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目的:观察隔药饼灸对慢性肾衰竭兔肾组织中TGF-β1、Smad3、Smad7蛋白表达的影响,探讨隔药饼灸抗慢性肾衰竭兔肾纤维化的分子机制.方法:健康新西兰纯种雄性兔45只,随机分为正常对照组、模型组、隔药饼灸组、直接灸组、氯纱坦钾组.除正常对照组用等量蒸馏水灌胃外,其他兔用腺嘌呤灌胃21 d致兔肾间质纤维化,建立慢性肾衰竭动物模型.除正常对照组和模型组外各组分别进行相应干预,均持续3个月,其中穴位为Ⅰ组(肾俞、脾俞)、Ⅱ组(足三里、关元)交替.干预结束通过免疫组化法检测各组兔肾组织TGF-31、Smad3 、Smad7蛋白表达.结果:免疫组化染色结果显示,与正常对照组比较,模型组兔肾组织TGF-31、Smad3阳性表达明显增加(P＜0.05),Smad7阳性表达明显降低(P＜0.05);与模型组比较,隔药饼灸组、直接灸组、氯纱坦钾组肾组织TGF-β1、Smad3阳性表达均明显下降(P＜0.05),Smad7阳性表达明显升高(P＜0.05);隔药饼灸组Smad7阳性表达较直接灸组、氯纱坦钾组升高更明显(P＜0.05).结论:隔药饼灸能有效干预慢性肾衰竭兔肾纤维化的形成,其分子机制可能是通过调节TGF-β1/Smad信号通路发挥抗肾纤维化的作用.“,”Objective:To observe the influence of medicinal cake-separated moxibustion on protein expressions of TGF-β1,Smad3 and Smad7 in kidney tissue of rabbits with chronic renal failure,and discuss the molecular mechanism of medicinal cake-separated moxibustion on renal fibrosis in rabbits with chronic renal failure.Methods:45 healthy New Zealand purebred male rabbits were randomly divided into the normal control group,model group,medicinal cake-separated moxibustion group,traditional moxibustion group and losartan potassium group.Except the normal control group that treated with equivalent distilled water by intragastric administration,the other rabbits were treated with adenine by intragastric administration for 21 days to induce the renal interstitial fibrosis and then the animal model of chronic renal failure was established.The corresponding intervention was given in the moxibustion groups and losartan potassium group for 3 months.Two groups of acpoints (group Ⅰ:Shenshu [BL23] and Pishu [BL20],group Ⅱ:Zusanli [ST36] and Guanyuan [CV4]) were alternately used in the moxibustion groups.After intervention,the protein expressions of TGF-β1,Smad3 and Smad7 in kidney tissue of rabbits in each group were detected by immunohistochemistry.Results:The staining results of immunohistochemistry showed that compared with the normal control group,the positive expressions of TGF-β1 and Smad3 in kidney tissue were significantly increased in the model group (P ＜ 0.05),and the positive expression of Smad7 was significantly decreased (P ＜ 0.05).Compared with the model group,the positive expressions of TGF-β1 and Smad3 in kidney tissue were significantly decreased in the medicinal cake-separated moxibustion group,traditional moxibustion group and losartan potassium group (P ＜ 0.05),and the positive expression of Smad7 was significantly increased (P ＜ 0.05).The positive expression of Smad7 in the medicinal cake-separated moxibustion group was significantly higher than that in the traditional moxibustion group and losartan potassium group(P＜ 0.05).Conclusion:Medicinal cake-separated moxibustion can effectively intervene on the formation of renal fibrosis in rabbits with chronic renal failure.Its molecular mechanism may be associated with the regulation of TGF-β1/Smad signaling pathway.