“以俞调枢”法对Cajal间质细胞缺失模型大鼠胃肠动力学主要指标的影响
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摘要
目的观察"以俞调枢"法干预对Cajal间质细胞(ICC)缺失模型大鼠主要胃肠动力学主要指标的影响,探索其改善胃肠动力的可能作用机制。方法 2016年1—12月,将120只清洁级SD大鼠随机分为造模组60只和空白组60只。造模组再随机分为模型对照亚组30只和模型治疗亚组30只,空白组再随机分为空白对照亚组30只和空白治疗亚组30只。造模组经腹腔隔天注射抗c-Kit单克隆抗体(ACK2)100μg制备ICC缺失模型;空白组经腹腔隔天注射等量0.9%氯化钠溶液,共5次。空白治疗亚组、模型治疗亚组每日固定22 min,并实施背俞指针治疗;空白对照亚组、模型对照亚组每日固定22 min,不实施背俞指针治疗,疗程均为14 d。观察并比较4组大鼠胃内残留率、小肠推进率、胃动素、胃泌素、血管活性肠肽和生长抑素。结果模型对照亚组胃内残留率高于空白对照亚组、模型治疗亚组,小肠推进率低于空白对照亚组、模型对照亚组(P<0.01)。模型对照亚组大鼠胃动素、胃泌素低于空白对照亚组、模型治疗亚组(P<0.01)。模型对照亚组血管活性肠肽、生长抑素高于空白对照亚组、模型治疗亚组(P<0.01)。空白对照亚组、空白治疗亚组胃内残留率、小肠推进率、胃动素、胃泌素、血管活性肠肽和生长抑素与模型治疗亚组比较,差异无统计学意义(P>0.05)。结论 "以俞调枢"法能够显著提高ICC缺失模型大鼠的胃肠动力,其机制可能与通过调节其体内胃肠激素(胃动素、胃泌素、血管活性肠肽、生长抑素)变化有关。
Objective To investigate the effect and possible mechanism of Yishutiaoshu therapy(improving the gastrointestinal motility via pressing the shu acupoints by fingers) on the major gastrointestinal motility parameters in a rat model of interstitial cells of Cajal(ICC) loss. Methods We conducted this study from January to December 2016. 120 SD cleanliness grade rats were randomly divided into the model group and blank group with 60 in each, then the 60 model rats were randomly and equally divided into the model control subgroup and model treatment subgroup, and 60 blank rats were randomly and equally divided into the blank control subgroup and blank treatment subgroup. The rats in the model group were injected monoclonal anti-c-kit antibody(ACK2) every other day for preparing the rat model of ICC loss and those in the blank group were injected the same amount of 0.9% sodium chloride solution every other day, all of them were injected 5 times. Then, both the blank treatment subgroup and model treatment subgroup were fixed and treated with yishutiaoshu therapy for 22 min once daily, but other two subgroups were only fixed for 22 min once daily, and all of them were intervened for 14 days. We observed and compared the incidence of gastric residue, small intestinal motility rate, levels of motilin, gastrin, vasoactive intestinal peptide and somatostatin between the 4 subgroups. Results Compared with both the blank control subgroup and model treatment subgroup, model control subgroup demonstrated higher incidence of gastric residues and higher mean vasoactive peptide and plasma somatostatin levels(P<0.01), but lower small intestinal motility rate, lower mean motilin and gastrin levels(P<0.01). There were no significant differences in the incidence of gastric residue, small intestinal motility rate, levels of motilin, gastrin,vasoactive intestinal peptide and somatostatin between the blank control subgroup, blank treatment subgroup and model treatment subgroup(P>0.05). Conclusion Yishutiaoshu therapy can significantly improve the gastrointestinal motility in the rat model of ICC loss, indicating that the therapy may play a role in regulating the gastrointestinal hormones(motilin, gastrin, vasoactive peptide and somatostatin).
