针刺治疗肠易激综合征的临床观察及对其模型大鼠CGRP、NPY和5-HT的影响研究
|
摘要
研究目的：
通过分析针刺对肠易激综合征的临床疗效及其脑-肠交互作用模型CGRP、HT、NPY的干预效果,探索针刺治疗肠易激综合征的机制。
研究方法：
采用单盲随机对照研究,将117例IBS患者随机分为两组,治疗组56例,予针刺治疗,对照组61例,予药物治疗,比较两组治疗前后症状积分和腹痛或不适程度视觉评分(VAS),评价临床疗效；将实验大鼠分为模型组、治疗组和对照组,通过慢急性联合应激建立和再评价脑-肠交互作用IBS动物模型,待建模成功后,部分模型大鼠作为治疗组,接受电针治疗14天后,与常规喂养的模型组和对照组比较一般行为学指标,并检测三组大鼠下丘脑、脊髓腰膨大和远端结肠中CGRP、HT、NPY的含量,评估针刺的影响作用。
研究结果：
①两组基线比较具有可比性,治疗结束后,治疗组症状评分低于对照组(p<0.05),两组随访评分较治疗结束时均有不同程度的升高(P<0.05),但治疗组仍低于对照组；针刺治疗组总有效率为90.0%,优于药物对照组84.0%(p<0.01),两组临床痊愈率均偏低。②复制并评价慢急性联合应激大鼠模型,证实该模型兼具肠道动力异常、内脏高敏感和心理行为的改变,其结肠未见明显的组织病理学异常发生,提示建模成功。③经连续2周电针干预后,治疗组1小时排便颗粒数、糖水摄取量和CRD阈值明显不同于模型组(P<0.01),接近对照组(P>0.05)；模型组结肠、下丘脑和脊髓标本的5-HT、CGRP和NPY的含量均有异常改变(P<0.05),而治疗组含量均接近对照组(P>0.05)。
结论：
①针刺治疗IBS,临床起效较快,并随疗程越长,临床症状的改善效果越明显,能够明显减轻患者的腹痛或不适症状,治疗结束1月后,患者病情均有不同程度的复发,但其长期疗效仍明显优于药物治疗。
②电针治疗能够调节脑-肠交互作用肠易激综合征模型大鼠的肠动力异常、心理行为异常和内脏高敏感等引起的症状,脑-肠轴5-HT、CGRP和NPY的含量异常与IBS症状密切相关,而针刺治疗能够调节模型大鼠5-HT、CGRP和NPY异常表达,使之恢复正常状态,达到治疗IBS的目的。
Purpose:
Through clinical observation and animal research, to explore the effect of interference and the regulation mechanism of acupuncture on irritable bowel syndrome and the CGRP,5HT, NPY of the brain-gut interaction model.
Methods:
It's a single-blind randomized controlled clinical trial, and 117 patients with IBS were randomly divided into two groups. Treatment group with 56 patients were accepted with acupuncture, and the control group with 61 patients was treated with Pinaverium Bromide Tablets and Fiberform for symptomatic treatment. Symptom scores and VAS scores of abdominal pain or discomfort before and after treatment were compared to evaluate its clinical effect; this research is to build and re-evaluate the brain-gut interaction model of IBS with the slow acute joint stress,16 of the successful models were randomly selected as the treatment group with EA therapy. After the treatment, the role of acupuncture was assessed with its general behavior and the detection of levels of CGRP,5HT, NPY in the hypothalamus, spinal cord (L4-L6) and distal colon among three groups.
Results:
①Symptom scores were compared, the treatment group score have been lower than the control group (p<0.05) since the first week.1 month after the treatment, both groups score increased than the score after treatment(P<0.05); the total effective rate of treatment group was 90.0%, better than the drug control group 84.0%(p<0.01), both clinical cure rates are low.
②After the modeling and evaluation, the result have confirmed that the model established with abnormal intestinal motility, visceral hypersensitivity and psychological behavior change, and there is no obvious intestinal histopathological abnormalities occur, which suggest modeling success.
③After the treatment with EA for 2 weeks, stool particles for 1 hour, syrup intake and CRD threshold of treatment group were significantly different from the model group (P<0.01), similar number of the control group (P>0.05); the levels of 5-HT, CGRP and NPY in the colon, hypothalamic and spinal cord specimens of model group were abnormal (P<0.05), while the levels of the treatment group were similar to the control group (P> 0.05).
Conclusion:
①The acupunctrue therapy for IBS produce faster effect and have more obvious effects with the longer course of treatment, can significantly reduce abdominal pain or discomfort. After the treatment, patients often have got the IBS symptoms again, but acupuncture still have better long-term effect than drug treatment.
②Electroacupuncture can regulate the symptoms caused by intestinal motility disorders, psychological and behavioral abnormalities and visceral hypersensitivity on the brain-gut interaction rat model of irritable bowel syndrome.The 5-HT, CGRP and NPY of the brain-gut axis were closely related with the IBS symptoms, while acupuncture can regulate the abnormal expression of 5-HT. CGRP and NPY, so as to restore the balance and to get good effect on IBS.
通过分析针刺对肠易激综合征的临床疗效及其脑-肠交互作用模型CGRP、HT、NPY的干预效果,探索针刺治疗肠易激综合征的机制。
研究方法：
采用单盲随机对照研究,将117例IBS患者随机分为两组,治疗组56例,予针刺治疗,对照组61例,予药物治疗,比较两组治疗前后症状积分和腹痛或不适程度视觉评分(VAS),评价临床疗效；将实验大鼠分为模型组、治疗组和对照组,通过慢急性联合应激建立和再评价脑-肠交互作用IBS动物模型,待建模成功后,部分模型大鼠作为治疗组,接受电针治疗14天后,与常规喂养的模型组和对照组比较一般行为学指标,并检测三组大鼠下丘脑、脊髓腰膨大和远端结肠中CGRP、HT、NPY的含量,评估针刺的影响作用。
研究结果：
①两组基线比较具有可比性,治疗结束后,治疗组症状评分低于对照组(p<0.05),两组随访评分较治疗结束时均有不同程度的升高(P<0.05),但治疗组仍低于对照组；针刺治疗组总有效率为90.0%,优于药物对照组84.0%(p<0.01),两组临床痊愈率均偏低。②复制并评价慢急性联合应激大鼠模型,证实该模型兼具肠道动力异常、内脏高敏感和心理行为的改变,其结肠未见明显的组织病理学异常发生,提示建模成功。③经连续2周电针干预后,治疗组1小时排便颗粒数、糖水摄取量和CRD阈值明显不同于模型组(P<0.01),接近对照组(P>0.05)；模型组结肠、下丘脑和脊髓标本的5-HT、CGRP和NPY的含量均有异常改变(P<0.05),而治疗组含量均接近对照组(P>0.05)。
结论：
①针刺治疗IBS,临床起效较快,并随疗程越长,临床症状的改善效果越明显,能够明显减轻患者的腹痛或不适症状,治疗结束1月后,患者病情均有不同程度的复发,但其长期疗效仍明显优于药物治疗。
②电针治疗能够调节脑-肠交互作用肠易激综合征模型大鼠的肠动力异常、心理行为异常和内脏高敏感等引起的症状,脑-肠轴5-HT、CGRP和NPY的含量异常与IBS症状密切相关,而针刺治疗能够调节模型大鼠5-HT、CGRP和NPY异常表达,使之恢复正常状态,达到治疗IBS的目的。
Purpose:
Through clinical observation and animal research, to explore the effect of interference and the regulation mechanism of acupuncture on irritable bowel syndrome and the CGRP,5HT, NPY of the brain-gut interaction model.
