世界中医药

作者	单位
崔云华1，雷菲1，赵继梦1，吴焕淦1，徐惠芬2，吴人照3，何金森4，余曙光5，黄艳1，吴璐一4，刘世敏4，胡玲6，刘慧荣1	1 上海中医药大学上海市针灸经络研究所,上海,200030； 2 浙江省湖州市中医院，湖州，313000； 3 浙江省中医药研究院，杭州，310007； 4 上海中医药大学，上海，201203； 5 成都中医药大学，成都，611137； 6 安徽中医药大学，合肥，230038

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中文摘要:

目的：观察艾灸干预实验性自身免疫性甲状腺炎（EAT）大鼠的效应，以及对炎性细胞因子IL-17、IL-23及受体表达的影响，拟阐释艾灸干预EAT的作用机制。方法：将SD大鼠随机分成5组：正常组、模型组、优甲乐组、隔附子饼灸组和温和灸组。采用碘剂和猪甲状腺球蛋白联合免疫的方法建立EAT动物模型，艾灸和西药各干预30 d。观察甲状腺组织形态学、血清抗甲状腺球蛋白抗体（TGAb)和抗甲状腺过氧化物酶抗体（TPOAb)、IL-17、IL-23和IL-23R的浓度；甲状腺组织IL-17、IL-23和IL-23R mRNA表达。结果：隔附子饼灸、温和灸和优甲乐均能纠正EAT大鼠甲状腺的组织病理学改变。与正常组比较，模型组大鼠血清FT3下降（P<0.01），血清TSH、TGAb、TPOAb浓度升高（P<0.05），血清IL-17、IL-23和IL-23R蛋白的浓度升高（P<0.05）；甲状腺组织IL-17、IL-23和IL-23R mRNA的表达上调（P<0.05）。与模型组比较，优甲乐组血清FT3升高（P<0.01），TPOAb、IL-23R浓度降低（P<0.05）；隔附子饼灸组大鼠血清FT3升高（P<0.01），血清TSH、TGAb、TPOAb、IL-17、IL-23和IL-23R浓度降低（P<0.05），甲状腺组织IL-17、IL-23和IL-23R mRNA表达下降（P<0.05）；温和灸组大鼠血清TSH、TGAb、TPOAb、IL-17和IL-23浓度降低（P<0.05）；血清IL-17、IL-23的浓度，甲状腺组织IL-17、IL-23、IL-23R mRNA的表达水平和血清中TGAb的浓度呈正相关关系；血清中IL-17、IL-23、IL-23R的浓度，甲状腺组织中IL-17 mRNA的表达水平与血清中TPOAb的浓度呈正相关关系。结论：隔附子饼灸、温和灸均能有效纠正EAT大鼠甲状腺组织病理学的变化，改善EAT大鼠的甲状腺功能，降低甲状腺自身抗体水平，可能与调节炎性细胞因子IL-17和IL-23的表达有关。

English Summary:

To observe the effect of moxibustion on rats with experimental autoimmune thyroiditis (EAT), and to study the effect of moxibustion on the expression of IL-17, IL-23 and its receptor. Methods:Sprague-Dawley rats were randomly divided into 5 groups:the normal group, the model group, the euthyrox group, the aconite cake-separated moxibustion group and the mild moxibustion group. Model rats were immunized with porcine thyrogiobulin followed high iodine water to established animal models. The EAT model was identified after the last immunization. After 30 days’intervention of moxibustion and western medicine, the concentration of TGAb, TPOAb, IL-17, IL-23, IL-23R in serum, as well as the expression levels of L-17, IL-23, IL-23R mRNA in thyroid gland were detected. Results:All of the aconite cake-separated moxibustion, the mild moxibustion and the euthyrox could correct the histopathological changes of thyroid gland in EAT rats. Compared with the normal group, the levels of serum FT3 decreased (P<0.01), the concentration of serum TSH, TGAb and TPOAb increased (P<0.05), and the levels of IL-17, IL-23 and IL-23R mRNA expressionin in the thyroid tissue were increased in model group (P<0.05). Compared with the model group, the levels of serum FT3 increased (P<0.01), the concentration of serum TPOAb, IL-23 decreased in euthyrox group (P<0.05); and the levels of serum FT3 increased (P<0.01), the concentration of serum TSH, TGAb, TPOAb, IL-17, IL-23, IL-23R decreased (P<0.05), and the levels of IL-17, IL-23 and IL-23R mRNA expression in the thyroid tissue increased in aconite cake-separated moxibustion group (P<0.05); the concentration of serum TSH, TGAb, TPOAb, IL-17, IL-23 decreased (P<0.05), the concentration of serum IL-17, IL-23 and the levels of IL-17, IL-23 and IL-23R mRNA expression in the thyroid tissue were positively correlated with serum TGAb, the concentration of serum IL-17, IL-23, IL-23R and the IL-23R mRNA expression in the thyroid tissue were positively correlated with serum TPOAb in mild moxibustion group. Conclusion:Aconite cake-separated moxibustion and mild moxibustion can effectively correct the pathological changes of thyroid tissue in EAT rats, improve the thyroid function of EAT rats and reduce the thyroid autoantibody level, which may be related to the regulation of inflammatory cytokines IL-17 and IL-23 Expression.

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