早期应激对SD大鼠内脏感觉和肠道炎症的影响
详细信息    本馆镜像全文|  推荐本文 |  |   获取CNKI官网全文
摘要
目的:1、探讨应激事件(包括早期应激与急性应激)对大鼠肠道炎症细胞浸润的影响;2、探讨早期应激与急性应激对大鼠内脏感觉的影响。
     方法:36只雄性新生SD幼鼠,分为正常对照组(CON,n=12)、母婴分离组(MS,n=12)、急性避水应激组(WA,n=12)。MS组幼鼠出生第2天开始进行母婴分离,持续至出生后第3周。WA组动物于出生后第60天接受避水实验。2月龄时各组大鼠接受直肠气囊扩张大鼠腹部回缩反射(AWR)评分和腹壁肌电测定;结束后取结肠组织作常规病理学检查和肥大细胞计数(甲苯胺蓝染色法)、并测定结肠黏膜孵育上清液白细胞介素-1β(IL-1β)和类胰蛋白酶水平(ELISA法)。
     结果:MS组结肠黏膜炎症评分(1.60±0.52)分别高于WA组(0.60±0.70)、CON组(0.50±0.53)(P均<0.05);MS组结肠黏膜肥大细胞数量(6.97±1.12,个/HPF)分别高于WA组(3.79±0.53,个/HPF)、CON组(3.76±0.61,个/HPF)(P均<0.05);MS组结肠粘膜组织孵育上清液IL-1β浓度(22.72±2.63pg/g)也分别高于WA组(13.96±1.34 pg/g)和CON组(13.94±1.71 pg/g)(P均<0.05);MS组上清液类胰蛋白酶浓度(2.99±0.37ng/g)分别高于WA组(1.66±0.27 ng/g)和CON组(1.66±0.33 ng/g)(P均<0.05)。当结肠内气囊压力为40、60、80 mmHg时, MS组和WA组的AWR评分和腹壁肌电幅值明显高于CON组(P均<0.05),而且与上述各项炎症指标存在正相关关系(P均<0.05)。
     结论:应激(包括早期、急性应激)可以诱导内脏感觉过敏,早期应激还可诱导肠道低度炎症,这种低度炎症与内脏感觉过敏相关。
AIM: To evaluate the role of stress(early-life stress and acute sterss) on intestinal mucosal inflammation and visceral sensitivity in rats.
     METHODS:Thirty-six newborn male Sprague-Dawley(SD) rats were randomly divided into control group(CON,n=12), maternal separation group(MS,n=12) and acute water avoidance group(WA,n=12). The newborn rats in MS were recepted maternal separation between 2~(nd) -21~(st) day postnatal . The rats in WA were recepted a water avoidance at the 60~(th) day. At the 2nd month, abdominal withdrawal reflex (AWR) and myoelectric amplitude (MA) of the oblique externus abdominis muscle were recorded respectively after colonic distention. The colonic tissue samples were collectted for histopathologic examinations and toluidine blue stain, and the contents of IL-1βand tryptase in colon tissue culture supernants were dected by ELISA.
     RESULT:The mean mucosal inflammation score in MS(1.60±0.52) was ,significantly higher than in WA(0.60±0.70,P=0.000) and in CON(0.50±0.53,P=0.000).The mast cell numbers in MS(6.97±1.12,cells/HPF) were significantly higher than that in WA(3.79±0.53,P=0.000) and in CON(3.76±0.61,P=0.000) respectively. The content of IL-1βin MS was 22.72±2.63pg/g,significantly higher than in WA (13.96±1.34 pg/g,P=0.001) and CON(13.94±1.71 pg/g,P=0.000). The content of tryptase in MS was 2.99±0.37ng/g,that's significantly higher than in WA(1.66±0.27 ng/g,P=0.000) and CON (1.66±0.33 ng/g,P=0.000).When the balloon pressure was up to 40, 60, 80mmHg respectively, the AWR score and MA in MS and WA were significantly higher than those in CON(all P < 0.05), and these indexes were positively correlated with the mucosal inflammation(P<0.05,respectively ).
     CONLUSIONS:The stress(including early-life stress and acute sterss) may activate the visceral sensitivity, and the arly-life stress may induce low grade mucosal inflammation in the colon which may activate the visceral sensitivity.