Methods:
It's a single-blind randomized controlled clinical trial, and 117 patients with IBS were randomly divided into two groups. Treatment group with 56 patients were accepted with acupuncture, and the control group with 61 patients was treated with Pinaverium Bromide Tablets and Fiberform for symptomatic treatment. Symptom scores and VAS scores of abdominal pain or discomfort before and after treatment were compared to evaluate its clinical effect; this research is to build and re-evaluate the brain-gut interaction model of IBS with the slow acute joint stress,16 of the successful models were randomly selected as the treatment group with EA therapy. After the treatment, the role of acupuncture was assessed with its general behavior and the detection of levels of CGRP,5HT, NPY in the hypothalamus, spinal cord (L4-L6) and distal colon among three groups.
Results:
①Symptom scores were compared, the treatment group score have been lower than the control group (p<0.05) since the first week.1 month after the treatment, both groups score increased than the score after treatment(P<0.05); the total effective rate of treatment group was 90.0%, better than the drug control group 84.0%(p<0.01), both clinical cure rates are low.
②After the modeling and evaluation, the result have confirmed that the model established with abnormal intestinal motility, visceral hypersensitivity and psychological behavior change, and there is no obvious intestinal histopathological abnormalities occur, which suggest modeling success.
③After the treatment with EA for 2 weeks, stool particles for 1 hour, syrup intake and CRD threshold of treatment group were significantly different from the model group (P<0.01), similar number of the control group (P>0.05); the levels of 5-HT, CGRP and NPY in the colon, hypothalamic and spinal cord specimens of model group were abnormal (P<0.05), while the levels of the treatment group were similar to the control group (P> 0.05).
Conclusion:
①The acupunctrue therapy for IBS produce faster effect and have more obvious effects with the longer course of treatment, can significantly reduce abdominal pain or discomfort. After the treatment, patients often have got the IBS symptoms again, but acupuncture still have better long-term effect than drug treatment.
②Electroacupuncture can regulate the symptoms caused by intestinal motility disorders, psychological and behavioral abnormalities and visceral hypersensitivity on the brain-gut interaction rat model of irritable bowel syndrome.The 5-HT, CGRP and NPY of the brain-gut axis were closely related with the IBS symptoms, while acupuncture can regulate the abnormal expression of 5-HT. CGRP and NPY, so as to restore the balance and to get good effect on IBS.
引文
[1]胡莹,王巧民.肠易激综合征的流行病学研究进展[J].安徽医学,2010,5(31)：547-549.
[2]德罗斯曼(Drossman,D. A)总主编,柯美云,方秀才译.罗马Ⅲ：功能性胃肠病——3版[M].北京：科学技术出版社,2008 ISBN 978-7-03-021314-3.
[3]姚欣,杨云生,赵卡冰,等.罗马Ⅲ标准研究肠易激综合征临床特点及亚型[J].世界华人消化杂志2008；16：563-566
[4]Lea R, Whorwell PJ. New insights into the psychosocial aspects of irritable bowel syndrome[J]. Curr Gastroenterol Rep.2003;5:343-350.
[5]汪安江,陈旻湖.肠易激综合征药物治疗的循证医学评价[J].胃肠病学和肝病学杂志,2009,5(18)：388-391.
[6]黄宣,吕宾.肠易激综合征诊治进展和面临的挑战[J].世界华人消化杂志.2010；18(21)：2234-2239.
[7]郑筱萸.中药新药临床研究指导原则(试行).[M]北京：中国医药科技出版社,2002,第1版：139-143.
[8]徐义勇,朱丽娟.肠易激综合征情志致病的理论探讨[J].辽宁中医药大学学报,2008,6(10)：51-52.
[9]Morcos A, Dinan T, Quigley EM.Irritable bowel syndrome:role of food in pathogenesis and management[J]. J Dig Dis.2009 Nov;10(4):237-46.
[10]Honghton LA, Atkinson W, Whitaker RP, et al. Increased platelet depleted plasma 5-hyndroxytryptamine concentration following meal ingestion in symptomatic female subjects with diarrhoea-predominant irritable bowel syndorome[J]. Gut 2003;52:633-670.
[11]中华中医药学会脾胃病分会.肠易激综合征中医诊疗共识意见[J].中华中医药杂志(原中国医药学报),2010,7(25)：1062-1065.
[12]张声生,周滔,汪红兵,肠易激综合征中医药诊疗现状与挑战[J].世界华人消化杂志2010；18(21)：2216-2220
[13]Hopton A. MacPherson H. Acupuncture for chronic pain:is acupuncture more than an effective placebo? A systematic review of pooled data from meta-analyses[J]. Pain Pract.2010 Mar-Apr; 10(2):94-102.
[14]Marshall R, Paul L. Wood L. The search for pain relief in people with chronic fatigue syndrome:A descriptive study [J]. Physiother Theory Pract.2010 Nov 1. PMID:21039301
[15]Yeung AS, Ameral VE, Chuzi SE, et al. A pilot study of acupuncture augmentation therapy in antidepressant partial and non-responders with major depressive disorder[J]. J Affect Disord.2010 Aug 5. PMID:20692042
[16]王艳杰,王升旭.针灸治疗原发性抑郁症的循证医学研究概况[J].时珍国医国药,2008,19(12)：2886-2889.
[17]程肖蕊,程凯.国外针灸治病作用机制研究概况[J].中国针灸,2008,6(28)：463-467.
[l]王伟岸，钱家呜，潘国宗，等．脑．肠互动指向性条件应激肠易激综合征动物模型的建立[J]．中华消化 杂志2004，24(10)：590-593
[2]LU H, Qian JM, Jin GL, Zhou DF, Shen YC. The establishment of an animal model of gut-brain interaction in irritable bowel syndrome for the evaluation of visceral sensation, motility and psychological behavior[J]. Zhonghua Nei Ke Za Zhi 2009,48(12): 1035-9.
[3]石君杰，戴玉英，王海云，徐发莹．慢性束缚及夹尾刺激致大鼠肠易激综合征模型的建立及其内脏敏感性评价[J]．中国中西医结合消化杂志2008，l 6(2)：87-90
[4]Spence MJ, Moss-Morris R. The cognitive behavioural model of irritable bowel syndrome: a prospective investigation of patients with gastroenteritis[J]. Gut 2007, 56(8): 1066-71.
