CN112972638B - 治疗银屑病中药在制备防治心肌缺血再灌注损伤药物中的应用 - Google Patents
治疗银屑病中药在制备防治心肌缺血再灌注损伤药物中的应用 Download PDFInfo
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Abstract
本发明涉及治疗银屑病中药在制备防治心肌缺血再灌注损伤药物中的应用,其中所述治疗银屑病中药的有效成分由20重量份土茯苓制成的粉末和以下原料药的水提物组成:莪术10重量份,肿节风20重量份,紫草20重量份,赤芍15重量份,乌梅20重量份,甘草10重量份,当归10重量份,川芎10重量份,生地20重量份。本发明所述防治心肌缺血再灌注损伤药物可以可以改善模型大鼠的心功能,抑制炎症反应,调节免疫,缓解心肌纤维化的病理改变,减轻心肌缺血再灌注损伤。
Description
技术领域
本发明涉及含有传统中药的未确定结构的药物制剂,具体涉及治疗心血管系统疾病的药物。
背景技术
冠心病心肌梗死的发病率与死亡率逐年攀升,随着医学研究的发展与进步,各种治疗手段如溶栓、经皮冠状动脉介入、冠状动脉支架术等在临床治疗中得到了普遍的运用。在通过这些治疗方法恢复心肌供血,减轻心肌损伤的同时,缺血再灌注可能加重心脏功能障碍和结构损伤,甚至造成心肌细胞的不可逆性死亡,称之为缺血再灌注损伤(myocardialischemia-reperfusion injury,MIRI)。因此,对于心肌缺血再灌注损伤的预防和治疗也获得了更多的关注,成为了研究的热门问题。
缺血再灌注损伤涉及到炎症反应、自由基的大量释放、兴奋性氨基酸以及代谢性受体的激活,核酸内切酶的激活、血小板活化因子的激活等内容。机体的应激性(免疫性)炎症反应是缺血再灌注损伤的基础,而各种炎症介质包括细胞毒素又是构成这些炎症反应的基础。
中医药可通过抑制炎症细胞的趋化及浸润、调节细胞因子的合成及分泌、恢复炎症抑制因子和促炎因子的平衡等多种途径干预心肌缺血/再灌注损伤后炎症反应,发挥心肌保护作用。近年来研究证明,中医药防治具有抑制血小板活化、调节炎症反应、抗血栓形成、抑制氧化应激损伤、促进心肌毛细血管新生等作用,可作用于心肌损伤的多个病理环节,显示有良好的应用前景。
公开号为CN105233150A的专利申请的实施例1公开了一种中药组合物,该中药组合物由以下重量份原料制成;莪术10重量份、肿节风20重量份、紫草20重量份、赤芍15重量份、土茯苓20重量份、乌梅20重量份、甘草10重量份、当归10重量份、川芎10重量份、生地20重量份。同时,上述专利申请还公开了所述中药组合物具有以下作用和治疗用途:“本发明同时具有清热解毒、活血化瘀的作用,用于治疗银屑病,疗效确切;具有祛风清热、除湿消肿、活血通络,用于治疗银屑病性关节炎以及类风湿性关节炎,疗效确切;本发明还有利湿清热、活血化瘀、解毒散结的作用,用于治疗恶性肿瘤,疗效确切。”但是,目前尚未见上述专利申请所述中药组合物有其它新用途的报道。
发明内容
本发明要解决的技术问题是提供治疗银屑病中药在制药中的新用途。
所述治疗银屑病中药在制药中的新用途具体是:
治疗银屑病中药在制备防治心肌缺血再灌注损伤药物中的应用,其中,所述的治疗银屑病中药的有效成分与公开号为CN105233150A专利申请的实施例1相同,即由20重量份土茯苓制成的粉末和以下原料药的水提物组成:
莪术10重量份,肿节风20重量份,紫草20重量份,赤芍15重量份,乌梅20重量份,甘草10重量份,当归10重量份,川芎10重量份,生地20重量份。
上述应用中,所述的有效成分由以下方法制成:
(1)取土茯苓粉碎过80目筛,得土茯苓粉末;
