化纤方药液穴位吸收配合艾灸疗法调控肺纤维化大鼠内源性SMAD2、SMAD3表达以影响其TGF—β信号传导通路的研究

目的研究化纤方药液穴位吸收并配合艾灸的新疗法（简称灸药配合法）对BLMA5诱导肺纤维化模型大鼠信号传导分子内源性SMAD2、SMAD3表达的调控作用，从阻断TGF—β信号传导通路视角探讨其治疗效应及其阻抑肺纤维化的作用机制，为本疗法介入肺纤维化的治疗提供实验依据：方法选用SD大鼠，以博莱霉素A5（BLMA5）气管内注入制作肺纤维化动物模型，造模成功48只，随机分成4组：模型组、激素治疗组、灸药配合治疗组、单纯艾灸治疗组，每组12只，另设空白对照组12只。造模7d后开始治疗：灸药配合组在其“膏肓俞”和“肺俞”滴加化纤方药液5滴再艾灸10min；单纯艾灸组只灸其“膏肓俞”和“肺俞”；激素治疗组每只腹腔注射5mg／kg泼尼松：各治疗组均每日1次，治疗连续1个月。治疗结束后，采用免疫组化法结合图像分析系统比较各组肺组织SMAD2、SMAD3蛋白表达。结果灸药配合治疗组、艾灸组、激素治疗组中SMAD2、SMAD3的表达程度均较模型组明显减少（P〈0．01），且其纤维化程度均有所减轻，尤以灸药配合治疗组为优。结论灸药配合治疗能在一定程度上更加有效地阻抑大鼠肺纤维化的形成和发展，且与激素治疔相比较具有无毒副作用之优势，其作用机制之一可能是通过干预其SMAD2、SMAD3的表达，从而切断其TGF—β的信号传导通路，以发挥阻抑肺纤维化的形成。

Effects of Acupoints Penetration of ＂Huaxian Decoction＂ and Moxibustion in Regulating Expressions of Endogeneous SMAD2 and SMAD3 in Pulmonary Fibrosis Rats and TGF-β Signaling Transmission

Objective To study the regulating effects of acupoints penetration of ＂ Huaxian Decoction＂ and moxibustion in regulating expressions of endogeneous SMAD2 and SMAD3 in pulmonary fibrosis rats and its mechanism in terms of TGF-β signaling transmission, and seek experimental foundation for this new therapy to treat puhnonary fibrosis. Methods Animal model was successfully duplicated by tracheal injection with BLMA5 in SD rats. Rats were then randomly divided into 4 groups： model group, prednisone group, moxibustion combined with herb group, and moxibustion group. In addition, 12 healthy rats were enrolled as control group. Seven days late , each group received eorresponding treatments, once daily for 30 consecutive days. Each group＇s treatment is as follow： model group with no treatment; moxibustion eombined with herh group with 5 drops of ＂Huaxian Decoction＂ at acupoints and subsequent moxibustion for about 10 minutes ; moxibustion group with moxibusfion at Gaohuangshu（ BE 38） and Feishu（ BL 13 ） ; predrisone group with intraperitoneal injection with prednisone at 5mg/kg. Then the immunoreaetivity of SMA02 and SMAD3 were measured. Results The expressions of SMAD2 and SMAD3 in preduisone group, moxibustion combined with herb group, and moxibustion group were more siguifieantly reduced than model group. All of the three groups had statistical significances （P 〈0.01 ）. Moreover, the degrees of fibrosis in the former three groups were all attenuated. Among which, moxibustion combined with herb group showed best results. Conclusion Moxibustion combined with herb is the best and most effective therapy in inhibiting the formation and the development of pulmonary fibrosis in rats, and safe without side effects; and one of the mechanisms may be involved in intervening the expressions of SMAD2 and SMAD3 and cut off the expression of TGF-β signaling transmission path to prevent pulmonary fibrosis.