[1]孔庆建,张辉,孙波,张德军.肠易激综合征的病因与发病机制[J].中国煤炭工业医学杂志2006；9：3-1034
[2]Blomhoff S,Spetalen S,Jacobsen MB.Irritatic Bowelsyndrome-a maltitaclorical disease in children and adults[J].Tiddsskr Nor Laegc-foren 2002; 122:12-13,
[3]丁义侠,储浩然.针灸治疗肠易激综合征的研究[J].长春中医药大学学报,2010,5(26)：672-674
[4]安彩萍,杨珊.针灸治疗肠易激综合征机制研究进展[J].上海针灸杂志,2010,7(29)：474-477.
[5]罗远红陆丽明杨晓军脑-肠轴与摄食行为机制的研究进展[J].现代中西医结合杂志,2009,18(30)：3777-3779
[6]Talley NJ.Howell S,Poulton R. The irritable bowel syndrome and psychiatric disorders in the communty:is there a link? [J]. Am I gastroenterol,2001,96(4):1072-1079
[7]Silverman DH,Munakata JA.Ennes H.Mandelkern MA,Hoh CK.Mayer EA.Regional cerebral activity in normal and pathological perception of visceral pain[J].GastroenteroIogy 1997;112:64-72
[8]康明祥,贾红.肠易激综合征内脏高敏感性机制的研究进展[J].世界华人消化杂志,2008；16(14)：1554-1558
[9]Sagami Y, ShimadaY,Tayama J,etal.Effect of a corticotropin releasing hormone receptor antagonist on colonic sensory and motor function in patientswith irritable bowel syndrome[J].Gut.2004 Jul:53(7):958-64.
[10]Coffin B,Bouhassira D.Sabate JM, et al.Alteration of the spinal modulation of nociceptive processing in patients with irritable bowel syndrome[J]. Gut.2004 Oct;53(10):1465-70.
[11]Carlson JD, Maire JJ, Martenson ME, et al. Sensitization of pain-modulating neurons in the rostral ventromedial medulla after peripheral nerve injury[J]. J Neurosci.2007 Nov 28;27(48):13222-31.
[12]Viisanen H,Pertovaara A.Influence of peripheral nerve injury on response properties of locus coeruleus neurons and coeruleospinal antinociception in the rat[J]. Neuroscience.2007 Jun 8;146(4):1785-94.
[13]Kohn A.Prantera C.Pera A,et al. Anti-tumour necrosis factor alpha (infliximab)in the treatment of severe ulcerative colitis:result of an open study on 13 patients[J].Dig Liver Dis 2002:34:626-630.
[14]王敬东.脑-肠互动在肠易激综合征发病中的作用[J].世界华人消化杂志,2006,14(34)：3299-3301.
[15]Spiller RC. Jenkins D, Thornley JP, et al.Inereased reetal mucosal enteroendoerine cells, T JymPhoeytes, and inereased gut permeability in CamPylobacter following acute CamPylobaeter enteritis and inpostdysenteric irritable bowel syndrome[J].Gut.2000,47:804-811.
[16]Lawson SN.Crepps BA,Perl ER.Calcitonin gene-related peptide immunoreactivity and afferent receptive properties of dorsal root ganglion neurons in guinea-pigs[J].J Physiol 2002;540:989-1002.
[17]Robinson DR,McNaughton PA,Evans ML,et a 1.Characterization of the primary spinal afferent innervation of the mouse colon using retrograde labelling[J].Neurogastroenterol Motil,2004,16(l):113-124.
[18]王垂杰,赵文娟,李玉锋.痛泻要方对肠易激综合征大鼠血浆及肠黏膜CGRP影响的实验研究[J].生命科学仪器,2009,7(10)：24-26.
[19]Delafoy L,Gelot A,Ardid D,et al. Interactive involvement of brain derived neurotrophicfactor,nerve growth factor,and calcitonin gene related peptide in colonic hypersensitivity in the rat[J]. Gut.2006 Jul;55(7):940-5.
[20]Vanderah TW.Pathophysiology of Pain[J].Med Clin N Am,2007,91:1-12.
[21]Cervero F,Laird JM.Understanding the signaling and transmission of visceral noci-ceptive events[J], J Neurobiol,2004,61 (1):45-54.
[22]章菲菲,莫剑忠.降钙素基因相关肽在内脏敏感性改变机制中的作用[J].胃肠病学和肝病学杂志,2005,14(2)：200-202.
[23]王锁儿,张俊义,王新亮.NPY的研究现状及进展[J].内蒙古医学杂志2010,42(6)：679-682
[24]Staud R, Spaeth M. Psychophysical and neurochemical abnormalitiesof pain processing in fibromyalgia[J]. CNS Spectr,2008.13(3 Suppl5):12-17.
[25]银新,宁守斌.肠易激综合征发病机制的研究进展[J].世界华人消化杂志2009；17(32):3318-3323
[26]张茹.肠易激综合征脑—肠交互作用模型结肠5-经色胺、酪氨酸经化酶水平变化及蛋白指纹图谱初探[D].北京协和医学院,2008.
[27]张尚志5-HT信号系统在FGIDS中的意义研究[J].胃肠病学和肝病学杂志2009年3月第18卷第3期201-203.
[28]Wu HG, Jiang B, Zhou EH, et al.Regulatory mechanism of electroacupuncture in irritable bowel syndrome: preventing MC activation and decreasing SP VIP secretion[J]. Dig Dis Sci.2008 Jun;53(6):1644-51.
[29]Garvin B, Wiley JW.The role of serotonin in irritable bowel syndrome:implications for management[J]. Curr Gastroenterol Rep.2008 Aug; 10(4):363-8.
[30]Spiller R.Recent advances in understanding the role of serotonin in gastrointestinal motility in functional bowel disorders:alterations in 5-HT signalling and metabolism in human disease[J]. Neurogastroenterol Motil.2007 Aug; 19 Suppl 2:25-31.
[31]Park JH, Rhee PL, Kim HS, et al.Mucosal mast cell counts correlate with visceral hypersensitivity in patients with diarrhea predominant irritable bowel syndrome[J]. J Gastroenterol Hepatol.2006 Jan;21(1 Pt 1):71-8.
[32]Xu JR, Luo JY, Shang L, Kong WM.Effect of change in an inhibitory neurotransmitter of the myenteric plexus on the pathogenetic mechanism of irritable bowel syndrome subgroups in rat models[J]. Chin J Dig Dis.2006;7(2):89-96.
[33]陈永萍.针灸对不同证型肠易激综合征结肠电、脑肠肽的影响[D].广州中医药大学博士学位论文,2000.
[34]荣培晶,朱兵,黄启福,等.针刺抑制直结肠伤害性扩张引起的大鼠脊髓背角神经元反应[J].中国针灸,2005,25(9)：645-650.