引文
[1] Elsenbruch S.Abdominal pain in Irritable Bowel Syndrome: a review of putative psychological,neural and neuro-immune mechanisms[J].Brain Behav Immune. 2011,25(3): 386-394.PMID: 21094682.
    [2]熊理守,陈曼湖,陈惠新,等.广东省社区人群肠易激综合征的流行病学研究.中华医学杂志,2004;84(4):278-281
    [3] Chapman S,Martin M.Attention to pain words in irritable bowel syndrome: increased orienting and speeded engagement[J].Br J Health Psychol.2011,16(1):47-60 .PMID: 21226783.
    [4] Keough ME,TimPano KR,Zawilinski LL,Schmidt NB.The association between irritable bowel syndrome and the anxiety vulnerability factors: body vigilance and discomfort intolerance[J].J Health Psychol.2011,16(1):91-98. PMID: 20631041.
    [5]Coutinho SV, Plotsky PM, Sabald M, Miller JC, Zhou H, Bayati AI, McRoberts JA, Mayer EA. Neonatal maternal separation alters stress-induced responses to viscerosomatic nociceptive stimuli in rat[J]. Am J Physiol Gastrointest Liver Physiol.2002;282(2): 307-316. PMID: 11804852.
    [6] O'Mahony SM;Hyland NP;Dinan TG;Cryan JF.Maternal separation as a model of brain-gut axis dysfunction[J].Psychopharmacology.2010,214(1):71-88. PMID: 20886335
    [7] SPiller R;Garsed K.Infection, inflammation, and the irritable bowel syndrome[J].Dig Liver Dis,2009,41(12):844-849. PMID: 19716778.
    [8] Park H.The pathophysiology of irritable bowel syndrome: inflammation and motor disorder[J].Korean J Gastroenterol,2006,47(2):101-110. PMID: 16498275.
    [9]王承党.重视粘膜炎症在肠易激综合征发病机制中的地位[J].胃肠病学, 2008, 13(9): 513-515
    [10] Cenac N,Andrews N,Holzhausen M,ChaPman K, CottrellG, Gordon P, Steiconoff M,BarbaraG,Beck P,Bunnett Nw,Sharkey KA,Ferraz JG,Shaffer E,Vergnolle N.Role for protease activityin visceral pain in irritable bowel syndrome[J].Clinvest.2007,117:636-647. PMID: 17304351.
    [11]Rijnierse A, Nijkamp FP, Kraneveld AD. Mast cells and nerves tickle in the tummy Implications for inflammatory bowel disease and irritable bowel syndrome. Phar Ther. 2007,116(2):207-235. PMID: 17719089.
    [12] La JH,Kim TW,Sung TS,Kim HJ,Kim JY,Yang IS.Role of mucosal mast cells in visceral hypersensitivity in a rat model of irritable bowel syndrome[J]. Vet Sci.2004;5(4):319-324.PMID: 15613185.
    [13]王承党,郭朝书.肥大细胞和类胰蛋白酶在腹泻型肠易激综合征升结肠黏膜中的表达及意义.世界华人消化杂志, 2010,18(16): 1682-1686
    [14]van den Wijngaard RM,Klooker TK,Welting O,Stanisor OI,Wouters MM,van der Coelen D,Bulmer DC,Peeters PJ,Aerssens J,de Hoogt R,Lee K,de Jonge WJ,Boeckxstaens GE. Essential role for TRPV1 in stress-induced (mast cell- dependent) colonic hypersensitivity in maternally separated rats[J].Neurogastroenterol Motil. 2009;21(10):10941107. PMID: 19523146
    [15]Al–Chaer, Motohiro Kawasaki, Pankaj J. Pasricha. A new model of chronic visceral hypersensitivity in adult rats induced by colon irritation during postnatal development[J]. Gastroenterology.2000;119(5):1276–1285. PMID: 11054385
    [16]王承党,郑雪雁,郑玮玮.结肠黏膜低度炎症对大鼠内脏感觉的影响.世界华人消化杂志,2009,17(16):1621-1625
    [17]赵香汝,王家鑫,崔平.肥大细胞用甲苯胺篮染色之体会.中国组织化学与细胞化学杂志,2000,9:359
    [18] Kruschewski M,Foitzik T,Perez-CantóA,Hübotter A,Buhr HJ.Changes of colonic mucosalmicrocirculation and histology in two colitismodels:an experim ental study using intravital microscopy and a new histological scoring system[J].Dig Dis Sci.2001; 46(11): 2336-2343. PMID: 11713932
    [19] Bravo JA,Dinan TG,Cryan JF. Alterations in the central CRF system of two different rat models of comorbid depression and functional gastrointestinal disorders[J]. Neuropsychopharmacology.2011;14(5):666-683. PMID: 20860876.