(2)取莪术、肿节风、紫草、赤芍、乌梅、甘草、当归、川芎和生地饮片,水煎煮提取三次,第一次加10~12倍量水,煎煮提取2小时,第二和三次分别加8~10倍量水,煎煮提取1小时;合并提取液,过滤,减压浓缩至80℃下热测比重为1.10~1.20g/cm3的清膏,冷却至室温,加入乙醇并控制乙醇的体积浓度为70%,静置24h,过滤,回收乙醇,浓缩至80℃下热测比重为1.30~1.40g/cm3的稠膏;
(3)将步骤(1)制备的土茯苓粉末加入到步骤(2)制备的稠膏中,混匀,即得所述的有效成分。
按上述方法制备好有效成分后,可按公开号为CN105233150A专利申请实施例1的方法制成每片当相于含生药材1~5g的片剂,该片剂的服用方法为:成人每次5片,一日3次(早中晚各一次,餐后服用),7天为一个疗程。
本发明所述防治心肌缺血再灌注损伤药物可以改善模型大鼠的心功能,抑制炎症反应,调节免疫,缓解心肌纤维化的病理改变,减轻心肌缺血再灌注损伤。
附图说明
图1为银屑灵片治疗各组大鼠30天后的效果图,其中,(a)为大鼠心电图,(b)为超声影像图,(c)为左心室射血分数结果柱状图,(d)为缩短分数结果柱状图;(c)图和(d)图中,**P<0.01。
图2为银屑灵片对各组大鼠血清水平影响的柱状图,其中,(a)为肌酸激酶同工酶(CK-MB),(b)为心肌肌钙蛋白I(CTn-I),(c)为乳酸脱氢酶(LDH);图中,*P<0.05**P<0.01。
图3为各组大鼠心肌受损部位炎症因子相对表达量的柱状图,其中,(a)为IL-4,(b)为IL-6,(c)为Foxp3,(d)为IL-17;图中,*P<0.05**P<0.01。
图4为各组大鼠心肌组织的染色图,其中,(a)为HE染色图,(b)为Masson染色图。
具体实施方式
下面结合实施例和附图对本发明作进一步详细的说明。
A、实验药物(以下称之为银屑灵片)
1、原料药及配比:莪术10重量份、肿节风20重量份、紫草20重量份、赤芍15重量份、土茯苓20重量份、乌梅20重量份、甘草10重量份、当归10重量份、川芎10重量份、生地20重量份。
2、制备方法:
(1)称取土茯苓粉碎过80目筛,得土茯苓粉末;
(2)称取莪术、肿节风、紫草、赤芍、乌梅、甘草、当归、川芎、生地干燥饮片,煎煮提取三次,第一次加11倍量水,提取2小时;第二和三次分别加9倍量水,提取1小时;合并提取液,过滤,减压浓缩至80℃下热测比重为1.15g/cm3的清膏,冷却至室温,加入乙醇并控制乙醇的体积浓度为70%,静置24h,过滤,回收乙醇,浓缩至80℃下热测比重为1.35g/cm3的稠膏;
(3)取乳糖、淀粉、糊精与步骤(2)得到的稠膏混合均匀,干燥,粉碎过80目筛,加入硬脂酸镁和步骤(1)得到的土茯苓粉末,混合均匀,按照常规方法制备成片剂;其中,所述乳糖、淀粉和糊精的加入量为所述稠膏重量的32.67%,乳糖、淀粉与糊精之间的重量比为1:2:6,所述硬脂酸镁的加入量为所述稠膏重量的0.67%。
B、药效实验
一、银屑灵片对MIRI大鼠的心肌功能保护及炎症抑制,缓解心肌纤维化作用的实验
1材料与方法
1.1实验材料
1.1.1实验动物
SPF级雄性SD大鼠50只,体重180-220g,购于北京维通利华实验动物技术有限公司。大鼠饲养条件:室温24±1℃,湿度40-80%,光照12h明暗交替,自由饮水,进食。实验前适应性饲养3-7天。实验过程遵守实验动物与保护的有关准则。
1.1.2主要仪器
