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电针治疗肠易激综合征的调节机制:预防肥大细胞激活并减少P物质和血管活性肠肽分泌。

Regulatory mechanism of electroacupuncture in irritable bowel syndrome: preventing MC activation and decreasing SP VIP secretion.

作者信息

Wu Huan-Gan, Jiang Bin, Zhou En-Hua, Shi Zheng, Shi Da-Ren, Cui Yun-Hua, Kou Suo-Tang, Liu Hui-Rong

机构信息

Shanghai Institute of Acupuncture-Moxibustion and Meridian, 650 South WanPing st., XuHui, Shanghai 200030, P.R. China.

出版信息

Dig Dis Sci. 2008 Jun;53(6):1644-51. doi: 10.1007/s10620-007-0062-4.

Abstract

The efficacy of electroacupuncture (EA) for treating patients with diarrhea-predominant IBS has been confirmed in the authors' former research, but the regulatory mechanism of EA in IBS is still unknown. The aim of this study was to explore the relationship between the effect of EA on treating IBS rats and the activation and proliferation of mast cell (MC), the secretion of substance P(SP), and vasoactive intestinal polypeptide (VIP). The IBS rat model was set up with stress of binding limbs and colorectal distention. All rats were randomly assigned to four groups (Normal, Model, Tegaserod and EA). Hematoxylin and eosin staining has been used to observe the pathological change in the rats' colonic mucosa and an AWR scoring system has been applied to evaluate improvement of visceral hypersensitivity in various methods of the different groups. Toluidine blue improved method (TBI) and immunohistochemistry have also been involved in observations of mucous mast cells in the colon, change of c-fos positive cells, and secretion of SP, SPR, VIP, VIPR in the local colon. Firstly, the threshold of visceral sensitivity in the rats model with IBS was remarkably reduced (P < 0.01). The MC count in colonic mucosa and c-fos positive cells count increased significantly (P < 0.01) with positive correlation within each. Secondly, EA on ST-25 and Tegaserod pouring into the stomach can inhibit the proliferation and activation of MC in the colon and regulate secretion of SP, SPR, VIP, VIPR (P < 0.01, P < 0.05), while the effect of EA is obviously superior to Tegaserod. We concluded, firstly, that the abnormal proliferation and activation of mucous mast cells in the colon, and oversecretion of neuropeptides such as SP, VIP and their receptors could be one of key mechanisms of etiology of IBS. Secondly, the inhibition of activation and proliferation and the secretion of SP, VIP could be major effects of EA when treating rats with IBS.

摘要

作者之前的研究已证实电针(EA)治疗腹泻型肠易激综合征(IBS)患者的疗效,但EA在IBS中的调节机制尚不清楚。本研究旨在探讨EA治疗IBS大鼠的效果与肥大细胞(MC)的活化和增殖、P物质(SP)及血管活性肠肽(VIP)分泌之间的关系。采用束缚四肢加结直肠扩张应激法建立IBS大鼠模型。将所有大鼠随机分为四组(正常组、模型组、替加色罗组和电针组)。采用苏木精-伊红染色观察大鼠结肠黏膜的病理变化,应用腹壁回撤反射(AWR)评分系统评估不同组不同方法对内脏高敏感性的改善情况。还采用甲苯胺蓝改良法(TBI)和免疫组织化学观察结肠黏膜肥大细胞、c-fos阳性细胞的变化以及局部结肠中SP、SP受体(SPR)、VIP、VIP受体(VIPR)的分泌情况。首先,IBS大鼠模型的内脏敏感性阈值显著降低(P<0.01)。结肠黏膜中的MC计数和c-fos阳性细胞计数显著增加(P<0.01),且二者呈正相关。其次,电针双侧天枢穴(ST-25)及替加色罗灌胃均可抑制结肠MC的增殖和活化,并调节SP、SPR、VIP、VIPR的分泌(P<0.01,P<0.05),且电针的效果明显优于替加色罗。我们得出结论:其一,结肠黏膜肥大细胞异常增殖和活化以及SP、VIP等神经肽及其受体分泌过多可能是IBS发病的关键机制之一。其二,抑制活化、增殖以及SP、VIP的分泌可能是电针治疗IBS大鼠的主要作用机制。

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