Objective To investigate the effect and possible mechanism of Yishutiaoshu therapy(improving the gastrointestinal motility via pressing the shu acupoints by fingers) on the major gastrointestinal motility parameters in a rat model of interstitial cells of Cajal(ICC) loss. Methods We conducted this study from January to December 2016. 120 SD cleanliness grade rats were randomly divided into the model group and blank group with 60 in each, then the 60 model rats were randomly and equally divided into the model control subgroup and model treatment subgroup, and 60 blank rats were randomly and equally divided into the blank control subgroup and blank treatment subgroup. The rats in the model group were injected monoclonal anti-c-kit antibody(ACK2) every other day for preparing the rat model of ICC loss and those in the blank group were injected the same amount of 0.9% sodium chloride solution every other day, all of them were injected 5 times. Then, both the blank treatment subgroup and model treatment subgroup were fixed and treated with yishutiaoshu therapy for 22 min once daily, but other two subgroups were only fixed for 22 min once daily, and all of them were intervened for 14 days. We observed and compared the incidence of gastric residue, small intestinal motility rate, levels of motilin, gastrin, vasoactive intestinal peptide and somatostatin between the 4 subgroups. Results Compared with both the blank control subgroup and model treatment subgroup, model control subgroup demonstrated higher incidence of gastric residues and higher mean vasoactive peptide and plasma somatostatin levels(P<0.01), but lower small intestinal motility rate, lower mean motilin and gastrin levels(P<0.01). There were no significant differences in the incidence of gastric residue, small intestinal motility rate, levels of motilin, gastrin,vasoactive intestinal peptide and somatostatin between the blank control subgroup, blank treatment subgroup and model treatment subgroup(P>0.05). Conclusion Yishutiaoshu therapy can significantly improve the gastrointestinal motility in the rat model of ICC loss, indicating that the therapy may play a role in regulating the gastrointestinal hormones(motilin, gastrin, vasoactive peptide and somatostatin).
引文
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[5]谢胜,冯金娟.药穴指针疗法治疗出口梗阻型便秘103例临床观察[J].江苏中医药,2010,42(10):58-60.DOI:10.3969/j.issn.1672-397X.2010.10.039.XIE S,FENG J J.Clinical observation of acupuncture point needle therapy for the treatment of 103 cases of outlet obstruction constipation[J].Jiangsu Journal of Traditional Chinese Medicine,2010,42(10):58-60.DOI:10.3969/j.issn.1672-397X.2010.10.039.
[6]JANSSEN P,VAN OUDENHOVE L,BISSCHOPS R,et al.Idiopathic gastroparesis or functional dyspepsia with delayed gastric mptying:where is the difference?[J].Gastroenterology,2011,140(7):2145-2146.DOI:10.1053/j.gastro.2011.02.078.
[7]林文注.实验针灸学实验指导[M].上海:上海中医学院出版社,1989:74-88.LIN W Z.Experimental guidance of experimental acupuncture[M].Shanghai:Shanghai University of Traditional Chinese Medicine Press,1989:74-88.
[8]华兴邦,周浩良.大鼠穴位图谱的研制[J].实验动物与动物实验,1991(1):1-5.
[9]彭丽华.胃肠动力障碍性疾病检测技术的应用与进展[J].解放军医学院学报,2015,36(3):201-203,207.DOI:10.3969/j.issn.2095-5227.2015.03.001.PENG L H.Application and advances in detection technology for gastrointestinal motility disorders[J].Academic Journal of Chinese PLA Medical School,2015,36(3):201-203,207.DOI:10.3969/j.issn.2095-5227.2015.03.001.
[10]HALDER S L,IOCKE G R 3rd,SCHLECK C D,et al.Natural history of functional gastrointestinal disorders:a 12-year longitudinal population based study[J].Gastroenterology,2007,133(3):799-807.DOI:10.1053/j.gastro.2007.06.010.
[11]GERSHON M D,TACK J.The serotonin signaling system:from basicunderstanding to drug development for functional GI disorders[J].Gastroenterology,2007,132(1):397-414.DOI:10.1053/j.gastro.2006.11.002.
[12]李小雯,郑松柏.促胃肠动力药物安全性研究现状[J].中国新药与临床杂志,2015,34(9):657-661.DOI:10.14109/j.cnki.xyylc.2015.09.003.LI X W,ZHENG S B.Current indication of safety of prokinetic agents[J].Chinese Journal of New Drugs and Clinical Remedies,2015,34(9):657-661.DOI:10.14109/j.cnki.xyylc.2015.09.003.