小动物超高分辨B超Vevo2100(FUJIFILM VisualSonic Inc,Canada);16道高速电生理记录仪(Millar,stz-0007593);小动物呼吸机(HARVARD APPARTUS CAT:55-7058,USA)切片机:LEICA RM2235;全自动倒置荧光显微镜分析系统(NiKon T300);离心机;低温冰箱(三洋,日本),超低温冰箱(美菱,中国),均质器(BD,美国),台式高速冷冻离心机(Eppendorf公司,德国),PCR仪、电泳装置(Bio-Rad公司,美国),7500序列荧光定量PCR仪(应用Biosystems,美国),和PM-30倒置显微镜-计算机图像分析系统(Olympus,日本)
1.1.3试剂
Promega Eastep Super总RNA提取试剂盒;RNA逆转录试剂盒(Thermo FisherScientific LOT00662404);引物合成(华大基因);SYBR Green Super Mix(Bio-rad公司);苏木素;伊红(中国广州化学试剂厂);Masson染色试剂盒(迈新MST-8003/8004),CK-MB试剂盒(南京建成),CTn-Ⅰ试剂盒(南京建成),LDH试剂盒(南京建成)。
1.1.4药液配制
根据《中药药理实验方法学》规定,大鼠给药剂量按照不同种属动物间等效剂量的直接折算公式计算,成人每日服用银屑灵片7.5g(5片×3次×0.5g),大鼠的用药剂量是成人的6倍,取所述的银屑灵片加入蒸馏水充分混悬配制成每毫升含有0.075g片重的混悬液,4℃保存备用。
1.2实验方法
1.2.1大鼠MIRI模型的制备
所有大鼠均在同一条件下常规喂养,术前12h禁食。实验组动物以1%戊巴比妥钠溶液(40mg/Kg)腹腔注射麻醉,充分麻醉后,行气管插管,连接小动物呼吸机(harvardapparatus CAT:55-7058)实施机械通气,潮气量为1ml/100g,通气频率为70次/分钟,呼吸比为1:1。经右前肢、左后肢和右后肢皮下插入针状电极,连接多通道电生理仪(Millar,stz-0007593),实施Ⅱ导联监测。将老鼠固定于解剖台,胸部常规备皮后,于第3~4肋间用眼科剪小心剪开皮肤约1.5cm,钝性分离胸大肌和前锯肌,用撑开器分开两侧固定,用生理盐水棉球轻柔地向下或向外侧推开左肺,钝性撕开心包膜以暴露心脏左前壁和心耳,采用带圆针的7-0号尼龙线从左心耳下缘中点进针,深度约1mm,于左心耳右缘与肺动脉圆锥之间出针,结扎左冠状动脉前下支(约左心耳下2mm)。随后,将缝合线的两头穿过一直径2mm、长1.5cm的聚乙烯管以形成一个套结。结扎1小时,松开套结即再灌注。再灌注观察30min后行逐层缝合,大鼠出现自主吞咽反射时拔出通气管。术毕腹腔注射青霉素10万U/100g。保温,等待苏醒。假手术组仅穿针不接扎,余处理同实验组。苏醒后各组动物均在同一环境下常规喂养。
缺血再灌注损伤模型建立成功的标准
结扎成功实施心肌缺血处理的表现为结扎线远端心外膜紫绀或呈灰白色,同步Ⅱ导联ECG显示ST段明显抬高,缺血期间出现室性心律失常;松开阻断的LAD恢复心肌血流灌注后,抬高的ST段相对降低(>50%),并且缺血区心外膜颜色恢复红润。按此标准,最终纳入本实验的假手术组大鼠共计13只,缺血再灌注损伤模型大鼠26只。
1.2.2分组与给药
将大鼠按随机数字表法随机分为假手术组(13只)、模型组(13只)、银屑灵片治疗组(13只),共3组。于造模后第5天开始灌胃给药,每天1次,银屑灵片治疗组给予银屑灵片(0.75g片重/kg)灌胃,模型组和假手术组给予等剂量蒸馏水灌胃,连续灌胃给药30天。所用剂量均根据人体用量换算得到。
1.3大鼠心脏超声,心电图检测
左心室功能的超声心动图检查