    [20]Mayer EA,Naliboff BD,Chang L,Coutinho SV. V.Stress and irritable bowel syndrome [J].Am J Physiol Gastrointest Liver Physiol,2001;280(4);519-524. PMID: 11254476
    [21] Mayer EA,Berman S,Derbyshire SW,Suyenobu B,Chang L,Fitzgerald L,Mandelkern M,Hamm L,Vogt B,Naliboff BD.The effect of the 5-HT3 receptor antagonist, alosetron, on brain responses to visceral stimulation in irritable bowel syndrome patients[J].Aliment Pharmacol Ther.2002;16(7):1357-1366. PMID: 12144587
    [22] Dickhaus B;Mayer EA;Firooz N;Stains J;Conde F;Olivas TI;Fass R;Chang L;Mayer M;Naliboff BD.Irritable bowel syndrome patients show econanced modulation of visceral perception by auditory stress[J].Am J Gastroenterol.2003;98(1):135-143. PMID: 12526949
    [23] Ronan PJ,Summers CH.Molecular signaling and translational significance of thecorticotropin releasing factor system[J].Prog Mol Biol Transl Sci.2011;98:235-292. PMID: 21199774.
    [24] O'Malley D,Dinan TG,Cryan JF.Alterations in colonic corticotropin-releasing factor receptors in the maternally separated rat model of irritable bowel syndrome: differential effects of acute psychological and physical stressors[J].Peptides,2010,31(4):662-670. PMID: 20096320
    [25] Tjong YW,IP SP,Lao L,Wu J;Fong HH,Sung JJ;Berman B,Che CT.Neonatal maternal separation elevates thalamic corticotrophin releasing factor type 1 receptor expression response to colonic distension in rat[J].Neuro Endocrinol Lett. 2010,31(2): 215-220. PMID: 20424584
    [26]任天华,胡品津,胡志远,沈祖尧.新生期母婴分离对大鼠成年后结直肠扩张后5-羟色胺表达的影响[J].中山大学学报(医学科学版),2004,25(3):234-236
    [27] Monnikes H,Tebbe JJ,Hildebrandt M,Arck P,Osmanoglou E,;Rose M,KlaPP B,Wiedenmann B,Heymann-Monnikes I.Role of stress in functional gastrointestinal disorders. Evidence for stress-induced alterations in gastrointestinal motility and sensitivity[J].Dig Dis, 2001,19(3):201-211. PMID: 11752838.
    [28] Lowry CA.Functional subsets of serotonergic neurones: implications for control of the hypothalamic-pituitary-adrenal axis[J]. Neuroendocrinol.2002,14(11):911-923. PMID: 12421345.
    [29]迟雁,刘新光,李江.5-羟色胺4受体在调节应激大鼠内脏敏感性中的作用[J].中华消化杂志,2004,24(9):21-24
    [30] Berman SM,Chang L,Suyenobu B,Derbyshire SW,Stains J,Fitzgerald L,Mandelkern M;Hamm L,Vogt B,Naliboff BD,Mayer EA.Condition-specific deactivation of brain regions by 5-HT3 receptor antagonist Alosetron[J].Gastroenterology.2002;123(4):969-977. PMID: 12360456.
    [31] Valentino RJ,Miselis RR,Pavcovich LA.Pontine regulation of pelvic viscera: Pharmacological target for pelvic visceral dysfunctions[J].Trends Pharmacol Sci.1999;20:253- 260. PMID: 10366869
    [32] Mayer EA.The neurobiology of stress and gastrointestinal disease[J].Gut.2000; 47(6): 861-869. PMID: 11076888
    [33]Crowell MD.The role of serotonin in the pathophysiology of irritable bowel syndrome[J].Am J Manag Care.2001;7(8):252-260. PMID: 11474910.