[13]王朝辉,韩东岳,郄丽丽,等.合募配穴和俞募配穴协同效应的理论研究[J].时珍国医国药,2014,25(7):1690-1692.WANG Z H,HAN D Y,YU L L,et al.The theoretical synergistic effect research of Xia He-Mu points and Back Shu-Mu points[J].Lishizhen Medicine and Materia Medica Research,2014,25(7):1690-1692.
[14]郑华斌,陈媛,陈骥,等.运用数据挖掘研究现代针灸治疗肠易激综合征的用穴规律[J].时珍国医国药,2013,24(3):701-702.DOI:10.3969/j.issn.1008-0805.2013.03.084.ZHENG H B,CHEN Y,CHEN J,et al.Use data mining to study the use of modern acupuncture in treating irritable bowel syndrome[J].Lishizhen Medicine and Materia Medica Research,2013,24(3):701-702.DOI:10.3969/j.issn.1008-0805.2013.03.084.
[15]范婷,李守然,张根腾.中医气机升降理论在脾胃病中的应用[J].世界中西医结合杂志,2013,8(5):512-514.DOI:10.3969/j.issn.1673-6613.2013.05.026.FAN T,LI S R,ZHANG G T.Application of the theory of qi and lift in the spleen and stomach[J].World Journal of Integrated Traditional and Western Medicine,2013,8(5):512-514.DOI:10.3969/j.issn.1673-6613.2013.05.026.
[16]郑芝田.胃肠病学[M].3版.北京:人民卫生出版社,2000:730-734.ZHENG Z T.Gastroenterology[M].3rd th.Beijing:People's Health Publishing House,2000:730-734.
[17]祝沛沛,彭雷,范才波,等.生长抑素对肝硬化食管胃底静脉曲张破裂出血患者胃肠激素及血流动力学的影响[J].疑难病杂志,2017,16(6):579-583.DOI:10.3969/j.issn.1671-6450.2017.06.010.ZHU P P,PENG L,FAN C B,et al.Gastrointestinal hormones and hemodynamic effect of somatostatin in cirrhotic patients with esophageal and gastric variceal bleeding[J].Chinese Journal of Difficult and Complicated Cases,2017,16(6):579-583.DOI:10.3969/j.issn.1671-6450.2017.06.010.
[18]丛培玮,尚冰,王艳杰,等.脾气虚和脾阳虚模型大鼠脑肠肽与下丘脑葡萄糖转运体1及葡萄糖转运体3表达水平变化的实验研究[J].中国全科医学,2016,19(18):2201-2205.DOI:10.3969/j.issn.1007-9572.2016.18.018.CONG P W,SHANG B,WANG Y J,et al.Change of expression levels of glucose transporter-1 and glucose transporter-3 in hypothalamus and brain-gut peptide of spleen-qi deficiency rats and spleen-yang deficiency rats[J].Chinese General Practice,2016,19(18):2201-2205.DOI:10.3969/j.issn.1007-9572.2016.18.018.
[19]胡建英.胃肠动力障碍性疾病发病机制及其药物研究概况[J].海峡药学,2008,20(11):110-111.DOI:10.3969/j.issn.1006-3765.2008.11.065.HU J Y.The pathogenesis of gastrointestinal dysplasia and its drug research[J].Strait Pharmaceutical Journal,2008,20(11):110-111.DOI:10.3969/j.issn.1006-3765.2008.11.065.
[20]JONSSON B H,HELLSTROM P M.Motilin and neuropeptide Ylike immunoreactivity in a psychophysiological stress experiment on patients with functional dyspepsia[J].Integr Physiol Behav Sci,2000,35(4):256-265.
[21]张林.SCL转基因联合SCF促Cajal间质细胞恢复的在体实验研究[D].重庆:第三军医大学,2007.ZHANG L.Estalishment of murine interstitial cells of Cajal loss model and study on SCF promoting its restoration[D].Chongqing:The Third Military Medical University,2007.
[22]贾后军.小鼠小肠Cajal间质细胞缺失模型的建立及SCF促其恢复研究[D].重庆:第三军医大学,2005.JIA H J.Effects of adenovirus-mediated stem cell leukemia gene transfer and administration of stem cell factor on restoration of interstitial cells of Cajal in vivo[D].Chongqing:The Third Military Medical University,2005.