动物称重后,进行异氟烷气麻,将大鼠左胸前毛剪短,再用棉球蘸取脱毛剂涂抹,脱毛分钟后可用温水洗净,然后以纱布擦干;固定四肢于操作台上。左侧卧位,左胸前涂少量耦合剂,将探头高频线阵探头、置于左胸前,并指向右上,选取标准左室乳头肌短轴切面和左室长轴切面结合型和多普勒超声进行检查。取个心动周期测量的数据,取其平均值。由于鼠科动物心率快,型曲线及多普勒血流频谱扫描速度设置>100mm/s。观测指标:左心室舒张末期内径(LVIDd)、左心室收缩末期内径、(LVIDs)室间隔舒张末期厚度(IVSTd)、室间隔收缩末期厚度(IVSTs)、左室后壁舒张末期厚度(LVPWs)、左室后壁收缩末期厚度(LVPWs);左室射血分数(EF%)和左室短轴缩短率(FS%)。
1.4取材及标本制备
各组大鼠经3%戊巴比妥钠(1.5ml/kg)腹腔注射麻醉后,于下腔静脉取血3ml/只,用于大鼠血清酶联免疫吸附实验。后每组随机选取5只,进行透心灌注,取心脏组织用于石蜡切片染色,并计算其心肌纤维化成都;每组随机选取8只经麻醉后,冰上切除受损部位心脏入EP管中,液氮速冻,-80℃冰箱保存,用于检测心肌组织mRNA的表达。
1.5大鼠血清酶联免疫吸附(ELISA)实验
①血清:室温血液自然凝固10-20min,2000-3000转/分,离心20分钟,收集上清。
此实验均将血清稀释5倍;
②使用前将试剂盒放室温平衡半小时;
③分别加入标准品孔,零孔,样品孔,然后加入HPR试剂50μl;
④轻轻摇晃,盖上封板膜,37℃培养箱中孵育60min;
⑤洗涤:小心揭掉封板膜,弃去液体,甩干,每孔用排枪加满洗涤液,静置30秒
后弃去,重复5次,拍干;
⑥显色:每孔加入显色剂A 50μl,再加入显色剂B 50μl,轻轻震荡混匀,37℃避光显色10min;
⑦终止:每孔加入终止液50μl,终止反应(此时蓝色立转黄色);
⑧测定:以空白孔调零,450nm波长依序测量各孔的吸光度(OD值)。测定应在加
终止液10min以内进行;
⑨计算:根据浓度和OD值算出标准曲线的回归方程,拟合模拟曲线选用logistic曲线。
1.6心肌组织总RNA提取分离(Promega Eastep Super)
①将50mg组织移至用液氮预冷的经180℃烤箱烘烤8小时的研钵中,研磨标本至粉末状,研磨过程中不断加入液氮;加入适量的RNA裂解液及稀释液并研磨;用移液枪混匀,室温下放置3-5分钟或70℃加热3分钟,可以提高RNA的得率。
②混匀后12000-14000xg离心5分钟。小心吸取上清液。
③加入0.5倍上清体积的无水乙醇,混匀。
④混合液转移至离心柱,12000-14000xg离心1分钟,弃滤液。加入600μl RNA洗液洗涤,12000-14000xg离心45秒,弃滤液。
⑤加入50μl DNA酶I孵育液孵育15分钟。
⑥然后加入600μlRNA洗液,12000-14000xg离心45秒,弃滤液。重复两次
⑦将离心柱重新安置于收集管上,12000-14000xg离心2分钟。
⑧将离心柱安放在洗脱管上,加入50μl无核酸酶水,12000-14000xg离心1分钟,收集的RNA保存于-70℃。
1.7逆转录
根据试剂盒说明书中的程序进行cDNA的合成。样品反应体系10μl含有2μgRNA和随机引物2μl,加入无核酸酶水至3.2μl,70℃加热5分钟。在冰上立即冷冻至少5分钟,加入逆转录混合物4.8μl,瞬时离心10秒。混匀后退火加热至25℃孵育5分钟、至37℃孵育120分钟,加热至85℃5分钟,冷却至4℃后取出,-20℃保存。逆转录混合物如下表1:
表1:RNA逆转录为cDNA 10μl体系试剂
1.8Real Time-PCR分析
在20μl的实时反应体系中含有:10μl的universal SYBR Green supermix(2×),上游和下游引物混合物5μl(各自终浓度均为500nM),稀释20倍的cDNA 5μl。