[35]朱青艳.电针上巨虚对急性束缚应激大鼠结肠功能的调节作用及中枢机制研究[D].湖北中医学院博士学位论文,2008.
[36]Liu HR, Wang XM, Zhou EH, et al.Acupuncture at both ST25 and ST37 improves the pain threshold of chronic visceral hypersensitivity rats[J]. Neurochem Res.2009 Nov;34(11):1914-8.
[1]徐俊荣等.5羟色胺受体可塑性在大鼠肠易激综合征中的作用.西安交通大学学报(医学版),2008,4：29(2)
[2]宁丽琴,叶柏.肠易激综合征研究进展.现代医学,2008,12：36(6)
[3]李文波,刘诗.针刺疗法治疗功能性肠疾病的研究进展.世界华人消化杂志.2006；14(2)：197-200
[4]施茵,张凌凌等.针灸治疗肠易激综合征临床概要.[J].上海针灸杂志,2007,26(8)：8
[5]孙菁,袁耀宗.肠易激综合征：罗马Ⅲ标准与我国共识意见解读.医学与哲学(临床决策论坛版),2008,6：29(6)
[6]詹群珊等.14种食物特异性lgG抗体检测在肠易激综合征中的应用价值.中国误诊学杂志,2008,3：8(8)
[7]熊嘉玮.针灸治疗肠易激综合征34例临床观察.江苏中医药,2009,41(1)：49-50
[8]崔大威.磁圆针配合针灸治疗肠易激综合征200例[J].上海针灸杂志,2005,24(5)：26.
[9]刘光英,朱文罡.腹泻型肠易激综合征的腹针治疗研究[J].光明中医,2005,20(3)：31-32.
[10]黄志刚,尤斌等.针灸辨证治疗肠易激综合征172例[J].上海针灸杂志,2006,25(7)：21-22.
[11]杨淑贤,王秀芹,蔡永.温针灸配合神阙穴贴敷治疗肠易激综合征疗效观察[J].上海针灸杂志,2006,25(12)：15-16.
[12]施茵等.针灸治疗肠易激综合征临床概要.上海针灸杂志,2007,26(8)：45-48.
[13]龙泽荣等.针刺加微生态制剂治疗便秘型肠易激综合征临床观察[J].中国针灸,2006,26(6)：403-405.
[14]石志敏.针灸治疗腹泻型肠易激综合征48例[J].浙江中医杂志,2005,40(7)：320.
[15]杨亚平.针灸治疗腹泻型肠易激综合征38例[J].现代康复,2001,5(5)：1-3.
[16]薛西林.针灸治疗肠易激综合征31例[J].上海针灸杂志,2000,19(5)：20.
[17]刘立平.针灸治疗肠易激综合征43例[J].临床荟萃,2004,19(15)：883.
[18]赵琛等.灸补脾胃之主方治疗腹泻型肠易激综合征91例临床观察[J].中国现代临床医学,2005,4(6)：31-33.
[19]黄子夏,何小琦,张桂珍等.73例肠易激综合征单纯及综合治疗临床观察[J].广州医学院学报,1999,27(4)：67-69.
[20]余南生,李永安,詹可顺.自拟健脾理气和胃汤配合灸脐治疗肠易激综合征观察[J].安徽中医临床杂志,2003,15(5)：374-375.
[21]谢胜,张志杰,梁谊深.中草药蒸汽疗法合指针治疗肠易激综合征64例[J].陕西中医,2006,27(1)：54-55.
[22]黄政德,梁立安,张维新.针刺推拿结合治疗肠易激综合征[J].中国针灸,2006,26(10)：717-718.
[23]何严,高宏.针灸配合按摩治疗肠易激综合征36例[J].陕西中医,2004,25(3)：258-259.
[1]张声生,李乾构,等.肠易激综合征中医诊疗共识意见.中华中医药学会脾胃病分会中华中医药杂志(原中国医药学报)2010,7：1062-1065.
[2]SpinelliA. Irritable bowel syndrome [J]. Clin Drug Investig 2007,27(1):15-33. [PMID:17177577]
[3]XiongLS, ChenMH, Chen HX, et al. A population-based epidemiologic studyof irritable bowel syndrome in South China: stratified randomized study by cluster sampling [J]. Aliment Pharmacol Ther 2004,19(11): 1217-1224. [PMID:15153175]
[4]张万岱.功能性胃肠病罗马标准的简介和解读.世界华人消化杂志2008,16(2)：120-124.
[5]张文静.成人肠易激综合征诊治新指南.现代消化及介入诊疗2007,12(2)：141.
[6]孙菁,袁耀宗.肠易激综合征：罗马Ⅲ标准与我国共识意见解读.医学与哲学(临床决策论坛版)2008,359(6)：12-16.
[7]孔庆建,张辉,等.肠易激综合征的病因与发病机制.中国煤炭工业医学杂志2006，9(10)：1033-1034.
[8]Arebi N, Gurmany S, et al. The psychoneuroimmunology of irritable bowel syndrome--an exploration of interactions between psychological, neurological and immunological observations. Aliment Pharmacol Ther 2008,28(7):830-40. [PMID:18637004]
[9]夏德雨,王景杰,陆松鹤,等.直肠扩张刺激引起IBS大鼠痛行为学以及骶髓DCN中神经元和胶质细胞的变化.胃肠病学和肝病学杂志2007,16(6)：589-594.
[10]王景杰,王胜智,夏德雨,等.结肠扩张刺激对P2X4受体在IBS大鼠神经中枢中表达的影响.胃肠病学和肝病学杂志2008,17(]0)：813-817.
[11]赖华梅,诸琦,王静,等.脑源性神经营养因子在乳鼠结肠扩张刺激诱导的慢性内脏高敏感和肠道动力异常中的作用.胃肠病学2008,13(4)：223-227.
[12]韩真,王运东.腹泻型肠易激综合征模型大鼠肠道Cajal间质细胞的变化及意义.中国病理生理杂志2008,24(11)：2263-2264、2271.
[13]唐洪梅,李得堂,黄樱华,等.肠激安方抑制肠易激综合征模型大鼠肥大细胞的实验研究.中药新药与临床药理2008,19(6)：464-466.
[14]徐海珍,谢建群,施斌,等.腹泻型肠易激综合征大鼠结肠黏膜炎性细胞因子的表达及温中健脾方对其影响的研究.上海中医药杂志2007,41(6)：69-72.
[15]吕宾,蒋霞,丁瑞峰,等.内脏高敏感大鼠脑干降钙素基因相关肽、c-fos基因表达的研究.胃肠病学2007,]2(11)：681-684.
[16]孙刚,杨云生,彭丽华,王巍峰.肠易激综合征大鼠内脏敏感性异常与结肠及中枢神经系统5-HT和c-fos表达的关系.胃肠病学和肝病学杂志2008,17(4)：313-317.