    [34]Chadwick VS,Chen W,Shu D,Paulus B,Bethwaite P,Tie A,Wilson I.Activation of themucosal immune system in irritable bowel syndrome[J].Gastroenterology 2002; 122(7): 1778-1783. PMID: 12055584
    [35]Holme’N N,Isaksson S,Simren′N M,Sjovall H,Ohman L.CD4+CD25+ regulatory T cells in irritable bowel syndrome patients[J]. Neurogastroenterol Motil .2007; 19(2):119–125. PMID: 17244166
    [36] Ohman L,Isaksson S,Lundgren A, Simrén M,Sj?vall H.A controlled study of colonic immune activity and beta7+ blood T lymphocytes in Patients with irritable bowel syndrome[J].J Clin Gastroenterol Hepatol.2005;3(10):980-986. PMID: 16230443
    [37] Park CH, Joo YE,Choi SK,Rew JS,Kim S. J,Lee MC.Activated mast cells infiltrate in close proximity to enteric nerves in diarrheapredominant irritable bowel syndrome[J]. Korean Med Sci,2003,18(2):204?210. PMID: 12691427
    [38] Barbara G.,Stanghellini V,De Giorgio R,Cremon C,Cottrell G. S, Santini D, Pasquinelli G, Morselli-Labate AM, Grady EF, Bunnett NW, Collins SM, Corinaldesi R.Activated mast cells in proximity to colonic nerves correlate with abdominal pain in irritable bowel syndrome[J]. Gastroenterology.2004,126(3), 693?702. PMID: 14988823
    [39] Barbara G.,Wang B,Stanghellini V, de Giorgio R,Cremon C,Di Nardo G., Trevisani M, Campi B, Geppetti P, Tonini M, Bunnett NW, Grundy D, Corinaldesi R..Mast cell-dependent excitation of visceralnociceptive sensory neurons in irritable bowel syndrome[J]. Gastroenterology.2007;132(1):26?37. PMID: 17241587.
    [40] John Macsharry,Liam O’Mahony,Aine Fanning,Emer Bairead, Sherlock G, Tiesman J, Fulmer A, Kiely B, Dinan TG, Shanahan F, Quigley EM.Mucosal cytokine imbalance in irritable bowel syndrome[J]. Scandinavian Journal of Gastroenterology. 2008; 43(12): 1467-1476. PMID: 18752146.
    [41]Wallon C,Yang PC,Keita AV,Ericson AC,McKay DM,Sherman PM,Perdue MH,Soderholm JD.Corticotropin-releasing hormone (CRH) regulates macromolecular permeability via mast cells in normal human colonic biopsies in vitro[J].Gut. 2008;57(1):50-58. PMID: 17525093
    [42]郭朝书,王承党.肥大细胞及类胰蛋白酶在肠易激综合征内脏敏感性中的作用[J].国际消化病杂志.2010;1(30):4-5
    [43]Cenac N, Garcia-Villar R,Ferrier L,Larauche M,Vergnolle N,Bunnett NW,Coelho AM,Fioramonti J,Bueno L.Proteinase-activated receptor-2-inducedcolonic inflammation in mice: possible involvementof afferent neurons, nitric oxide, and paracellularpermeability[J]. Immunol.2003; 170(8): 4296-4300. PMID: 12682265
    [44] Gwee KA,Collins SM,Read NW,Rajnakova A,Deng Y,Graham JC,McKendrickMW,Moochhala SM.Increased rectal mucosal expression of interleukin-1βin recently acquired post-infectious irritable bowel syndrome[J].Gut.2003;52(4):523–526. PMID: 12631663
    
    [1] Elsenbruch S.Abdominal pain in Irritable Bowel Syndrome: a review of putative psychological, neural and neuro-immune mechanisms[J].Brain Behav Immune. 2011;25(3):386-394. PMID: 21094682.
    [2] Chapman S,Martin M.Attention to pain words in irritable bowel syndrome: increased orienting and speeded engagement[J].Br J Health Psychol. 2011;16(1): 47-60 .PMID: 21226783.
    [3] Keough ME,Timpano KR,Zawilinski LL,Schmidt NB.The association between irritable bowel syndrome and the anxiety vulnerability factors: body vigilance and discomfort intolerance[J].Health Psychol. 2011;16(1):91-98. PMID: 20631041.
    [4] Quera R,Valenzuela J.Visceral hypersensitivity: a concept within our reach[J]. Rev Med Chil. 2003;131(1):85-92. PMID: 12643225.