用荧光定量专用封口膜覆盖96孔板,瞬时离心后放入荧光定量PCR仪内,扩增40个循环,变性、退火、延伸所需温度、时间分别为95℃30s、60℃30s、72℃90s。
GAPDH作为内参基因,每个样品重复测定3次。mRNA的相对量用Ct值表示,平均相对表达量通过2-△△Ct计算方法分析。
所用引物序列如下表2:
表2:引物序列
1.9HE染色
给药30天后大鼠取心脏,固定,制成切片,HE染色,过程如下所述。
苏木素-伊红(Hematoxylin-eosin,HE)染色:用石蜡切片机进行石蜡样本的切片,厚度4.5-5μm,连续切片,染色程序为烤片干燥20分钟,二甲苯2次×10分钟,无水乙醇2次×2分钟,95%乙醇1分钟,80%乙醇1分钟,70%乙醇1分钟,水洗1分钟,苏木素8分钟,苏木素10分钟,水洗2次×1分钟,0.5%盐酸酒精10秒,水洗10分钟,伊红2分钟,水洗1分钟,80%乙醇5秒,85%乙醇5秒,90%乙醇5秒,95%乙醇1分钟,无水乙醇2次×2分钟,无水乙醇3分钟,二甲苯2次×2分钟,结束染色后直接用中性树胶封片。
2.0Masson染色
根据试剂盒(迈新MST-8003/8004)说明书:
(1)组织石蜡块切片,每片4.5μm厚,65℃烘片仪烘干,65℃电热恒温鼓风干燥箱过夜。
(2)将Masson复合染液1滴(试剂A)滴加到组织上,然后染色5分钟。用蒸馏水冲掉染液。
(3)将磷钼酸(试剂C)染色1滴滴加到组织上,然后染色5分钟,然后把染液甩干。
(4)直接滴加1滴(100μl)苯胺蓝(试剂D)染色5分钟蒸馏水稍冲。
(5)滴加1滴分化液(试剂B)分化30~60秒(2次)
(6)95%乙醇,无水乙醇脱水,透明,封固。
2.1统计学处理
二、结果与分析
1.银屑灵片对各组大鼠心功能的影响;
心电图:与MIRI模型组相比,银屑灵片治疗组ST段下移较少,心肌缺血症状改善,结果见图1(a)。
心脏超声:银屑灵片能显著改善心肌收缩功能及顺应性,保护心肌进一步受损,结果见图1(b)。
MIRI组在术后第35天LVEF值下降为43.09±2.117(%),LVFS值为24.86±1.461,银屑灵片LVEF值恢复为67±1.728(%),LVFS值为38.95±1.193;表明银屑灵片能有效恢复心肌功能。
组间比较,由于方差不齐,采用Dunnett’s T3检验法检验。结果显示,30天后模型组的左心室射血分数与缩短分数与假手术组相比,P<0.01,提示模型稳定;模型组的左心室射血分数与缩短分数与治疗组比较,P<0.01,说明药物治疗有效,结果见图1(c)和图1(d)。
2.银屑灵片对各组大鼠血清CK-MB,CTn-Ⅰ,LDH的影响;
心肌损伤导致生物膜系统损伤,肌酸激酶同工酶(CK-MB),心肌肌钙蛋白I(CTn-I)和乳酸脱氢酶(LDH)从损伤的心肌内部进入到血液中,银屑灵片治疗组肌酸激酶同工酶(CK-MB),心肌肌钙蛋白I(CTn-I)和乳酸脱氢酶(LDH)水平远低于MIRI模型组,采用独立样本t检验进行统计分析。结果显示,与假手术组相比,差异有统计学意义,P<0.05。表明银屑灵片能有效改善心肌损伤,缓解心肌梗死进程。
3.银屑灵片对各组大鼠心肌受损部位炎症因子相对表达量的影响:
IL-4能够刺激B细胞增殖,抑制IFN-γ生成。采用独立样本t检验进行统计分析,结果显示:治疗组IL-4基因的相对表达量高于模型组,差异具有统计学意义(P<0.05),结果见图3a。
IL-6能够通过刺激T细胞分化,促进炎性细胞因子的分泌,加剧炎症反应,另一方又可促进自身抗体的生成,诱导自身免疫性病变。同时IL-6是一种重要的促炎因子,在心肌缺血再灌注损伤过程中的浓度反映了心肌损伤程度。采用独立样本t检验进行统计分析,结果显示:模型组IL-6基因的相对表达量高于治疗组,差异具有统计学意义(P<0.05),结果见图3b。
