Shang Hai-Xia, Wang An-Qi, Bao Chun-Hui, Wu Huan-Gan, Chen Wei-Feng, Wu Lu-Yi, Ji Rong, Zhao Ji-Meng, Shi Yin
Hai-Xia Shang, An-Qi Wang, Lu-Yi Wu, Rong Ji, Ji-Meng Zhao, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
World J Gastroenterol. 2015 Apr 28;21(16):4986-96. doi: 10.3748/wjg.v21.i16.4986.
To investigate the effect of herb-partitioned moxibustion combined with acupuncture on the expression of intestinal epithelial tight junction (TJ) proteins.
Sixty patients diagnosed with mild to moderate Crohn's disease (CD) were allocated into the herb-partitioned moxibustion combined with acupuncture (HMA) group (n = 30) or the mesalazine (MESA) group (n = 30) using a parallel control method. There were 2 sets of acupoints used alternately for HMA treatment. The following points were included in Set A: ST25 (Tianshu), RN6 (Qihai), and RN9 (Shuifen) for herb-partitioned moxibustion and ST36 (Zusanli), ST37 (Shangjuxu), LI11 (Quchi), and LI4 (Hegu) for acupuncture. The points for Set B included BL23 (Shenshu) and BL25 (Dachangshu) for herb-partitioned moxibustion and EX-B2 of T6-T1 (Jiajixue) for acupuncture. The patients received the same treatment 6 times a week for 12 consecutive weeks. The MESA group received 1 g of mesalazine enteric coated tablets 4 times daily for 12 consecutive weeks. Intestinal tissues were stained and examined to compare the morphological and ultrastructural changes before and after the treatment session. Immunohistochemistry and in situ hybridization assays were used to detect the expression of intestinal epithelial TJ proteins zonula occludens-1 (ZO-1), occludin, and claudin-1. The mRNA levels were also evaluated.
After the treatment, both herb-partitioned moxibustion combined with acupuncture and mesalazine improved intestinal morphology and ultrastructure of CD patients; the patients treated with HMA showed better improvement. HMA significantly increased the expression of ZO-1 (P = 0.000), occludin (P = 0.021), and claudin-1 (P = 0.016). MESA significantly increased the expression of ZO-1 (P = 0.016) and occludin (P = 0.026). However, there was no significant increase in the expression of claudin-1 (P = 0.935). There was no statistically significant difference between the two groups for the expression of occludin and claudin-1 (P > 0.05). The HMA group showed a significant improvement in ZO-1 expression compared to the MESA group (2333.34 ± 352.51 vs 2160.38 ± 307.08, P = 0.047). HMA significantly increased the expression of ZO-1 mRNA (P = 0.000), occludin mRNA (P = 0.017), and claudin-1 mRNA (P = 0.017). MESA significantly increased the expression of ZO-1 mRNA (P = 0.000), occludin mRNA (P = 0.042), and claudin-1 mRNA (P = 0.041). There was no statistically significant difference between the two groups in the expression of occludin and claudin-1 mRNA (P > 0.05). However, the HMA group showed a significant improvement in ZO-1 mRNA expression compared with the MESA group (2378.17 ± 308.77 vs 2200.56 ± 281.88, P = 0.023).
HMA can repair intestinal epithelial barrier lesions and relieve inflammation by upregulating the expression of TJ proteins and their mRNAs.
探讨隔药饼灸联合针刺对肠道上皮紧密连接（TJ）蛋白表达的影响。
将60例诊断为轻至中度克罗恩病（CD）的患者采用平行对照法分为隔药饼灸联合针刺（HMA）组（n = 30）和美沙拉嗪（MESA）组（n = 30）。HMA治疗交替使用两组穴位。A组包括用于隔药饼灸的ST25（天枢）、RN6（气海）和RN9（水分），以及用于针刺的ST36（足三里）、ST37（上巨虚）、LI11（曲池）和LI4（合谷）。B组穴位包括用于隔药饼灸的BL23（肾俞）和BL25（大肠俞），以及用于针刺的T6 - T1的EX - B2（夹脊穴）。患者每周接受相同治疗6次，连续治疗12周。MESA组连续12周每天4次口服1 g美沙拉嗪肠溶片。对肠道组织进行染色和检查，以比较治疗前后的形态和超微结构变化。采用免疫组织化学和原位杂交试验检测肠道上皮TJ蛋白闭合蛋白 - 1（ZO - 1）、闭锁蛋白和紧密连接蛋白 - 1的表达，并评估mRNA水平。
治疗后，隔药饼灸联合针刺和美沙拉嗪均改善了CD患者的肠道形态和超微结构；HMA组患者改善更佳。HMA显著增加了ZO - 1（P = 0.000）、闭锁蛋白（P = 0.021）和紧密连接蛋白 - 1（P = 0.016）的表达。MESA显著增加了ZO - 1（P = 0.016）和闭锁蛋白（P = 0.026）的表达。然而，紧密连接蛋白 - 1的表达无显著增加（P = 0.935）。两组间闭锁蛋白和紧密连接蛋白 - 1的表达无统计学差异（P > 0.05）。与MESA组相比，HMA组ZO - 1表达有显著改善（2333.34 ± 352.51 vs 2160.38 ± 307.08，P = 0.047）。HMA显著增加了ZO - 1 mRNA（P = 0.000）、闭锁蛋白mRNA（P = 0.017）和紧密连接蛋白 - 1 mRNA（P = 0.017）的表达。MESA显著增加了ZO - 1 mRNA（P = 0.000）、闭锁蛋白mRNA（P = 0.042）和紧密连接蛋白 - 1 mRNA（P = 0.041）的表达。两组间闭锁蛋白和紧密连接蛋白 - 1 mRNA的表达无统计学差异（P > 0.05）。然而，与MESA组相比，HMA组ZO - 1 mRNA表达有显著改善（2378.17 ± 308.77 vs 2200.56 ± 281.88，P = 0.023）。
HMA可通过上调TJ蛋白及其mRNA的表达来修复肠道上皮屏障损伤并减轻炎症。
