逍遥散及其功效拆方对慢性铁过载诱导的肝纤维化的影响
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(上海中医药大学附属上海市中西医结合医院脾胃病科,上海 200082)

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R285.5

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收稿日期: 2020 - 12- 06基金项目: 上海市青年科技英才扬帆计划(19YF1445200),上海市卫健委中发办青年基金(2018LQ016),上海中医药大学预算内项目(18LK074);上海虹口区卫健委临床重点扶持专科建设项目(HKZK2020A01)第一作者简介: 周薏(1984-),女,主治医师,硕士,研究方向:消化系统疾病的临床与基础研究。△通信作者: 阙任烨,E-mail: 824492@qq.com


Effects of Xiaoyao Powder and Its Efficacy Decomposed Recipes on Hepatic Fibrosis Induced by Chronic Iron Overload
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(Department of Gastroenterology, Shanghai TCM-integrated Hospital Affiliated Shanghai University of Traditional Chinese Medicine, Shanghai 200082,China)

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    摘要:

    目的通过制作慢性铁过载诱导的大鼠肝纤维化模型,观察逍遥散对肝纤维化的改善作用及对体内铁代谢过程的影响,并通过功效拆方研究,探索逍遥散中疏肝药、健脾药、养血药在整方疗效中的作用及地位。方法 通过腹腔注射右旋糖酐铁50 mg/kg/d,连续7周制作慢性铁过载诱导的大鼠肝纤维化模型,药物干预在造模同时每日通过灌胃的方式给予逍遥散全方、逍遥散去疏肝药、逍遥散去健脾药、逍遥散去养血药、去铁胺(DFO)。使用全自动生化分析仪检测血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、血清铁(SI)、铁蛋白(SF)水平;肝组织进行病理组织学检测,包括HE染色、Masson染色、苦味酸-天狼星红染色等;免疫组化检测肝组织α-平滑肌肌动蛋白(α-SMA)、I型胶原蛋白(COL-1)的表达水平;采用火焰原子吸收光谱法检测大鼠肝组织铁含量。结果 与对照组比较,模型组大鼠肝功能ALT、AST明显升高,病理切片HE染色符合肝纤维化镜下表现,Ishak纤维化评分显著升高,Masson染色、苦味酸-天狼星红染色可见胶原纤维沉积明显,免疫组化结果提示肝组织内α-SMA、COL-1表达显著上升,血清铁、铁蛋白、肝脏总铁含量均显著升高。与模型组比较,逍遥散全方及各功效拆方组可明显降低大鼠肝功能ALT、AST,改善病理过程如Ishak评分及胶原染色半定量等均显著下降,肝组织α-SMA、COL-1表达显著降低,血清铁、铁蛋白、肝脏总铁含量亦明显下降,阳性对照药物去铁胺结果与逍遥散全方相仿。与逍遥散全方相比,逍遥散各功效拆方组均较整方疗效有显著降低。结论 逍遥散可显著改善慢性铁过载诱导的大鼠肝纤维化,其方中疏肝药、健脾药、养血药均对改善铁过载及纤维化有一定作用。推测逍遥散抑制铁过载维持铁稳态的作用可能是其疏肝、健脾、养血功效的核心机制。

    Abstract:

    Objective To observe the effect of Xiaoyao Powder on the improvement of liver fibrosis and iron metabolism in rats induced by chronic iron overload, and to explore the role and status of liver soothing, spleen strengthening and blood nourishing drugs in Xiaoyao Powder. Methods Rat liver fibrosis model induced by chronic iron overload was established by intraperitoneal injection of iron dextran(50 mg/kg/d) for 7 weeks. At the same time, the whole prescription of Xiaoyao Powder, or removing Liver Soothing drugs, spleen strengthening drugs, blood nourishing drugs and deferoxamine(DFO) were given daily by gavage. The levels of serum alanine aminotransferase(ALT), aspartate aminotransferase (AST), serum iron (SI) and ferritin (SF) were detected by automatic biochemical analyzer liver tissues were detected by histopathology, including HE staining, Masson staining, picric acid Sirius red staining, etc. immunohistochemistry was used to detect α-smooth muscle actin (α-SMA) and type I collagen protein (COL-1) expression. The content of liver iron in rat was detected by flame atomic absorption spectrometry. Results Compared with the control group, ALT and AST of liver function in the model group were significantly higher than those in the control group. The HE staining of pathological sections was consistent with the microscopic manifestations of liver fibrosis. The Ishak fibrosis score was significantly increased. Masson staining and picric acid Sirius red staining showed obvious collagen fiber deposition. Immunohistochemical results showed that the expression of α-SMA and COL-1 in liver tissue was significantly increased. Serum iron, ferritin and total liver iron were also significantly increased. Compared with the model group, the whole Xiaoyao powder recipe and its efficacy decomposed recipes could significantly reduce the ALT and AST of liver function, improve the pathological process, such as Ishak score and semi quantitative staining of collagen. The expressions of α-SMA and COL-1 in liver tissue were significantly decreased, and the contents of serum iron, ferritin and total liver iron were also significantly decreased. The results of positive control drug deferoxamine were similar to those of Xiaoyao Powder. Compared with the whole Xiaoyao Powder prescription, efficacy decomposed recipes in each group was significantly lower than that in the whole formula. Conclusion Xiaoyao Powder can significantly improve liver fibrosis induced by chronic iron overload in rats, and the drugs of soothing liver, strengthening spleen and nourishing blood have certain effects on improving iron overload and fibrosis. It is speculated that the effect of Xiaoyao Powder on inhibiting iron overload and maintaining iron homeostasis may be the core mechanism of its functions of soothing liver, strengthening spleen and nourishing blood.

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