[17]朱雪萍,陈卫昌,朱晓黎,等.幼鼠肠易激综合征模型肠道微生态的对照研究.实用儿科临床杂志 2007,22(7)：530-531.
[18]O'Mahony SM, Marchesi JR. et al. Early life stress alters behavior, immunity, and microbiota in rats: implications for irritable bowel syndrome and psychiatric illnesses. Biol Psychiatry 2009.65(3):263-7. [PMID: 18723164]
[19]朱力阳,彭成,谢晓芳,王嫣虹.化学刺激引起的两种大鼠内脏高教感性模型的建立.中国药理学通报2010,26(2)：267-270.
[20]李冬华,李春森,李伍善,等.痛泻要方对肠易激综合征模型大鼠血管活性肠肤的影响.时珍国医国药2007,18(9)：2098-2099.
[21]费晓燕,谢建群,郑昱,等.疏肝饮对腹泻型肠易激综合征模型大鼠胃动素和胆囊收缩素的影响.上海中医药杂志2008,42(4)：63-65.
[22]石君杰,戴玉英,王海云,徐发莹.慢性束缚及夹尾刺激致大鼠肠易激综合征模型的建立及其内脏敏感性评价.中国中西医结合消化杂志2008,16(2)：87-90.
[23]Spence MJ, Moss-Morris R. The cognitive behavioural model of irritable bowel syndrome:a prospective investigation of patients with gastroenteritis. Gut 2007.56(8):1066-71. [PMID:17324974]
[24]Anthony C. Johnson, et al. Brain Activation in Response to Visceral Stimulation in Rats with Amygdala Implants of Corticosterone:An fMRI Study. PLoS One.2010,5(1):e8573. [PMID:20052291]
[25]Eutamene H, Bradesi S. et al. Guanylate cyclase C-mediated antinociceptive effects of linaclotide in rodent models of visceral pain. Neurogastroenterol Motil 2010,22(3):312-e84. [PMID:19706070]
[26]Ma XP. Tan LY, et al. Effect of electro-acupuncture on substance P, its receptor and corticotropin-releasing hormone in rats with irritable bowel syndrome. World J Gastroenterol 2009,15(41):5211-7. [PMID: 19891022]
[27]安钰,白殿卿,等.乙酸灌肠加束缚应激致大鼠肠易激综合征模型的建立及其评价.世界华人消化杂志2009,17(15)：1548-1551.
[28]朱雪萍,陈卫昌,朱晓黎,等.脑肠肽、脑肠轴在肠易激综合征模型中作用机制研究.临床儿科杂志2008,26(3)：236-239.
[29]王伟岸,钱家鸣,潘国宗,等.脑-肠互动指向性条件应激肠易激综合征动物模型的建立.中华消化杂志2004,24(10)：590-593.
[30]Lu H, Qian JM, Jin GL, Zhou DF, Shen YC. The establishment of an animal model of gut-brain interaction in irritable bowel syndrome for the evaluation of visceral sensation, motility and psychological behavior. Zhonghua Nei Ke Za Zhi 2009.48(12):1035-9. [PMID:20193524]
[31]Van Kerkhoven LA, Laheij RJ, Jansen JB. Meta-analysis:a functional polymorphism in the gene encoding for activity of the serotonin transporter protein is not associated with the irritable bowel syndrome. Aliment Pharmacol Ther 2007.26:979-986. [PMID:17877505]
[32]Camilleri M, Andrews CN. Bharucha AE, et al. Alterations in expression of p11 and SERT in mucosal biopsy specimens of patients with irritable bowel syndrome. Gastroenterology 2007,132:17-25. [PMID: 17241856]
[33]Wang Z, Guo Y, et al. Sex differences in functional brain activation during noxious visceral stimulation in rats. Pain 2009,145(1-2):120-8. [PMID:19560270]
[34]O'Mahony SM. Bulmer DC, et al.5-HT(2B) receptors modulate visceral hypersensitivity in a stress-sensitive animal model of brain-gut axis dysfunction. Neurogastroenterol Motil 2010,22(5):573-8. [PMID:20003079]
[35]Gibney SM, Gosselin RD, et al. Colorectal distension-induced prefrontal cortex activation in the Wistar-Kyoto rat:implications for irritable bowel syndrome. Neuroscience 2010,165(3):675-83. [PMID: 19765638]
[36]Tian SL, Wang XY, Ding GH. Repeated electro-acupuncture attenuates chronic visceral hypersensitivity and spinal cord NMDA receptor phosphorylation in a rat irritable bowel syndrome model. Life Sci 2008, 83(9-10):356-63. [PMID:18694764]
[37]Liu HR, Wang XM, et al. Acupuncture at both ST25 and ST37 improves the pain threshold of chronic visceral hypersensitivity rats. Neurochem Res 2009,34(11):1914-8. [PMID:19387829]
[38]Xu GY. Winston JH, Chen JD. Electroacupuncture attenuates visceral hyperalgesia and inhibits the enhanced excitability of colon specific sensory neurons in a rat model of irritable bowel syndrome. Neurogastroenterol Motil 2009,21(12):1302-e125. [PMID:19558427]
[2]德罗斯曼(Drossman,D. A)总主编,柯美云,方秀才译.罗马Ⅲ：功能性胃肠病——3版[M].北京：科学技术出版社,2008 ISBN 978-7-03-021314-3.
[3]姚欣,杨云生,赵卡冰,等.罗马Ⅲ标准研究肠易激综合征临床特点及亚型[J].世界华人消化杂志2008；16：563-566
[4]Lea R, Whorwell PJ. New insights into the psychosocial aspects of irritable bowel syndrome[J]. Curr Gastroenterol Rep.2003;5:343-350.
[5]汪安江,陈旻湖.肠易激综合征药物治疗的循证医学评价[J].胃肠病学和肝病学杂志,2009,5(18)：388-391.
[6]黄宣,吕宾.肠易激综合征诊治进展和面临的挑战[J].世界华人消化杂志.2010；18(21)：2234-2239.
[7]郑筱萸.中药新药临床研究指导原则(试行).[M]北京：中国医药科技出版社,2002,第1版：139-143.
[8]徐义勇,朱丽娟.肠易激综合征情志致病的理论探讨[J].辽宁中医药大学学报,2008,6(10)：51-52.
[9]Morcos A, Dinan T, Quigley EM.Irritable bowel syndrome:role of food in pathogenesis and management[J]. J Dig Dis.2009 Nov;10(4):237-46.
[10]Honghton LA, Atkinson W, Whitaker RP, et al. Increased platelet depleted plasma 5-hyndroxytryptamine concentration following meal ingestion in symptomatic female subjects with diarrhoea-predominant irritable bowel syndorome[J]. Gut 2003;52:633-670.
[11]中华中医药学会脾胃病分会.肠易激综合征中医诊疗共识意见[J].中华中医药杂志(原中国医药学报),2010,7(25)：1062-1065.
