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目的:探索艾灸对类风湿性关节炎(rheumatoid arthritis,RA)炎性因子白介素-6(Interleukin-6,IL-6)的节律调控机制。方法:将144只Sprague-Dawley(SD)大鼠随机分为空白组、模型组、艾灸组、假摘除肾上腺组(假摘组)、摘除肾上腺组(摘除组)、摘除肾上腺艾灸组(摘灸组),每组24只,各组分4个时间点(即0:00组、6:00组、12:00组、18:00组),每个时间点6只大鼠。各组大鼠实验全程给予Light-Dark(LD)12∶12的光暗周期限制,除空白组外其余各组采用右后足足垫部皮内注入福氏完全佐剂建立RA模型。造模后对摘除组、摘灸组大鼠摘除双侧肾上腺预处理,假摘组不摘除肾上腺,但手术步骤相同。艾灸组、摘灸组大鼠在上午7:00-9:00进行单侧麦粒灸“肾俞”“足三里”治疗(双侧交替),每日1次,6次为一疗程,共治疗3个疗程;其他组大鼠同法固定,但不行艾灸治疗。各组大鼠在造模前、造模后、治疗后分别进行整体状况评价及足容积测定。治疗结束后分别在相应各个时间点处死大鼠,取血,采用酶免法检测IL-6含量。结果:与空白组比较,模型组大鼠足肿胀度明显升高(P<0.05),IL-6保持昼夜节律性(P<0.05),但峰相位有后移趋势,振幅有增高趋势,中值明显增高(P<0.05);与模型组比较,艾灸组大鼠足肿胀度明显降低(P<0.05),IL-6存在昼夜节律性(P<0.05),峰相位有前移趋势,振幅有降低趋势,中值明显降低(P<0.05);与艾灸组比较,摘灸组大鼠足肿胀度明显升高(P<0.05),IL-6昼夜节律存在,但是峰相位前移,中值明显增高(P<0.05)。结论:RA大鼠血浆IL-6具有明显的病理性昼夜节律特征;在下丘脑-垂体-肾上腺轴(hypothalamic-pituitary-adrenal axis,HPA)完整的条件下,艾灸可能通过调整RA模型大鼠IL-6的昼夜节律发挥控制炎性反应的作用。
Objective: To explore the rhythm regulation mechanism of moxibustion on interleukin-6 (IL-6), an inflammatory factor of rheumatoid arthritis (RA). Methods: 144 Sprague-Dawley (SD) rats were randomly divided into blank group, model group, moxibustion group, false adrenalectomy group, adrenalectomy group, adrenal moxibustion group (Group 0:00, group 6:00, group 12:00, group 18:00) with 6 rats in each group. All rats were given Light-Dark (LD) 12:12 light and dark cycle limit. All the rats in other groups were injected with Freund’s complete adjuvant intradermally to establish RA model. After modeling, in the ablation group, rats in the moxibustion group were pretreated with bilateral adrenalectomy, while those in the sham group were not removed with the adrenal gland. However, the procedure was the same. The moxibustion group and the moxibustion group were treated with unilateral granule moxibustion, “Shensu” and “Zusanli” at 7:00 a.m. to 9:00 a.m. (bilateral alternation), once daily and 6 times For a course of treatment, a total of three courses of treatment; other groups of rats fixed with the law, but not moxibustion treatment. Rats in each group before modeling, modeling, after treatment, respectively, the overall condition assessment and foot volume determination. At the end of treatment, rats were sacrificed at corresponding time points, blood was collected and the content of IL-6 was detected by enzyme immunoassay. Results: Compared with the blank group, the degree of paw edema in model group was significantly increased (P <0.05), IL-6 kept circadian rhythms (P <0.05), but the peak phase posterior trend and amplitude increased (P <0.05). Compared with the model group, the degree of paw edema in the moxibustion group was significantly decreased (P <0.05), the circadian rhythmicity of IL-6 was present (P <0.05) (P <0.05). Compared with the moxibustion group, the degree of paw edema in the moxibustion group was significantly increased (P <0.05), and the circadian rhythm of IL-6 existed, but the peak phase shifted , The median was significantly higher (P <0.05). CONCLUSIONS: IL-6 in plasma of RA rats has obvious pathological circadian rhythm. In the hypothalamic-pituitary-adrenal axis (HPA) intact condition, moxibustion may be induced by adjusting RA -6 circadian rhythm play a role in controlling the inflammatory response.