【目的】 探讨隔药饼灸抗动脉粥样硬化机制。【方法】 将24只新西兰纯种雄兔随机分为正常组、模型组、隔药饼灸组和 阿托伐他汀组，每组 6只。除正常组，其他各组兔采用喂养高脂饲料拌入丙基硫氧嘧啶法构建动脉粥样硬化模型。造模同 期，给予相应干预。12周后取材，检测血清总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）水平，苏木素- 伊红（HE）染色法观察兔主动脉组织病理改变，酶联免疫吸附分析（ELISA）检测血清肿瘤坏死因子α（TNF-α）、白细胞介素6 （IL-6）、白细胞介素 10（IL-10）水平，Western Blot法检测心肌组织磷脂酰肌醇 3-激酶（PI3K）、磷酸化蛋白激酶 B（p-AKT）、 磷酸化哺乳动物雷帕霉素靶蛋白（p-mTOR）蛋白含量。【结果】 与正常组比较，模型组血清TC、TG、LDL-C水平均显著升高 （P＜0.001），主动脉血管内皮结构明显受损，血清TNF-α、IL-6含量升高（P＜0.001），IL-10含量降低（P＜0.01），心肌组织 PI3K、p-AKT、p-mTOR蛋白表达量显著降低（P＜0.05或P＜0.01）；与模型组比较，隔药饼灸组、阿托伐他汀组上述指标均 得到明显改善（P＜0.05或P＜0.01或P＜0.001）；与阿托伐他汀组比较，隔药饼灸组TG、LDL-C含量升高（P＜0.01），其他指 标均无显著变化（P＞0.05）。【结论】 隔药饼灸抗动脉粥样硬化机制可能与激活 PI3K/AKT/mTOR 信号通路，调节炎症介质 TNF-α、IL-6、IL-10表达相关。

Objective To investigate the anti-atherosclerotic mechanism of herbal cake-separated moxibustion. Methods Twenty-four New Zealand purebred male rabbits were randomly divided into normal group， model group，herbal cake-separated moxibustion group and Atorvastatin group，with 6 rabbits in each group. Except for the normal group，the rabbits in the other groups were fed with high-fat diet mixed with Propylthiouracil（PTU） method to construct an atherosclerosis model. At the same period of modeling， corresponding intervention was given. After 12 weeks，the levels of serum total cholesterol（TC），triglyceride（TG）and low density lipoprotein cholesterol（LDL-C）were detected. The pathological changes of rabbit aortic tissue were observed by hematoxylineosin（HE）staining. The levels of serum tumor necrosis factor α（TNF-α），interleukin 6（IL-6）and interleukin 10 （IL-10）were detected by enzyme-linked immunosorbent assay（ELISA）. The contents of phosphatidylinositol 3- kinase（PI3K），phosphorylated protein kinase B（p-AKT）and phosphorylated mammalian target of rapamycin（pmTOR）in myocardial tissue were detected by Western Blot. Results Compared with the normal group，the serum levels of TC，TG and LDL-C in the model group were significantly increased（P＜0.001），the aortic vascular endothelial structure was significantly damaged，the serum levels of TNF-α and IL-6 were increased（P＜0.001）， the serum level of IL-10 was decreased（P＜0.01）， and the protein expression levels of PI3K， p-AKT and p-mTOR in myocardial tissue were significantly decreased（P＜0.05 or P＜0.01）. Compared with the model group， the above indexes in the herbal cake-separated moxibustion group and the Atorvastatin group were significantly improved（P＜0.05 or P＜0.01 or P＜0.001）. Compared with the Atorvastatin group， the contents of TG and LDL-C in the herbal cake-separated moxibustion group were increased（P＜0.01），and other indicators did not change significantly （P＞0.05）. Conclusion The mechanism of anti-atherosclerosis of herbal cake-separated moxibustion may be related to the activation of PI3K/AKT/mTOR signaling pathway and the regulation of the expressions of inflammatory mediators TNF-α，IL-6 and IL-10.

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国家自然科学基金资助项目（编号：82074559，81704182）；湖南省科技计划项目（编号：2022RC1222）；湖南省中医药管理局 一般课题（编号：202206）；长沙市杰出创新青年培养计划项（编号：kq1905036）；湖南中医药大学研究生创新课题（编号： 2022CX111）