[12]张声生,周滔,汪红兵,肠易激综合征中医药诊疗现状与挑战[J].世界华人消化杂志2010；18(21)：2216-2220
[13]Hopton A. MacPherson H. Acupuncture for chronic pain:is acupuncture more than an effective placebo? A systematic review of pooled data from meta-analyses[J]. Pain Pract.2010 Mar-Apr; 10(2):94-102.
[14]Marshall R, Paul L. Wood L. The search for pain relief in people with chronic fatigue syndrome:A descriptive study [J]. Physiother Theory Pract.2010 Nov 1. PMID:21039301
[15]Yeung AS, Ameral VE, Chuzi SE, et al. A pilot study of acupuncture augmentation therapy in antidepressant partial and non-responders with major depressive disorder[J]. J Affect Disord.2010 Aug 5. PMID:20692042
[16]王艳杰,王升旭.针灸治疗原发性抑郁症的循证医学研究概况[J].时珍国医国药,2008,19(12)：2886-2889.
[17]程肖蕊,程凯.国外针灸治病作用机制研究概况[J].中国针灸,2008,6(28)：463-467.
[l]王伟岸，钱家呜，潘国宗，等．脑．肠互动指向性条件应激肠易激综合征动物模型的建立[J]．中华消化 杂志2004，24(10)：590-593
[2]LU H, Qian JM, Jin GL, Zhou DF, Shen YC. The establishment of an animal model of gut-brain interaction in irritable bowel syndrome for the evaluation of visceral sensation, motility and psychological behavior[J]. Zhonghua Nei Ke Za Zhi 2009,48(12): 1035-9.
[3]石君杰，戴玉英，王海云，徐发莹．慢性束缚及夹尾刺激致大鼠肠易激综合征模型的建立及其内脏敏感性评价[J]．中国中西医结合消化杂志2008，l 6(2)：87-90
[4]Spence MJ, Moss-Morris R. The cognitive behavioural model of irritable bowel syndrome: a prospective investigation of patients with gastroenteritis[J]. Gut 2007, 56(8): 1066-71.
[1]孔庆建,张辉,孙波,张德军.肠易激综合征的病因与发病机制[J].中国煤炭工业医学杂志2006；9：3-1034
[2]Blomhoff S,Spetalen S,Jacobsen MB.Irritatic Bowelsyndrome-a maltitaclorical disease in children and adults[J].Tiddsskr Nor Laegc-foren 2002; 122:12-13,
[3]丁义侠,储浩然.针灸治疗肠易激综合征的研究[J].长春中医药大学学报,2010,5(26)：672-674
[4]安彩萍,杨珊.针灸治疗肠易激综合征机制研究进展[J].上海针灸杂志,2010,7(29)：474-477.
[5]罗远红陆丽明杨晓军脑-肠轴与摄食行为机制的研究进展[J].现代中西医结合杂志,2009,18(30)：3777-3779
[6]Talley NJ.Howell S,Poulton R. The irritable bowel syndrome and psychiatric disorders in the communty:is there a link? [J]. Am I gastroenterol,2001,96(4):1072-1079
[7]Silverman DH,Munakata JA.Ennes H.Mandelkern MA,Hoh CK.Mayer EA.Regional cerebral activity in normal and pathological perception of visceral pain[J].GastroenteroIogy 1997;112:64-72
[8]康明祥,贾红.肠易激综合征内脏高敏感性机制的研究进展[J].世界华人消化杂志,2008；16(14)：1554-1558
[9]Sagami Y, ShimadaY,Tayama J,etal.Effect of a corticotropin releasing hormone receptor antagonist on colonic sensory and motor function in patientswith irritable bowel syndrome[J].Gut.2004 Jul:53(7):958-64.
[10]Coffin B,Bouhassira D.Sabate JM, et al.Alteration of the spinal modulation of nociceptive processing in patients with irritable bowel syndrome[J]. Gut.2004 Oct;53(10):1465-70.
[11]Carlson JD, Maire JJ, Martenson ME, et al. Sensitization of pain-modulating neurons in the rostral ventromedial medulla after peripheral nerve injury[J]. J Neurosci.2007 Nov 28;27(48):13222-31.
[12]Viisanen H,Pertovaara A.Influence of peripheral nerve injury on response properties of locus coeruleus neurons and coeruleospinal antinociception in the rat[J]. Neuroscience.2007 Jun 8;146(4):1785-94.
[13]Kohn A.Prantera C.Pera A,et al. Anti-tumour necrosis factor alpha (infliximab)in the treatment of severe ulcerative colitis:result of an open study on 13 patients[J].Dig Liver Dis 2002:34:626-630.
[14]王敬东.脑-肠互动在肠易激综合征发病中的作用[J].世界华人消化杂志,2006,14(34)：3299-3301.
[15]Spiller RC. Jenkins D, Thornley JP, et al.Inereased reetal mucosal enteroendoerine cells, T JymPhoeytes, and inereased gut permeability in CamPylobacter following acute CamPylobaeter enteritis and inpostdysenteric irritable bowel syndrome[J].Gut.2000,47:804-811.
[16]Lawson SN.Crepps BA,Perl ER.Calcitonin gene-related peptide immunoreactivity and afferent receptive properties of dorsal root ganglion neurons in guinea-pigs[J].J Physiol 2002;540:989-1002.
[17]Robinson DR,McNaughton PA,Evans ML,et a 1.Characterization of the primary spinal afferent innervation of the mouse colon using retrograde labelling[J].Neurogastroenterol Motil,2004,16(l):113-124.
[18]王垂杰,赵文娟,李玉锋.痛泻要方对肠易激综合征大鼠血浆及肠黏膜CGRP影响的实验研究[J].生命科学仪器,2009,7(10)：24-26.
[19]Delafoy L,Gelot A,Ardid D,et al. Interactive involvement of brain derived neurotrophicfactor,nerve growth factor,and calcitonin gene related peptide in colonic hypersensitivity in the rat[J]. Gut.2006 Jul;55(7):940-5.
[20]Vanderah TW.Pathophysiology of Pain[J].Med Clin N Am,2007,91:1-12.
[21]Cervero F,Laird JM.Understanding the signaling and transmission of visceral noci-ceptive events[J], J Neurobiol,2004,61 (1):45-54.
[22]章菲菲,莫剑忠.降钙素基因相关肽在内脏敏感性改变机制中的作用[J].胃肠病学和肝病学杂志,2005,14(2)：200-202.
[23]王锁儿,张俊义,王新亮.NPY的研究现状及进展[J].内蒙古医学杂志2010,42(6)：679-682
[24]Staud R, Spaeth M. Psychophysical and neurochemical abnormalitiesof pain processing in fibromyalgia[J]. CNS Spectr,2008.13(3 Suppl5):12-17.
[25]银新,宁守斌.肠易激综合征发病机制的研究进展[J].世界华人消化杂志2009；17(32):3318-3323
[26]张茹.肠易激综合征脑—肠交互作用模型结肠5-经色胺、酪氨酸经化酶水平变化及蛋白指纹图谱初探[D].北京协和医学院,2008.
