隔药灸结合针刺对克罗恩病患者肠黏膜TNF-α、TNFR1、TNFR2表达及肠上皮细胞凋亡的影响  

Effects of herbs-partitioned moxibustion on the expressions of intestinal mucosa TNF-α,TNFR1,TNFR2 and apoptosis of intestinal epithelial cells in Crohn's disease patients

作　　者：施茵[1] 包春辉[1] 吴焕淦[1] 陈巍峰[2] 秦秀娣[1] 张榕[1] 吴璐一[3] 

机构地区：[1]上海市针灸经络研究所,上海200030 [2]复旦大学医学院附属中山医院,上海200032 [3]上海中医药大学,上海201203

出　　处：《上海中医药杂志》2011年第1期46-50,共5页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家重点基础研究发展计划("973"计划)资助项目(2009CB522900);国家自然科学基金资助项目(30772831);上海市重点学科资助项目(S30304)

摘　　要：目的观察隔药灸结合针刺对克罗恩病患者肠黏膜TNFα-、TNFR1、TNFR2含量以及肠上皮细胞凋亡的影响,探讨其对克罗恩病肠上皮屏障损伤的保护作用。方法将60例符合轻、中度克罗恩病诊断标准的患者分为治疗组和对照组(各30例),治疗组予以隔药灸结合针刺治疗,12次为1个疗程,疗程间休息3天,共治疗6个疗程;对照组予以常规西药美沙拉嗪口服,连续服用12周。采用克罗恩病活动指数评价两种治疗方法的临床疗效,同时观察患者治疗前后肠黏膜TNFα-、TNFR1、TNFR2含量及肠上皮细胞凋亡情况。结果治疗组和对照组临床总有效率分别为86.67%、63.33%;组间疗效比较,差异有统计学意义(P<0.05);两组治疗后肠黏膜TNFα-、TNFR1、TNFR2含量和肠上皮细胞凋亡率均明显降低(P<0.01);组间治疗后比较,肠黏膜TNFα-、TNFR1含量及肠上皮细胞凋亡率差异有统计学意义(P<0.05)。结论隔药灸结合针刺可能是通过降低克罗恩病肠黏膜异常增高的TNFα-、TNFR1、TN-FR2,从而抑制肠上皮细胞的异常凋亡,达到保护肠上皮屏障损伤和减轻肠道炎症反应之目的。Objective To observe the effects of herbs-partitioned moxibustion combined with acupuncture on the expressions of intestinal mucosa TNF-α,TNFR1,TNFR2 and apoptosis of intestinal epithelial cells in Crohn＇s disease patients,and explore the protective mechanisms of moxibustion on the defect of intestinal epithelium barrier in CD.Methods Total 60 cases of mild to moderate Crohn＇s disease were randomized into two groups： treatment group in which 30 cases were treated by herbs-partitioned moxibustion combined with needling therapy,and control group in which 30 cases were treated by oral administration of mesalazine.The Crohn＇s disease activity index（CDAI）,and contents of intestinal mucosa TNF-α,TNFR1,TNFR2 and apoptosis of intestinal epithelial cells were observed.Results The contents of TNF-α、TNFR1、TNFR2 and the apoptosis rates of intestinal epithelial cells in intestinal mucosa were all distinctively reduced（P0.01） in these two groups,but the effects on intestinal mucosa TNF-α,TNFR1 and the apoptosis rates of intestinal epithelial cells were better in the treatment group than in the control group（P0.05）.Conclusion Herbs-partitioned moxibustion combined with needling therapy can reduce the abnormal increase of TNF-alpha,TNFR1 and TNFR2 in intestinal mucosa to down-regulate or inhibit the intestinal epithelial cells apoptosis,and hence to protect intestinal epithelium barrier and decrease intestinal inflammatory reaction in CD.

关 键 词：克罗恩病 针灸疗法 隔药灸 肿瘤坏死因子 

分 类 号：R246[医药卫生—针灸推拿学]