Affiliated Hospital, College of Medicine, Hebei University of Engineering, Handan, China.
Key Laboratory of Nanjing University of Chinese Medicine, Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China.
Neurogastroenterol Motil. 2018 Jul;30(7):e13318. doi: 10.1111/nmo.13318. Epub 2018 Feb 28.
On the basis of the importance of the enteric nervous system (ENS) in gastrointestinal motility, we hypothesized that the ENS may mediate the therapeutic efficacy of electro-acupuncture (EA) in constipation by regulating the mechanisms underlying the effects of EA on gastrointestinal function.
Model mice with constipation were generated by gastric instillation of 0-4°C normal saline. Defecation time and stool (form and wet and dry weight) were assessed. The effect of EA at ST37 or ST25 on colorectal motility and proximal colonic motility was assessed using a water-filled balloon. The expression of protein gene product 9.5 (PGP9.5), the cholinergic neuron marker acetyltransferase (ChAT) and the anticholinergic neuron marker nitric oxide synthase (nNOS) was detected by immunohistochemistry, real-time quantitative polymerase chain reaction (qPCR) and western blot analysis.
ST37 and ST25 improved colorectal pressure; however, ST37 but not ST25 improved proximal colonic pressure. In the proximal colon, the expression of PGP9.5 returned to normal after EA at ST 37, while EA at ST25 did not have this effect. In addition, qPCR and western blot analysis showed that ST37 could downregulate the expression of nNOS and upregulate the expression of ChAT to normal levels, while ST25 could only downregulate the expression of nNOS to normal levels.
Electro-acupuncture at specific acupoints can improve intestinal motility in constipation by altering the ENS and differentially affecting excitatory and inhibitory neurons, restoring the coordination between contraction and relaxation muscles, and working in concert with the central nervous system and peripheral neural pathways.
基于肠神经系统(ENS)在胃肠动力中的重要性,我们假设 ENS 可能通过调节 EA 对胃肠功能影响的机制来介导 EA 在便秘中的治疗效果。
通过胃内灌注 0-4°C 生理盐水生成便秘模型小鼠。评估排便时间和粪便(形态和干湿重)。使用充水气球评估 EA 在 ST37 或 ST25 对结直肠和近端结肠运动的影响。通过免疫组织化学、实时定量聚合酶链反应(qPCR)和 Western blot 分析检测蛋白基因产物 9.5(PGP9.5)、胆碱能神经元标志物乙酰转移酶(ChAT)和抗胆碱能神经元标志物一氧化氮合酶(nNOS)的表达。
ST37 和 ST25 改善结直肠压力;然而,ST37 而非 ST25 改善近端结肠压力。在近端结肠中,EA 在 ST37 后 PGP9.5 的表达恢复正常,而 ST25 则没有这种作用。此外,qPCR 和 Western blot 分析表明,ST37 可以下调 nNOS 的表达并上调 ChAT 的表达至正常水平,而 ST25 只能将 nNOS 的表达下调至正常水平。
特定穴位的电针可以通过改变 ENS 来改善便秘中的肠道动力,并对兴奋性和抑制性神经元产生不同的影响,恢复收缩和松弛肌肉之间的协调,与中枢神经系统和外周神经通路协同作用。