    [5] Quigley EM. Current concepts of the irritable bowel syndrome[J]. Scand J Gastroenterol Suppl. 2003;237:1-8. PMID: 12797672
    [6] Bouin M,Plourde V,Boivin M, Riberdy M, Lupien F, Laganière M, Verrier P, Poitras P..Rectal distention testing in patients with irritable bowel syndrome: sensitivity,specificity,and predictive values of pain sensory thresholds[J]. Gastroenterology.2002;122(7):1771-1777. PMID: 12055583
    [7] Dunphy RC,Bridgewater L,Price DD,Robinson ME,Zeilman CJ 3rd,Verne GN. Visceral and cutaneous hypersensitivity in Persian Gulf war veterans with chronic gastrointestinal symptoms[J]. Pain. 2003;102(1-2):79-85. PMID: 12630599
    [8] Gupta V,Sheffield D,Verne GN. Evidence for autonomic dysregulation in the irritable bowel syndrome[J]. Dig Dis Sci. 2002; 47(8):1716-1722. PMID: 12184520
    [9] Sands BE,Tremaine WJ,Sandbom WJ, Rutgeerts PJ, Hanauer SB, Mayer L, Targan SR, Podolsky DK.Infliximab in thetreatment of severe steroid refractory ulcerative colitis:a pilot study[J].Inflammatory Bowel Disease. 2001;7(2):83-88. PMID: 11383595
    [10] Drewes AM,Petersen P,Rossel P,Gao C,Hansen JB,Arendt-Nieson L.Sensitivity and distensibility of the rectum and sigmoid colon in patients with irritable bowel syndrome[J].Scand J Gastroentrol. 2001,36(8):27-32. PMID: 11495078
    [11] Al–Chaer, Motohiro Kawasaki, Pankaj J. Pasricha. A new model of chronic visceral hypersensitivity in adult rats induced by colon irritation during postnatal development[J]. Gastroenterology.2000;119(5):1276–1285. PMID: 11054385
    [12] Cui K M,Li W M,Gao X,Chuang K,Chuang JM,Wu GC.Electro-acupuncture relieves chronic visceral hyperalgesia in rats[J].Neuroscience Letters. 2005; 376(1): 20-23. PMID: 15694267
    [13]刘雁冰,袁耀宗,陶然君.肥大细胞在应激所致大鼠直肠高敏感性中的作用[J].中华胃肠杂志.2003,23(12):727-730.
    [14] Hinde RA,McGinnis L. Some factors influencing the effects of temporary mother-infant separation: some experiments with rhesus monkeys[J]. Psychol Med . 1977;7(2): 197–212. PMID: 406620
    [15] Jurcovicova J,Dobrakovova M. Repeated maternal deprivation alters behavioral pattern and attenuates prolactin response to mild stressor in adult male Wistar rats[J]. Endocr Regul.1998;32(3):161–165. PMID: 10196513
    [16] Meaney MJ, Diorio J, Widdowson J, LaPlante P, Caldji C,Seckl JR, Plotsky PM. Early environmental regulation of forebrain glucocorticoid receptor gene expression: implications for adrenocortical response to stress[J]. Dev Neurosci.1996;18(1-2): 49-72. PMID: 8840086
    [17]Coutinho SV, Plotsky PM, Sabald M, Miller JC, Zhou H, Bayati AI, McRoberts JA, Mayer EA. Neonatal maternal separation alters stress-induced responses to viscerosomatic nociceptive stimuli in rat[J]. Am J Physiol Gastrointest Liver Physiol.2002;282(2): 307-316. PMID: 11804852
    [18] O'Mahony SM;Hyland NP;Dinan TG;Cryan JF.Maternal separation as a model of brain-gut axis dysfunction[J].Psychopharmacology. 2010;214(1):71-88. PMID: 20886335
    [19] Stam R,Croiset G,Akkermansl M,Wiegant VM.Sensitization of the colonic response to novel stress after previous stressful experience[J].Am J Physiol.1996; 271(5): 1270-1273. PMID: 8945963
    [20] Mayer EA;Collins SM. Evolving pathophysiologic models of functional gastrointestinal disorders[J]. Gastroenterology.2002;122(7): 2032-2048. PMID: 12055608
