电针足三里、合谷穴对IBS模型大鼠肠道痛敏及动力异常治疗效应的比较研究  

Comparing effects of ST36 and LI14 on intestinal pain sensitivity and abnormal motility in IBS rat

作　　者：吴艳英[1] 任晓暄[1] 郭孟玮[1] 谭莉华[1] 李凯歌[1] 蓝莹[1] 王珊[1] 吉毛先 张红林[1] WU Yanying REN Xiaoxuan GUO Mengwei TAN Lihua LI Kaige LAN Ying WANG Shan JI Maoxian ZHANG Honglin(Beijing University of Chinese Medicine, Beijing, 100029, China)

机构地区：[1]北京中医药大学,北京100029

出　　处：《北京中医药大学学报》2017年第6期514-521,共8页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(No.81473776)~~

摘　　要：目的探讨不同经脉及不同神经节段支配的穴位对同一疾病不同症状的疗效差异及相关机制。方法新生Wistar大鼠随机分为空白组、模型组、足三里组和合谷组,每组10~12只。除空白组外,均采用母子分离加醋酸灌肠结合结直肠扩张(CRD)联合制备肠易激综合征(IBS)模型。造模成功者,2月龄时,足三里组、合谷组给予相应穴位电针刺激,20 min/次,隔日1次,共5次。观察各组大鼠电针前后的粪便性状,采用Bristol分型标准评分;腹部回撤反射(AWR)评价内脏痛觉敏感性;免疫组化法检测结肠辣椒素受体(TRPV1)、5-HT2AR的阳性表达。结果与空白组比较,针刺前,模型组、足三里组及合谷组大鼠的Bristol评分均显著升高(P<0.01);针刺后,模型组(P<0.01)、合谷组(P<0.05)大鼠的评分升高;模型组、足三里组腹抬压力阈值明显降低(P<0.01),收缩波明显增加(P<0.01),结肠TRPV1阳性表达均升高(P<0.01),合谷组结肠TRPV1表达增高(P<0.05)。模型组、合谷组结肠5-HT2AR阳性表达升高(P<0.01)。与模型组比较,足三里组及合谷组,针刺后Bristol大便评分降低(P<0.01);腹抬压力阈值升高(P<0.01)、收缩波个数减少(P<0.01);结肠TRPV1、5-HT2AR阳性表达均显著性降低(P<0.01)。与足三里组相比,合谷组针后Bristol评分升高(P<0.05),结肠TRPV1表达下降(P<0.01),5-HT2AR表达升高(P<0.01)。结论电针足三里穴和合谷穴均能降低IBS大鼠肠道痛敏感性,改善胃肠动力障碍。两穴比较,合谷穴对IBS内脏痛的治疗效应略优于足三里穴,而足三里穴对胃肠运动的调节效应更具优势。说明不同经脉、不同神经节段支配的穴位可以治疗同一病症,但存在效应差异,证实了经穴效应特异性存在且具有相对性。Objective To compare the effects and explore mechanism of acupoints on various meridians or nerve segments in treating different symptoms in one disease.Methods Neonatal Wistar rats were randomly divided into 4 groups： normal control group, model group, ST36 group, and LI14 group （n=10-12 in each group）.IBS model was established by administering acetic acid enema combining colorectal distension （CRD） test to rats in all groups except the normal control group.These rats were all isolated from their mothers.2-month old rats in the ST36 group and LI14 group received electro-acupuncture five times, once every two days for 20 minutes.Stool consistency was evaluated according to the Bristol Stool Form Scale （BSFS）, and visceral sensitivity was observed based on abdominal withdraw reflection （AWR）.Levels of TRPV1 and 5-HT2AR in rat colon tissues were measured with immunohistochemical method.Results Before electro-acupuncture stimulation, BSFS score of rats in all groups increased significantly （P〈0.01） compared with the normal control group;after electro-acupuncture, BSFS score of the model group （P〈0.01） and LI14 group （P〈0.05） were increased;threshold value of intestinal pressure of model group and ST36 group decreased （P〈0.01）, and the contraction waves increased significantly （P〈0.01）.Positive TRPV1 expression increased （P〈0.01）;and TRPV1 expression in LI14 group increased （P〈0.05）.The level of 5-HT2AR in the model group and LI14 group were raised markedly （P〈0.01）.Compared with the model group, BSFS score of the EA groups decreased significantly （P〈0.01）;threshold value of intestinal pressure increased （P〈0.01）;contraction wave decreased significantly （P〈0.01）, and the expression of TRPV1 and 5-HT2AR reduced significantly （P〈0.01）.Compared with the ST36 group, BSFS score of the LI14 group increased significantly （P〈0.05）;expression of TRPV1 reduced （P〈0.01）, and the level of 5-HT2AR increased significantly （P〈0

关 键 词：肠易激综合征 合谷穴 足三里穴 内脏痛 胃肠动力 经穴效应特异性 大鼠 

分 类 号：R245.97[医药卫生—针灸推拿学]