目的 探究电针丰隆穴对高脂血症患者的降脂疗效及对巨噬细胞与人血清共培养ATP结合盒转运子A1（ATP binding cassette transporter A1，ABCA1）表达的影响。方法 将120例辨证为痰浊阻遏证高脂血症患者，随机分为电针组、药物组与对照组，每组40例。电针组予以电针针刺丰隆穴治疗；药物组予以口服血脂康治疗；对照组不予以特殊处理。观察治疗前后及治疗后3个月、6个月3组患者总胆固醇（total cholesterol，TC）、三酰甘油（triacylglycerol，TG）、高密度脂蛋白胆固醇（high-density lipoprotein cholesterol，HDL-C）、低密度脂蛋白胆固醇（low-density lipoprotein cholesterol，LDL-C）水平的变化；分别采用RT-PCR法和免疫印迹法检测3组患者巨噬细胞ABCA1 mRNA及其蛋白的表达水平。结果 药物组和电针组总有效率均高于对照组（P＜0.05）。药物组和电针组治疗后TG、TC、LDL-C水平均较治疗前显著下降（P＜0.05），两组治疗前后TG、TC、LDL-C水平降低程度显著大于对照组（P＜0.05），两组TG、TC、LDL-C水平差值比较，差异均无统计学意义（P＞0.05）。电针组治疗后3个月、6个月TC、TG、LDL-C水平与治疗后比较，差异均无统计学意义（P＞0.05），药物组治疗后3个月、6个月TC、TG、LDL-C水平均较治疗后显著上升（P＜0.05）；两组治疗后、治疗后3个月、6个月TC、TG、LDL-C水平仍显著低于对照组（P＜0.05）。药物组、电针组ABCA1 mRNA及蛋白表达水平均明显高于对照组（P＜0.05）；两组间ABCA1 mRNA及蛋白表达水平比较，差异无统计学意义（P＞0.05）。结论 电针丰隆穴可降低高脂血症患者TC、TG、LDL-C水平，且疗效较药物组稳定，可促进巨噬细胞ABCA1 mRNA和蛋白的表达，促进胆固醇逆转运，降低巨噬细胞胆固醇负荷，减轻炎症反应，从而防治动脉粥样硬化性心脑血管疾病。
Objective To investigate the antihyperlipidemic effect of electroacupuncture at Fenglong acupoint on patients with hyperlipidemia and its effect on the expression of ATP-binding cassette transporter A1 (ABCA1) in macrophages co-cultured with human serum. Methods A total of 120 hyperlipidemia patients with sputum stasis syndrome were randomly divided into electroacupuncture group, drug group, and control group, with 40 patients in each group. The patients in the electroacupuncture group were given electroacupuncture at Fenglong, those in the drug group were given oral Xuezhikang, and those in the control group were not given special treatment. The levels of triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were measured before treatment, immediately after treatment, and at 3 and 6 months after treatment, and RT-PCR and Western blotting were used to measure the mRNA and protein expression of ABCA1 in macrophages. Results The drug group and the electroacupuncture group had a significantly higher overall response rate than the control group (P<0.05). Immediately after treatment, the drug group and the electroacupuncture group had significant reductions in TG, TC, and LDL-C (P<0.05); compared with the control group, the drug group and the electroacupuncture group had significantly greater reductions in TG, TC, and LDL-C (P<0.05), while there were no significant differences in the changes in TG, TC, and LDL-C between the drug group and the electroacupuncture group (P>0.05). The electroacupuncture group had no significant changes in TC, TG, and LDL-C from immediately after treatment to 3 and 6 months after treatment (P>0.05), and the drug group had significant increases in TC, TG, and LDL-C from immediately after treatment to 3 and 6 months after treatment (P<0.05); these two groups still had significantly lower TC, TG, and LDL-C than the control group immediately and at 3 and 6 months after treatment (P<0.05). The drug group and the electroacupuncture group had significantly higher mRNA and protein expression of ABCA1 than the control group (P<0.05), while there were no significant differences in the mRNA and protein expression of ABCA1 between the two groups (P>0.05). Conclusion Electroacupuncture at Fenglong acupoint can reduce the levels of TC, TG, and LDL-C in hyperlipidemia patients and has a more stable clinical effect than drug therapy. It can also improve the mRNA and protein expression of ABCA1 in macrophages, promote reverse cholesterol transport, reduce cholesterol load in macrophages, and alleviate inflammatory response, and thus it can be used for the prevention and treatment of atherosclerotic cardiovascular and cerebrovascular diseases.
王 琼,周 利,邹 燃,乐 薇,杨 敏,孙 滨,庞争争,徐派的.电针丰隆穴对高脂血症患者血脂水平及对巨噬细胞ABCA1表达的影响[J].安徽中医药大学学报,2020,39(5):54-59复制