    [21] Mayer EA.The neurobiology of stress and gastrointestinal disease.Gut. 2000;47(6):861-869. PMID: 11076888
    [22]Mayer EA,Naliboff BD,Chang L,Coutinho SV. V.Stress and irritable bowel syndrome[J].Am J Physiol Gastrointest Liver Physiol,2001;280(4);519-524. PMID: 11254476
    [23]Mayer EA,Berman S,Derbyshire SW,Suyenobu B,Chang L,Fitzgerald L,Mandelkern M,Hamm L,Vogt B,Naliboff BD.The effect of the 5-HT3 receptor antagonist, alosetron, on brain responses to visceral stimulation in irritable bowel syndrome patients.Aliment Pharmacol Ther.2002;16(7):1357-1366. PMID: 12144587
    [24] Dickhaus B,Mayer EA,Firooz N,Stains J,Conde F,Olivas TI,Fass R,Chang L,Mayer M,Naliboff BD.Irritable bowel syndrome patients show enhanced modulation of visceral perception by auditory stress[J].Am J Gastroenterol. 2003;98(1):135-43 .PMID: 12526949
    [25] Ronan PJ,Summers CH.Molecular signaling and translational significance of the corticotropin releasing factor system[J].Prog Mol Biol Transl Sci. 2011;98:235-292. PMID:21199774
    [26] O'Malley D,Dinan TG,Cryan JF.Alterations in colonic corticotropin-releasing factor receptors in the maternally separated rat model of irritable bowel syndrome: differential effects of acute psychological and physical stressors[J].Peptides. 2010;31(4):662-670.PMID: 20096320
    [27] Tjong YW,Ip SP,Lao L,Wu J,Fong HH,Sung JJ,Berman B,Che CT.Neonatal maternal separation elevates thalamic corticotrophin releasing factor type 1 receptor expression response to colonic distension in rat[J].Neuro Endocrinol Lett. 2010;31(2):215-220. PMID: 20424584
    [28] Monnikes H,Tebbe JJ,Hildebrandt M,Arck P, Osmanoglou E,Rose M,Klapp B,Wiedenmann B,Heymann-Monnikes I.Role of stress in functional gastrointestinal disorders. Evidence for stress-induced alterations in gastrointestinal motility and sensitivity[J].Dig Dis. 2001;19(3):201-211. PMID: 11752838
    [29] Valentino RJ,Miselis RR,Pavcovich LA.Pontine regulation of pelvic viscera: pharmacological target for pelvic visceral dysfunctions[J].Trends Pharmacol Sci.1999;20:253-260. PMID: 10366869
    [30]迟雁,刘新光,李江.5-羟色胺4受体在调节应激大鼠内脏敏感性中的作用[J].中华消化杂志.2004;24(9):21-24.
    [31] Lowry CA.Functional subsets of serotonergic neurones: implications for control of the hypothalamic-pituitary-adrenal axis[J].Neuroendocrinol. 2002;14(11):911-923. PMID: 12421345.
    [32]任天华,胡品津,胡志远.新生期母婴分离对大鼠成年后结直肠扩张后5-羟色胺表达的影响[J].中山大学学报(医学科学版).2004;25(3):234.
    [33] Crowell MD.The role of serotonin in the pathophysiology of irritable bowel syndrome[J].Am J Manag Care.2001;7(8):252-260. PMID: 11474910.
    [34] Chadwick VS,Chen W,Shu D,Paulus B,Bethwaite P,Tie A,Wilson I.Activation of the mucosal immune system in irritable bowel syndrome[J].Gastroenterology 2002; 122(7): 1778-1783. PMID: 12055584
    [35] Holme’N N,Isaksson S,Simren′N M,Sjovall H,Ohman L.CD4+CD25+ regulatory T cells in irritable bowel syndrome patients[J]. Neurogastroenterol Motil .2007; 19(2):119–125. PMID: 17244166
    [36]van den Wijngaard RM,Klooker TK,Welting O,Stanisor OI,Wouters MM,van der Coelen D,Bulmer DC,Peeters PJ,Aerssens J,de Hoogt R,Lee K,de Jonge WJ,Boeckxstaens GE.Essential role for TRPV1 in stress-induced (mast cell- dependent) colonic hypersensitivity in maternally separated rats. [J] Neurogastroenterol Motil. 2009;21(10):10941107. PMID: 19523146
    [37]王承党,郭朝书.肥大细胞和类胰蛋白酶在腹泻型肠易激综合征升结肠黏膜中的表达及意义[J].世界华人消化杂志.2010; 18(16): 1682-1686.
