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目的探讨比较不同针法对寒证类风湿关节炎(RA)模型家兔滑膜组织代谢物谱的影响及热补针法治疗RA的特异性机制。方法 40只清洁级青紫蓝家兔随机分为正常组、模型组、平补平泻组、捻转补法组、热补针法组,每组8只。以卵蛋白诱导联合低温冷冻法建立寒证RA模型。除正常组、模型组外,其余各组分别于足三里穴施以平补平泻、捻转补法、热补针法针刺,1次/d,留针30 min,共7次。治疗结束后分离家兔膝关节滑膜组织,采用液相色谱-四级杆飞行时间质谱(LC-Q/TOF-MS)检测滑膜组织代谢物,利用主成分分析(PCA)和正交偏最小二乘方判别分析(OPLS-DA)方法对数据进行统计分析。结果与正常组比较,模型组滑膜组织代谢物变化主要体现于丙氨酸、瓜氨酸、脯氨酸、谷氨酰胺、甘氨酸、谷氨酸、鞘氨醇1-磷酸、溶血卵磷脂、肌酸、异亮氨酸/亮氨酸、缬氨酸含量降低(P<0.05);与模型组比较,各针刺组上述代谢物含量增高(P<0.05),且热补针法组肌酸、异亮氨酸/亮氨酸、缬氨酸含量明显高于平补平泻组和捻转补法组。结论热补针法通过调节与RA能量代谢相关的氨基酸代谢,在改善RA机体氨基酸的供给及减缓负氮平衡方面有一定的特异性作用。
Objective To investigate the effects of different acupuncture methods on the synovial tissue metabolite profiles in rabbits with rheumatoid arthritis (RA) and the specific mechanism of heat-acupuncture on RA. Methods Totally 40 clean grade blue-purple blue rabbits were randomly divided into normal group, model group, flat-tonifying and diarrhea group, twirling-supplementation group and hot-dressing group, with 8 in each group. The cold syndrome RA model was established by ovalbumin combined with cryogenic freezing. Except the normal group and the model group, the other groups were implanted with Zusanli points respectively, supplemented with twisting and twisting methods, acupuncture with hot-fill acupuncture, once a day, and needle-holding for 30 min for 7 times. Synovial tissues of rabbit knee joints were isolated and the synovial tissue metabolites were detected by LC-Q / TOF-MS. The PCA and orthogonal polarimetry Least square discriminant analysis (OPLS-DA) method for statistical analysis of the data. Results Compared with the normal group, the changes of the synovial tissue metabolites in the model group mainly reflected in the changes of alanine, citrulline, proline, glutamine, glycine, glutamic acid, sphingosine 1-phosphate, lysolecithin, Creatine, isoleucine / leucine and valine (P <0.05). Compared with the model group, the contents of these metabolites in each acupuncture group increased (P <0.05) Acid, isoleucine / leucine, valine content was significantly higher than the flat complement and flatulence group and twirling make up group. Conclusion Heat-stitched acupuncture can regulate the amino acid metabolism associated with RA energy metabolism and has a specific role in improving the supply of amino acids and alleviating the negative nitrogen balance in RA patients.