素(prostacyclin,6-keto-PGF_1α)水平变化,及主动脉超微结构的变化,分析其抗高血脂及动脉粥样硬化的作用。方法:通过高脂饲料喂养及注射牛血清蛋白造成兔高脂血症合并动脉粥样硬化模型,分别给予不同组兔相同穴位直接灸、隔药灸不同的治疗方法。运用放射免疫法测定治疗后TC、TG、HDL、LDL、ApoA、ApoB、TXB₂、6-keto-PGF_1α含量的变化;电子显微镜观察兔主动脉内皮细胞超微结构的变化。结果:（1）透射电镜观察主动脉内皮细胞结果分析显示:直接灸组与隔药饼灸组的内皮细胞较完整,大多形态正常,内弹力膜连续,厚薄较均匀,中膜平滑肌细胞较正常,与空白组的主动脉内皮细胞结构相似。模型组主动脉内皮细胞结构变化较大,主要表现在内皮细胞消失,膜浆可见大量脂质沉积,内弹力膜中断,厚薄不均,有灶性溶解,中膜平滑肌细胞有脂质沉积,且有泡沫样改变。（2）隔药饼灸组和直接灸组胆固醇、甘油三酯含量明显低于模型组,二者之间有显著性差异（P＜0.01）。隔药饼灸组胆固醇含量明显低于直接灸组,二者之间有显著性差异（P＜0.01）。（3）隔药饼灸组、直接灸组和空白组的高密度脂蛋白含量明显高于模型组,三组与模型组之间有显著性差异（P＜0.01;P＜0.05;P＜0.05）。三组的低密度脂蛋白含量明显低于模型组（P＜0.01;P＜0.01;P＜0.01）。三组的高低密度脂蛋白含量比值及高密度脂蛋白与胆固醇比值明显高于模型组（P＜0.01;P＜0.05;P＜0.05）。（4）隔药饼灸组、直接灸组和空白组载脂蛋白A含量明显高于模型组,三组与模型组之间有显著性差异（P＜0.01;P＜0.01;P＜0.05）。载脂蛋白B含量明显低于模型组,三组与模型组之间有显著性差异（P＜0.01;P＜0.01;P＜0.01）。A/B值明显高于模型组,三组与模型组之间有显著性差异（P＜0.01;P＜0.01;P＜0.01）。（5）模型组血浆6-酮-前列腺素的含量明显低于空白组、直接灸组和隔药饼灸组,且有显著性差异（P＜0.05;P＜0.05;P＜0.05）。（6）模型组血浆血栓素B₂含量明显高于空白组、直接灸组和隔药饼灸组,且具有显著性差异（P＜0.05;P＜0.05;P＜0.05）。（7）模型组TXB₂/6-keto-PGF_1α比值明显高于空白组、直接灸组和隔药饼灸组,且具有显著性差异（P＜0.01;P＜0.01;P＜0.01）。结论:（1）隔药饼灸与直接灸均能有效降低兔高脂血症合并动脉粥样硬化血浆中胆固醇和甘油三酯含量,且能降低血中低密度脂蛋白和载脂蛋白B的含量,使动脉粥样变动物的高密度脂蛋白升高。提示隔药饼灸与直接灸对脂质及脂蛋白的代谢都具有良好的调整作用。（2）隔药饼灸组降低胆固醇含量的作用优于直接灸组。（3）隔药饼灸组对高脂血症兔血浆TXB₂、6-keto-PGF_1α含量及TXB₂/6-keto-PGF_1α的比值具有调节作用。（4）隔药饼灸对高脂血症兔的主动脉内皮细胞有一定的保护作用。更多还原

【Abstract】 Objective: To observe the effect on TC、TG、HDL、LDL、ApoA、ApoB、thromboxane B₂、6-keto-PGF_1α and aortic endothelial cells of HLP combined AS rabbits treated by herbal-cake-separated moxibustion and to analyze the anti-hyperlipemia rationale of the therapy.Method: While fed with high fat food everyday and injected with BSA, HLP combined AS rabbits were treated with different way of direct and herbal-cake-separated moxibustion on the same acupuncture points.Results: （1） Under transmission electron microscope, observation of aortic endothelial cells shows: endothelial cells in direct-moxibustion group and herbal-cake-separated-moxibustion group are intacter, most of them are normal in forms, internal elastic membrane is continuous, thickness is even, the cells of muscles of medial membrane are relatively normal and the structure of aortic endothelial cells of those groups are similar to those of blank group. But the structure of aortic endothelial cells in model group is different , endothelial cells disappeared, in cytoplasm the sedimentation of a great quantity of lipide can be seen, internal elastic membrane is interrupted, thickness is uneven, there is focal dissolution, the cells of smooth muscle in the medial membrane has sedimentation of lipide, and has frothy change.（2） Compared with model group , the TC and TG content in herbal-cake-separated-moxibustion group and direct-moxibustion group is obviously lower （P<0.01 ）. Compared with direct-moxibustion group, TC content in herbal-cake-separated-moxibustion group is obviously lower（P<0.01）.（3） Compared with model group , the HDL content in herbal-cake-separated-moxibustion group、direct-moxibustion group and blank group is obviously higher （P<0.01, P<0.05; P<0.05）, the LDL content is obviously lower （P<0.01; P<0.01; P<0.01）, the ratio of HDL/LDL and the ratio of HDL/TC is obviously higher （P<0.01; P<0.05; P<0.05）.（4） Compared with model group , the ApoA content in herbal-cake-separated-moxibustion group、direct-moxibustion group and blank group is obviously higher （P<0.01, P<0.01; P<0.05）, ApoB content is obviously lower （P<0.01; P<0.01; P<0.01）, ratio of ApoA/ApoB is obviously higher （P<0.01; P<0.01; P<0.01）.（5） Compared with model group , the 6-keto-PGF_1α content in herbal-cake-separated-moxibustion group、direct-moxibustion group and blank group is obviously higher （P<0.05; P<0.05; P<0.05）,（6） Compared with model group , the TXB₂ content in herbal-cake-separated-moxibustion group、direct-moxibustion group and blank group is obviously lower （P<0.05; P<0.05; P<0.05）.（7） Compared with model group, the ratio of TXB₂/6-keto-PGF_1α in herbal-cake-separated-moxibustion group, direct-moxibustion group and blank group is obviously lower （P<0.01; P<0.01; P<0.01）.Conclusion:（1） Content of TC、TG、LDL and ApoB of HLP combined AS rabbit is decreased after treated with direct-moxibustion or herbal-cake-separated -moxibustion , while HDL content is increased. It points out direct -moxibustion and herbal-cake-separated-moxibustion has favorable regulated effect to metabolism of lipide and lipoprotein.（2） In decreasing effect on TC of HLP combined AS rabbits , herbal-cake-separated-moxibustion is better than direct-moxibustion,（3） Herbal-cake-separated-moxibustion has regulating effect to the content of 6-keto-PGF_1α、TXB₂ and ratio of T/P of hyperlipemia rabbits,,（4） Herbal-cake-separated moxibustion has protective effect to the aortic endothelial cells of hyperlipemia rabbits.更多还原