电针不同穴位对腹泻型肠易激综合征大鼠不同肠道症状的比较性研究  

Comparative Study on Different Intestinal Symptoms of Diarrhea-predominant Irritable Bowel Syndrome Rats with Different Acupoints of Electroacupuncture

作　　者：覃颖 秦丽娜 任晓暄[2] 朱文莲[2] 王一凡 Qin Ying;Qin Lina;Ren Xiaoxuan;Zhu Wenlian;Wang Yifan(Third Affiliated Hospital of Beijing University of the Chinese Medicine,Beijing 100000,China)

机构地区：[1]北京中医药大学第三附属医院,北京100000 [2]北京中医药大学,北京100029

出　　处：《中国中医急症》2023年第12期2086-2089,2106,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家重点研发计划(2022YFC2503902);中医药服务覆盖专项“中医特色康复体系建设项目”;北京中医药大学第三附属医院教育部工程研究中心培育项目(BZYSY-2022-GCYJZXQX-03);北京中医药大学新教师启动基金项目(2023-JYB-XJSJJ058);北京中医药大学校级课题(2019-2XF2JJ-095)。

摘　　要：目的观察电针合谷、天枢穴对腹泻型肠易激综合征(IBS-D)大鼠肠道痛敏和动力异常的影响,观察其疗效差异并探讨相关机制。方法新生Wistar大鼠随机分为正常组、模型组、合谷组和天枢组,每组10只。采用母婴分离、醋酸灌肠和结直肠扩张(CRD)联合制备IBS-D模型。第9周时,两穴位组分别对双侧合谷、天枢穴进行电针干预,隔日1次,每次20 min,共5次。通过Bristol便型分类法及腹部回撤反射法(AWR)进行肠道动力与敏感性的评估;通过免疫组化法检测结肠内肌层ICC特异性标志物C-kit与黏膜层5-HT3A受体的阳性表达。结果与正常组比较,模型组Bristol评分明显上升(P<0.01),潜伏期明显缩短、收缩波个数明显增多(P<0.01),肌层C-kit和结肠黏膜层5-HT3A受体的阳性表达均明显升高(P<0.01),说明IBS-D模型制备成功;与模型组比较,两穴位组的Bristol评分明显降低(P<0.01),且潜伏期明显增长、收缩波个数减少(P<0.01),肌层C-kit和结肠黏膜层5-HT3A受体表达明显降低(P<0.01);与合谷组比较,天枢组的大便评分明显降低(P<0.01),肌层C-kit表达降低(P<0.05),两组黏膜层5-HT3A受体的阳性表达无明显变化。结论电针合谷、天枢能有效调节IBS模型大鼠肠道痛敏和动力异常,两者对肠道痛敏症状的改善均有明显效果,电针天枢对IBS-D模型大鼠肠道痛敏和动力异常的调节作用明显优于合谷。Objective:To compare and observe the effects of electroacupuncture at the acupoints"Hegu"(LI4)and"Tianshu"(ST25)on intestinal hypersensitivity and motility abnormalities in rats with diarrhea-predominant ir⁃ritable bowel syndrome(IBS-D),and to explore the differences in therapeutic efficacy and related mechanisms.Methods:Newborn Wistar rats were randomly divided into normal group,model group,LI4 group,and ST25 group,with 10 rats in each group.The IBS-D model was established by maternal separation,acetic acid enema,and colorectal distension(CRD).In the 9th week,the LI4 and ST25 groups received electroacupuncture interven⁃tion at the bilateral acupoints LI4 and ST25,once every other day for 20 minutes each time,for a total of 5 times.Intestinal motility and sensitivity were evaluated using the Bristol stool form scale and the abdominal withdrawal reflex(AWR)method.Immunohistochemistry was used to detect the positive expression of specific markers C-kit in the colonic muscular layer and 5-HT3A receptor in the mucosal layer.Results:Compared with the normal group,the Bristol score of the model group significantly increased(P<0.01),the latency period significantly short⁃ened,and the number of contraction waves significantly increased(P<0.01).The positive expression of C-kit in the muscle layer and 5-HT3A receptors in the colonic mucosal layer were significantly elevated(P<0.01),indicat⁃ing successful preparation of the IBS-D model.Compared with the model group,the Bristol scores in the two acu⁃puncture groups significantly decreased(P<0.01),and the latency period significantly increased while the number of contraction waves decreased(P<0.01).The expression of C-kit in the muscle layer and 5-HT3A receptors in the colonic mucosal layer were significantly reduced(P<0.01).Compared with the LI4 group,the ST25 group showed a significant decrease in fecal score(P<0.01),a decrease in C-kit expression in the muscle layer(P<0.05),and there was no significant changes in the positive expression of 5-HT3A receptors in the

关 键 词：腹泻型肠易激综合征 肠道痛敏 肠道动力异常 5-羟色胺3A受体 Cajal间质细胞1 大鼠 

分 类 号：R285.5[医药卫生—中药学]