[27]张尚志5-HT信号系统在FGIDS中的意义研究[J].胃肠病学和肝病学杂志2009年3月第18卷第3期201-203.
[28]Wu HG, Jiang B, Zhou EH, et al.Regulatory mechanism of electroacupuncture in irritable bowel syndrome: preventing MC activation and decreasing SP VIP secretion[J]. Dig Dis Sci.2008 Jun;53(6):1644-51.
[29]Garvin B, Wiley JW.The role of serotonin in irritable bowel syndrome:implications for management[J]. Curr Gastroenterol Rep.2008 Aug; 10(4):363-8.
[30]Spiller R.Recent advances in understanding the role of serotonin in gastrointestinal motility in functional bowel disorders:alterations in 5-HT signalling and metabolism in human disease[J]. Neurogastroenterol Motil.2007 Aug; 19 Suppl 2:25-31.
[31]Park JH, Rhee PL, Kim HS, et al.Mucosal mast cell counts correlate with visceral hypersensitivity in patients with diarrhea predominant irritable bowel syndrome[J]. J Gastroenterol Hepatol.2006 Jan;21(1 Pt 1):71-8.
[32]Xu JR, Luo JY, Shang L, Kong WM.Effect of change in an inhibitory neurotransmitter of the myenteric plexus on the pathogenetic mechanism of irritable bowel syndrome subgroups in rat models[J]. Chin J Dig Dis.2006;7(2):89-96.
[33]陈永萍.针灸对不同证型肠易激综合征结肠电、脑肠肽的影响[D].广州中医药大学博士学位论文,2000.
[34]荣培晶,朱兵,黄启福,等.针刺抑制直结肠伤害性扩张引起的大鼠脊髓背角神经元反应[J].中国针灸,2005,25(9)：645-650.
[35]朱青艳.电针上巨虚对急性束缚应激大鼠结肠功能的调节作用及中枢机制研究[D].湖北中医学院博士学位论文,2008.
[36]Liu HR, Wang XM, Zhou EH, et al.Acupuncture at both ST25 and ST37 improves the pain threshold of chronic visceral hypersensitivity rats[J]. Neurochem Res.2009 Nov;34(11):1914-8.
[1]徐俊荣等.5羟色胺受体可塑性在大鼠肠易激综合征中的作用.西安交通大学学报(医学版),2008,4：29(2)
[2]宁丽琴,叶柏.肠易激综合征研究进展.现代医学,2008,12：36(6)
[3]李文波,刘诗.针刺疗法治疗功能性肠疾病的研究进展.世界华人消化杂志.2006；14(2)：197-200
[4]施茵,张凌凌等.针灸治疗肠易激综合征临床概要.[J].上海针灸杂志,2007,26(8)：8
[5]孙菁,袁耀宗.肠易激综合征：罗马Ⅲ标准与我国共识意见解读.医学与哲学(临床决策论坛版),2008,6：29(6)
[6]詹群珊等.14种食物特异性lgG抗体检测在肠易激综合征中的应用价值.中国误诊学杂志,2008,3：8(8)
[7]熊嘉玮.针灸治疗肠易激综合征34例临床观察.江苏中医药,2009,41(1)：49-50
[8]崔大威.磁圆针配合针灸治疗肠易激综合征200例[J].上海针灸杂志,2005,24(5)：26.
[9]刘光英,朱文罡.腹泻型肠易激综合征的腹针治疗研究[J].光明中医,2005,20(3)：31-32.
[10]黄志刚,尤斌等.针灸辨证治疗肠易激综合征172例[J].上海针灸杂志,2006,25(7)：21-22.
[11]杨淑贤,王秀芹,蔡永.温针灸配合神阙穴贴敷治疗肠易激综合征疗效观察[J].上海针灸杂志,2006,25(12)：15-16.
[12]施茵等.针灸治疗肠易激综合征临床概要.上海针灸杂志,2007,26(8)：45-48.
[13]龙泽荣等.针刺加微生态制剂治疗便秘型肠易激综合征临床观察[J].中国针灸,2006,26(6)：403-405.
[14]石志敏.针灸治疗腹泻型肠易激综合征48例[J].浙江中医杂志,2005,40(7)：320.
[15]杨亚平.针灸治疗腹泻型肠易激综合征38例[J].现代康复,2001,5(5)：1-3.
[16]薛西林.针灸治疗肠易激综合征31例[J].上海针灸杂志,2000,19(5)：20.
[17]刘立平.针灸治疗肠易激综合征43例[J].临床荟萃,2004,19(15)：883.
[18]赵琛等.灸补脾胃之主方治疗腹泻型肠易激综合征91例临床观察[J].中国现代临床医学,2005,4(6)：31-33.
[19]黄子夏,何小琦,张桂珍等.73例肠易激综合征单纯及综合治疗临床观察[J].广州医学院学报,1999,27(4)：67-69.
[20]余南生,李永安,詹可顺.自拟健脾理气和胃汤配合灸脐治疗肠易激综合征观察[J].安徽中医临床杂志,2003,15(5)：374-375.
[21]谢胜,张志杰,梁谊深.中草药蒸汽疗法合指针治疗肠易激综合征64例[J].陕西中医,2006,27(1)：54-55.
[22]黄政德,梁立安,张维新.针刺推拿结合治疗肠易激综合征[J].中国针灸,2006,26(10)：717-718.
[23]何严,高宏.针灸配合按摩治疗肠易激综合征36例[J].陕西中医,2004,25(3)：258-259.
[1]张声生,李乾构,等.肠易激综合征中医诊疗共识意见.中华中医药学会脾胃病分会中华中医药杂志(原中国医药学报)2010,7：1062-1065.
[2]SpinelliA. Irritable bowel syndrome [J]. Clin Drug Investig 2007,27(1):15-33. [PMID:17177577]
[3]XiongLS, ChenMH, Chen HX, et al. A population-based epidemiologic studyof irritable bowel syndrome in South China: stratified randomized study by cluster sampling [J]. Aliment Pharmacol Ther 2004,19(11): 1217-1224. [PMID:15153175]
[4]张万岱.功能性胃肠病罗马标准的简介和解读.世界华人消化杂志2008,16(2)：120-124.
[5]张文静.成人肠易激综合征诊治新指南.现代消化及介入诊疗2007,12(2)：141.
[6]孙菁,袁耀宗.肠易激综合征：罗马Ⅲ标准与我国共识意见解读.医学与哲学(临床决策论坛版)2008,359(6)：12-16.
[7]孔庆建,张辉,等.肠易激综合征的病因与发病机制.中国煤炭工业医学杂志2006，9(10)：1033-1034.