    [38]郭朝书,王承党.肥大细胞及类胰蛋白酶在肠易激综合征内脏敏感性中的作用[J].国际消化病杂志.2010;20(1):4-5.
    [39] Cenac N, Garcia-Villar R,Ferrier L,Larauche M,Vergnolle N,Bunnett NW,Coelho AM,Fioramonti J,Bueno L.Proteinase-activated receptor-2-inducedcolonic inflammation in mice: possible involvementof afferent neurons, nitric oxide, and paracellularpermeability[J]. Immunol.2003; 170(8): 4296-4300. PMID: 12682265
    [40] Wallon C,Yang PC,Keita AV,Ericson AC,McKay DM,Sherman PM,Perdue MH,Soderholm JD.Corticotropin-releasing hormone (CRH) regulates macromolecular permeability via mast cells in normal human colonic biopsies in vitro[J].Gut. 2008;57(1):50-58. PMID: 17525093
    [41] Jackson JL,O’Malley PG,Tomkins G,Balden E,Santoro J,Kroenke K.Treatment of functional gastrointestinal disorders with antidepressant medications:a meta- analysis[J].Am J Med.2000; 108(1): 65-72. PMID: 11059442
    [42] Bixquert-Jimónez M, Bixquert-Pla L.Antidepressant therapy in functional gastrointestinal disorders[J].J Gastroenterol Hepatol.2005;28(8):485-492. PMID: 16185584
    [43]孙琛明,王萍,吴杰,张姮.马来酸曲美布汀联合抗抑郁焦虑药物治疗肠易激综合征疗效观察[J].中国医药导报.2010;7(12):96-97.
    [44] Bleser S. Alosetron for severe diarrhea-predominant irritable bowel syndrome: improving patient outcomes[J]. Curr Med Res Opin. 2011;27(3):503-512. PMID: 21208319
    [45] Kwon JG,Park KS,Park JH,Park JM,Park CH,Lee KJ,Park HJ,Rhee JC. Guidelines for the Treatment of Irritable Bowel Syndrome [J]. Korean J Gastroenterol. 2011;57(2):82-99. PMID: 21350320
    [46] Talley NJ,Kellow JE,Boyce P,et a1.Antidepressant therapy (imipramine and citalopram) for irritable bowel syndrome:a double-lind,randomized, placebo- controlled trial[J]. Dig Dis Sci.2008;53(1):108-115. PMID: 17503182
    [47] Ford AC,Talley NJ.Mucosal inflammation as a potential etiological factor in irritable bowel syndrome: a systematic review[J].J Gastroenterol. 2011;46(4):421-431.PMID: 21331765
    [48]Moser G.Functional gastrointestinal disorders[J].Wien Med Wochenschr.2006; 156: (15-16) : 435- 440. PMID: 17041768.
    [49]Jones M;Koloski N;Boyce P;Talley NJ.Pathways connecting cognitive behavioral therapy and change in bowel symptoms of IBS[J]. Psychosom Res. 2011; 70(3): 278- 285. PMID: 21334499
    [50]Oerlemans S,van Cranenburgh O,Herremans PJ,Spreeuwenberg P,van Dulmen S. Intervening on cognitions and behavior in irritable bowel syndrome: A feasibility trial using PDAs[J]. Psychosom Res. 2011;70(3):267-277. PMID: 21334498
    [51] Heymann-Monnikes I,Arnold R,Florin I.The combination of medical treatment plus multicomponent behavioral therapy is superior to medical treatment alone in the therapy of irritable bowel syndrome[J]. Am J Gastroenterol .2000;95(4):981-994. PMID: 10763948.
    [52] Simren M,Ringstrom G,Bjornsson ES.Treatment with hypnotherapy reduces the sensory and motor component of the gastrocolonic response in irritable bowel syndrome[J]. Psychosom Med.2004;66(2):233-238. PMID: 15039508

© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号

地址:北京市海淀区学院路29号 邮编:100083

电话:办公室:(+86 10)66554848;文献借阅、咨询服务、科技查新:66554700