CAJ | 학술논문

目的：探讨解毒祛瘀滋阴方联合糖皮质激素应用于系统性红斑狼疮小鼠的疗效和机制。方法2012年4月—2014年5月选取60只MRL／lpr小鼠采用随机数字表法分为3组，模型组20只，西药组20只，联合组20只；同时选取20只健康昆明小鼠作为空白对照组。空白对照组和模型组给予0.9％氯化钠溶液灌胃；西药组给予0.5 g／ml泼尼松混悬液灌胃；联合组给予1.0 g／ml泼尼松混悬液联合解毒祛瘀滋阴汤剂。比较各组小鼠的死亡率、外周血淋巴细胞（ PBLC）凋亡率、皮质醇水平和糖皮质激素受体（ GR） mRNA表达水平。结果干预12周后，空白对照组、模型组、西药组、联合组小鼠分别死亡0只、11只（55％）、7只（35％）、3只（15％），差异有统计学意义（χ2＝5.237， P＜0.05）。培养24 h和48 h时，模型组和西药组PBLC凋亡率低于空白对照组（P＜0.05）；西药组和联合组高于模型组（P＜0.05）；联合组高于西药组（P＜0.05）。各组小鼠皮质醇水平比较，差异有统计学意义（P＜0.05）；其中西药组和联合组高于空白对照组和模型组（P＜0.05）；联合组低于西药组（P＜0.05）。各组小鼠GRαmRNA和GRβmRNA表达水平比较，差异有统计学意义（P＜0.05）；其中模型组、西药组和联合组低于空白对照组（P＜0.05）；西药组和联合组低于模型组（P＜0.05）；联合组高于西药组（P＜0.05）。结论解毒祛瘀滋阴方联合糖皮质激素应用于系统性红斑狼疮小鼠可改善其死亡情况，疗效优于西药单独应用，机制可能与降低皮质醇水平、升高GR mRNA表达水平有关。
목적：탐토해독거어자음방연합당피질격소응용우계통성홍반랑창소서적료효화궤제。방법2012년4월—2014년5월선취60지MRL／lpr소서채용수궤수자표법분위3조，모형조20지，서약조20지，연합조20지；동시선취20지건강곤명소서작위공백대조조。공백대조조화모형조급여0.9％록화납용액관위；서약조급여0.5 g／ml발니송혼현액관위；연합조급여1.0 g／ml발니송혼현액연합해독거어자음탕제。비교각조소서적사망솔、외주혈림파세포（ PBLC）조망솔、피질순수평화당피질격소수체（ GR） mRNA표체수평。결과간예12주후，공백대조조、모형조、서약조、연합조소서분별사망0지、11지（55％）、7지（35％）、3지（15％），차이유통계학의의（χ2＝5.237， P＜0.05）。배양24 h화48 h시，모형조화서약조PBLC조망솔저우공백대조조（P＜0.05）；서약조화연합조고우모형조（P＜0.05）；연합조고우서약조（P＜0.05）。각조소서피질순수평비교，차이유통계학의의（P＜0.05）；기중서약조화연합조고우공백대조조화모형조（P＜0.05）；연합조저우서약조（P＜0.05）。각조소서GRαmRNA화GRβmRNA표체수평비교，차이유통계학의의（P＜0.05）；기중모형조、서약조화연합조저우공백대조조（P＜0.05）；서약조화연합조저우모형조（P＜0.05）；연합조고우서약조（P＜0.05）。결론해독거어자음방연합당피질격소응용우계통성홍반랑창소서가개선기사망정황，료효우우서약단독응용，궤제가능여강저피질순수평、승고GR mRNA표체수평유관。
Objective To study the curative effect and mechanism of Jieduquyuziyinfang combined with glucocorticoid in treatment of mice with systemic lupus erythematosus.Methods 60 MRL/lpr mice were equally divided into 3 groups by random number table method: model group, western medicine group, and combined treatment group; 20 healthy Kunming mice were chosen as blank control group from April 2012 to May 2014.Mice in blank control group and model group received intragastric administration of 0.9%sodium chloride solution; mice in western medicine group received intragastric administration of 0.5 g/ml metacortandracin suspension; mice in combined treatment group received intragastric administration of 1.0 g/ml metacortandracin suspension and Jieduquyuziyin decoction.The rate of death, rate of PBLC apoptosis, levels of CORT and GR mRNA were compared among different groups.Results 12 weeks after treatment, 0 case in blank control group, 11 cases (55%) in model group, 7 cases (35%) in western medicine group and 3 cases (15%) in combined treatment group mice died, there were significant differences in the rate of death among different groups (χ2 =5.237, P<0.05) .24 h and 48 h after treatment, the rate of PBLC apoptosis in model group and western medicine group was significantly lower than that in blank control group, respectively; the rate of PBLC apoptosis in western medicine group and combined treatment group was significantly higher than that in model group ( P<0.05 ); the rate of PBLC apoptosis in combined treatment group was significantly higher than that in western medicine group ( P<0.05 ) .There were significant differences in level of peripheral blood CORT among different groups of mice (P<0.05), level of peripheral blood CORT in western medicine group and combined treatment group was significantly higher than that in blank control group and model group, respectively ( P<0.05 ); level of peripheral blood CORT in combined treatment group was significantly lower than that in western medicine group ( P <0.05 ) .There were significant differences in expression levels of GRαmRNA and GRβmRNA among different groups of mice ( P <0.05 );expression levels of GRαmRNA and GRβmRNA in model group, western medicine group and combined treatment group were significantly lower than those in blank control group, respectively ( P <0.05 ); expression levels of GRαmRNA and GRβmRNA in western medicine group and combined treatment group were significantly lower than those in model group, respectively ( P<0.05); expression levels of GRαmRNA and GRβmRNA in combined treatment group were significantly higher than those in western medicine group ( P<0.05 ) .Conclusion Jieduquyuziyinfang combined with glucocorticoid can reduce the rate of death among mice with systemic lupus erythematosus, the curative effect of which is better than that of western medicine, the mechanism may be related to the reduction effect of Jieduquyuziyinfang combined with glucocorticoid on CORT level and the enhancement effect of Jieduquyuziyinfang combined with glucocorticoid on GR mRNA expression level.