[2]颜春艳,谢胜,税典奎,等.药穴指针疗法治疗胃食管反流病患者食管下括约肌压力的变化[J].中国中西医结合消化杂志,2009,17(2):122,125.DOI:10.3969/j.issn.1671-038X.2009.02.017.YAN C Y,XIE S,SHUI D K,et al.The under esophageal sphincter pressure changes treated by medicine acupuncture point needle therapy in the treatment of gastroesophageal reflux disease[J].Chinese Journal of Intergrated Traditional and Western Medicine on Digestion,2009,17(2):122,125.DOI:10.3969/j.issn.1671-038X.2009.02.017.
[3]张志杰,谢胜,杨文革,等.药穴指针疗法治疗功能性消化不良52例[J].四川中医,2011,29(9):116-117.ZHANG Z J,XIE S,YANG W G,et al.Acupuncture point needle therapy was used to treat 52 cases of functional dyspepsia[J].Journal of Sichuan Traditional Chinese Medicine,2011,29(9):116-117.
[4]谢胜,周晓玲,韦金秀,等.背俞指针疗法治疗小儿功能性腹痛临床观察[J].辽宁中医药大学学报,2013,15(9):20-21.DOI:10.13194/j.issn.1673-842x.2013.09.029.XIE S,ZHOU X L,WEI J X,et al.Back Shu Needle Therapy in treatment of children with functional abdominal pain[J].Journal of Liaoning University of Traditional Chinese Medicine,2013,15(9):20-21.DOI:10.13194/j.issn.1673-842x.2013.09.029.
[5]谢胜,冯金娟.药穴指针疗法治疗出口梗阻型便秘103例临床观察[J].江苏中医药,2010,42(10):58-60.DOI:10.3969/j.issn.1672-397X.2010.10.039.XIE S,FENG J J.Clinical observation of acupuncture point needle therapy for the treatment of 103 cases of outlet obstruction constipation[J].Jiangsu Journal of Traditional Chinese Medicine,2010,42(10):58-60.DOI:10.3969/j.issn.1672-397X.2010.10.039.
[6]JANSSEN P,VAN OUDENHOVE L,BISSCHOPS R,et al.Idiopathic gastroparesis or functional dyspepsia with delayed gastric mptying:where is the difference?[J].Gastroenterology,2011,140(7):2145-2146.DOI:10.1053/j.gastro.2011.02.078.
[7]林文注.实验针灸学实验指导[M].上海:上海中医学院出版社,1989:74-88.LIN W Z.Experimental guidance of experimental acupuncture[M].Shanghai:Shanghai University of Traditional Chinese Medicine Press,1989:74-88.
[8]华兴邦,周浩良.大鼠穴位图谱的研制[J].实验动物与动物实验,1991(1):1-5.
[9]彭丽华.胃肠动力障碍性疾病检测技术的应用与进展[J].解放军医学院学报,2015,36(3):201-203,207.DOI:10.3969/j.issn.2095-5227.2015.03.001.PENG L H.Application and advances in detection technology for gastrointestinal motility disorders[J].Academic Journal of Chinese PLA Medical School,2015,36(3):201-203,207.DOI:10.3969/j.issn.2095-5227.2015.03.001.
[10]HALDER S L,IOCKE G R 3rd,SCHLECK C D,et al.Natural history of functional gastrointestinal disorders:a 12-year longitudinal population based study[J].Gastroenterology,2007,133(3):799-807.DOI:10.1053/j.gastro.2007.06.010.
[11]GERSHON M D,TACK J.The serotonin signaling system:from basicunderstanding to drug development for functional GI disorders[J].Gastroenterology,2007,132(1):397-414.DOI:10.1053/j.gastro.2006.11.002.
[12]李小雯,郑松柏.促胃肠动力药物安全性研究现状[J].中国新药与临床杂志,2015,34(9):657-661.DOI:10.14109/j.cnki.xyylc.2015.09.003.LI X W,ZHENG S B.Current indication of safety of prokinetic agents[J].Chinese Journal of New Drugs and Clinical Remedies,2015,34(9):657-661.DOI:10.14109/j.cnki.xyylc.2015.09.003.