Foxp3突变会引起自身免疫内分泌疾病、炎症性肠病、致命性感染和严重的变态反应等,研究证实了foxp3在免疫调节中具有重要作用。采用独立样本t检验进行统计分析,结果显示:模型组Foxp3基因的相对表达量远高于治疗组,差异较显著(P<0.01),结果见图3c。
IL-17家族的作用也相当广泛,包括募集巨噬细胞、中性粒细胞到炎性反应组织、作用于内皮细胞和巨噬细胞,产生IL-6,IL-1,TNF-α,C反应蛋白(C-Reactive protein,CRP)和金属基质蛋白酶介导的炎性反应、通过调节趋化因子的表达而增加炎性细胞的黏附功能以及促进细胞凋亡等。研究表明受损组织的细胞因子和炎性反应递质的释放如:IL-6、TNFα、IL-10、IL-17等能引起细胞凋亡及远端器官损害。抑制IL-17可延迟炎症的发生,减轻心肌病理损伤程度。采用独立样本t检验进行统计分析,结果显示:模型组IL-17基因的相对表达量远高于治疗组,差异具有统计学意义(P<0.05),结果见图3d。
4.银屑灵片对MIRI大鼠心肌纤维化的影响:
心肌HE染色结果:假手术组大鼠心肌排列大致较为规则,心肌形态较为完整;模型组大鼠心肌排列紊乱,心肌断裂,心肌纤维化的面积增大,并伴随着较多炎性细胞浸润。银屑灵片大鼠心肌组织纤维排列欠规则,心肌纤维化面积较小,炎性细胞数量较少。结果见图4a。心肌Masson染色结果:Masson染色显示MIRI组被苯胺蓝染色面积区域大,说明胶原、纤维连接蛋白等基质大量沉积。而银屑灵片治疗组,上述病变呈现显著改善。结果见图4b。心肌纤维化面积比计算:将各组大鼠R心肌切片经Masson染色后,在切片上随机选取5个视野,利用Image-pro软件进行细胞大小计数并计算胶原容积分数(CVF%)。CVF%=心肌胶原面积/心肌细胞总面积*100%。先进行数据的正态性检验和方差齐性检验,符合正态性分布,但方差不齐,所以采用非参数检验法中Wilcoxon检验法进行统计分析,用进行描述。结果显示,治疗组与模型组比较,P<0.01,差异较显著。
表3:各组大鼠心肌纤维化的影响
注:模型组与假手术组比较**P<0.01;银屑灵片组与模型组比较**P<0.01。
序列表
<110> 南方医科大学
<120> 治疗银屑病中药在制备防治心肌缺血再灌注损伤药物中的应用
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Claims (2)
1.治疗银屑病中药在制备防治心肌缺血再灌注损伤药物中的应用,其中所述治疗银屑病中药的有效成分由20重量份土茯苓制成的粉末和以下原料药的水提物组成:
莪术10重量份,肿节风20重量份,紫草20重量份,赤芍15重量份,乌梅20重量份,甘草10重量份,当归10重量份,川芎10重量份,生地20重量份。
2.根据权利要求1所述的应用,其特征在于,所述的有效成分由以下方法制成:
(1)取土茯苓粉碎过80目筛,得土茯苓粉末;
(2)取莪术、肿节风、紫草、赤芍、乌梅、甘草、当归、川芎和生地饮片,水煎煮提取三次,第一次加10~12倍量水,煎煮提取2小时,第二和三次分别加8~10倍量水,煎煮提取1小时;合并提取液过滤,减压浓缩至80℃下热测比重为1.10~1.20g/cm3的清膏,冷却至室温,加入乙醇并控制乙醇的体积浓度为70%,静置24h,过滤,回收乙醇,浓缩至80℃下热测比重为1.30~1.40g/cm3的稠膏;
(3)将步骤(1)制备的土茯苓粉末加入到步骤(2)制备的稠膏中,混匀,即得所述的有效成分。
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