[8]Arebi N, Gurmany S, et al. The psychoneuroimmunology of irritable bowel syndrome--an exploration of interactions between psychological, neurological and immunological observations. Aliment Pharmacol Ther 2008,28(7):830-40. [PMID:18637004]
[9]夏德雨,王景杰,陆松鹤,等.直肠扩张刺激引起IBS大鼠痛行为学以及骶髓DCN中神经元和胶质细胞的变化.胃肠病学和肝病学杂志2007,16(6)：589-594.
[10]王景杰,王胜智,夏德雨,等.结肠扩张刺激对P2X4受体在IBS大鼠神经中枢中表达的影响.胃肠病学和肝病学杂志2008,17(]0)：813-817.
[11]赖华梅,诸琦,王静,等.脑源性神经营养因子在乳鼠结肠扩张刺激诱导的慢性内脏高敏感和肠道动力异常中的作用.胃肠病学2008,13(4)：223-227.
[12]韩真,王运东.腹泻型肠易激综合征模型大鼠肠道Cajal间质细胞的变化及意义.中国病理生理杂志2008,24(11)：2263-2264、2271.
[13]唐洪梅,李得堂,黄樱华,等.肠激安方抑制肠易激综合征模型大鼠肥大细胞的实验研究.中药新药与临床药理2008,19(6)：464-466.
[14]徐海珍,谢建群,施斌,等.腹泻型肠易激综合征大鼠结肠黏膜炎性细胞因子的表达及温中健脾方对其影响的研究.上海中医药杂志2007,41(6)：69-72.
[15]吕宾,蒋霞,丁瑞峰,等.内脏高敏感大鼠脑干降钙素基因相关肽、c-fos基因表达的研究.胃肠病学2007,]2(11)：681-684.
[16]孙刚,杨云生,彭丽华,王巍峰.肠易激综合征大鼠内脏敏感性异常与结肠及中枢神经系统5-HT和c-fos表达的关系.胃肠病学和肝病学杂志2008,17(4)：313-317.
[17]朱雪萍,陈卫昌,朱晓黎,等.幼鼠肠易激综合征模型肠道微生态的对照研究.实用儿科临床杂志 2007,22(7)：530-531.
[18]O'Mahony SM, Marchesi JR. et al. Early life stress alters behavior, immunity, and microbiota in rats: implications for irritable bowel syndrome and psychiatric illnesses. Biol Psychiatry 2009.65(3):263-7. [PMID: 18723164]
[19]朱力阳,彭成,谢晓芳,王嫣虹.化学刺激引起的两种大鼠内脏高教感性模型的建立.中国药理学通报2010,26(2)：267-270.
[20]李冬华,李春森,李伍善,等.痛泻要方对肠易激综合征模型大鼠血管活性肠肤的影响.时珍国医国药2007,18(9)：2098-2099.
[21]费晓燕,谢建群,郑昱,等.疏肝饮对腹泻型肠易激综合征模型大鼠胃动素和胆囊收缩素的影响.上海中医药杂志2008,42(4)：63-65.
[22]石君杰,戴玉英,王海云,徐发莹.慢性束缚及夹尾刺激致大鼠肠易激综合征模型的建立及其内脏敏感性评价.中国中西医结合消化杂志2008,16(2)：87-90.
[23]Spence MJ, Moss-Morris R. The cognitive behavioural model of irritable bowel syndrome:a prospective investigation of patients with gastroenteritis. Gut 2007.56(8):1066-71. [PMID:17324974]
[24]Anthony C. Johnson, et al. Brain Activation in Response to Visceral Stimulation in Rats with Amygdala Implants of Corticosterone:An fMRI Study. PLoS One.2010,5(1):e8573. [PMID:20052291]
[25]Eutamene H, Bradesi S. et al. Guanylate cyclase C-mediated antinociceptive effects of linaclotide in rodent models of visceral pain. Neurogastroenterol Motil 2010,22(3):312-e84. [PMID:19706070]
[26]Ma XP. Tan LY, et al. Effect of electro-acupuncture on substance P, its receptor and corticotropin-releasing hormone in rats with irritable bowel syndrome. World J Gastroenterol 2009,15(41):5211-7. [PMID: 19891022]
[27]安钰,白殿卿,等.乙酸灌肠加束缚应激致大鼠肠易激综合征模型的建立及其评价.世界华人消化杂志2009,17(15)：1548-1551.
[28]朱雪萍,陈卫昌,朱晓黎,等.脑肠肽、脑肠轴在肠易激综合征模型中作用机制研究.临床儿科杂志2008,26(3)：236-239.
[29]王伟岸,钱家鸣,潘国宗,等.脑-肠互动指向性条件应激肠易激综合征动物模型的建立.中华消化杂志2004,24(10)：590-593.
[30]Lu H, Qian JM, Jin GL, Zhou DF, Shen YC. The establishment of an animal model of gut-brain interaction in irritable bowel syndrome for the evaluation of visceral sensation, motility and psychological behavior. Zhonghua Nei Ke Za Zhi 2009.48(12):1035-9. [PMID:20193524]
[31]Van Kerkhoven LA, Laheij RJ, Jansen JB. Meta-analysis:a functional polymorphism in the gene encoding for activity of the serotonin transporter protein is not associated with the irritable bowel syndrome. Aliment Pharmacol Ther 2007.26:979-986. [PMID:17877505]
[32]Camilleri M, Andrews CN. Bharucha AE, et al. Alterations in expression of p11 and SERT in mucosal biopsy specimens of patients with irritable bowel syndrome. Gastroenterology 2007,132:17-25. [PMID: 17241856]
[33]Wang Z, Guo Y, et al. Sex differences in functional brain activation during noxious visceral stimulation in rats. Pain 2009,145(1-2):120-8. [PMID:19560270]
[34]O'Mahony SM. Bulmer DC, et al.5-HT(2B) receptors modulate visceral hypersensitivity in a stress-sensitive animal model of brain-gut axis dysfunction. Neurogastroenterol Motil 2010,22(5):573-8. [PMID:20003079]
[35]Gibney SM, Gosselin RD, et al. Colorectal distension-induced prefrontal cortex activation in the Wistar-Kyoto rat:implications for irritable bowel syndrome. Neuroscience 2010,165(3):675-83. [PMID: 19765638]
[36]Tian SL, Wang XY, Ding GH. Repeated electro-acupuncture attenuates chronic visceral hypersensitivity and spinal cord NMDA receptor phosphorylation in a rat irritable bowel syndrome model. Life Sci 2008, 83(9-10):356-63. [PMID:18694764]
[37]Liu HR, Wang XM, et al. Acupuncture at both ST25 and ST37 improves the pain threshold of chronic visceral hypersensitivity rats. Neurochem Res 2009,34(11):1914-8. [PMID:19387829]
[38]Xu GY. Winston JH, Chen JD. Electroacupuncture attenuates visceral hyperalgesia and inhibits the enhanced excitability of colon specific sensory neurons in a rat model of irritable bowel syndrome. Neurogastroenterol Motil 2009,21(12):1302-e125. [PMID:19558427]