[13]王朝辉,韩东岳,郄丽丽,等.合募配穴和俞募配穴协同效应的理论研究[J].时珍国医国药,2014,25(7):1690-1692.WANG Z H,HAN D Y,YU L L,et al.The theoretical synergistic effect research of Xia He-Mu points and Back Shu-Mu points[J].Lishizhen Medicine and Materia Medica Research,2014,25(7):1690-1692.
[14]郑华斌,陈媛,陈骥,等.运用数据挖掘研究现代针灸治疗肠易激综合征的用穴规律[J].时珍国医国药,2013,24(3):701-702.DOI:10.3969/j.issn.1008-0805.2013.03.084.ZHENG H B,CHEN Y,CHEN J,et al.Use data mining to study the use of modern acupuncture in treating irritable bowel syndrome[J].Lishizhen Medicine and Materia Medica Research,2013,24(3):701-702.DOI:10.3969/j.issn.1008-0805.2013.03.084.
[15]范婷,李守然,张根腾.中医气机升降理论在脾胃病中的应用[J].世界中西医结合杂志,2013,8(5):512-514.DOI:10.3969/j.issn.1673-6613.2013.05.026.FAN T,LI S R,ZHANG G T.Application of the theory of qi and lift in the spleen and stomach[J].World Journal of Integrated Traditional and Western Medicine,2013,8(5):512-514.DOI:10.3969/j.issn.1673-6613.2013.05.026.
[16]郑芝田.胃肠病学[M].3版.北京:人民卫生出版社,2000:730-734.ZHENG Z T.Gastroenterology[M].3rd th.Beijing:People's Health Publishing House,2000:730-734.
[17]祝沛沛,彭雷,范才波,等.生长抑素对肝硬化食管胃底静脉曲张破裂出血患者胃肠激素及血流动力学的影响[J].疑难病杂志,2017,16(6):579-583.DOI:10.3969/j.issn.1671-6450.2017.06.010.ZHU P P,PENG L,FAN C B,et al.Gastrointestinal hormones and hemodynamic effect of somatostatin in cirrhotic patients with esophageal and gastric variceal bleeding[J].Chinese Journal of Difficult and Complicated Cases,2017,16(6):579-583.DOI:10.3969/j.issn.1671-6450.2017.06.010.
[18]丛培玮,尚冰,王艳杰,等.脾气虚和脾阳虚模型大鼠脑肠肽与下丘脑葡萄糖转运体1及葡萄糖转运体3表达水平变化的实验研究[J].中国全科医学,2016,19(18):2201-2205.DOI:10.3969/j.issn.1007-9572.2016.18.018.CONG P W,SHANG B,WANG Y J,et al.Change of expression levels of glucose transporter-1 and glucose transporter-3 in hypothalamus and brain-gut peptide of spleen-qi deficiency rats and spleen-yang deficiency rats[J].Chinese General Practice,2016,19(18):2201-2205.DOI:10.3969/j.issn.1007-9572.2016.18.018.
[19]胡建英.胃肠动力障碍性疾病发病机制及其药物研究概况[J].海峡药学,2008,20(11):110-111.DOI:10.3969/j.issn.1006-3765.2008.11.065.HU J Y.The pathogenesis of gastrointestinal dysplasia and its drug research[J].Strait Pharmaceutical Journal,2008,20(11):110-111.DOI:10.3969/j.issn.1006-3765.2008.11.065.
[20]JONSSON B H,HELLSTROM P M.Motilin and neuropeptide Ylike immunoreactivity in a psychophysiological stress experiment on patients with functional dyspepsia[J].Integr Physiol Behav Sci,2000,35(4):256-265.
[21]张林.SCL转基因联合SCF促Cajal间质细胞恢复的在体实验研究[D].重庆:第三军医大学,2007.ZHANG L.Estalishment of murine interstitial cells of Cajal loss model and study on SCF promoting its restoration[D].Chongqing:The Third Military Medical University,2007.
[22]贾后军.小鼠小肠Cajal间质细胞缺失模型的建立及SCF促其恢复研究[D].重庆:第三军医大学,2005.JIA H J.Effects of adenovirus-mediated stem cell leukemia gene transfer and administration of stem cell factor on restoration of interstitial cells of Cajal in vivo[D].Chongqing:The Third Military Medical University,2005.
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