Du Yuzhu, Liang Yulei, Shi Yu, Xue Yuqiang, Liu Xiang, Tian Zan, Sun Mingxin, Wang Yanjun
College of Acupuncture-Moxibustion and Tuina, Hebei University of CM, Shijiazhuang 050200, China.
Department of Rehabilitation, Affiliated Hospital of Hebei University.
Zhongguo Zhen Jiu. 2024 Nov 12;44(11):1273-80. doi: 10.13703/j.0255-2930.20240320-k0002.
To observe the effects of acupuncture combined with bloodletting on the expression of inflammatory factors in serum, the morphology of sensitized skin tissue and the mast cell degranulation in urticaria rats, and to explore the potential mechanism of this therapy for urticaria.
Among 42 SD rats of SPF grade, 6 rats were randomly collected for the preparation of sensitized antiserum; and the rest 36 rats were randomized into a blank group, a model group, a positive drug group, an acupuncture group, a bloodletting group and a combined treatment group (acupuncture + bloodletting), 6 rats in each one. The rat model of urticaria was established by passive cutaneous anaphylaxis. In the positive drug group, loratadine (1 mg•kg) by gavage was administered once a day. In the acupuncture group, 1 h after gavage with 0.9% NaCl (1 mL), acupuncture was delivered at "Baihui" (GV 20), "Zhongwan" (CV 12), and bilateral "Quchi" (LI 11) and "Xuehai" (SP 10) for 15 min, once daily . In the bloodletting group, 1 h after gavage with 0.9% NaCl (1 mL), bloodletting was operated at "Dazhui" (GV 14) and bilateral "Geshu" (BL 17), around 0.1 mL of bleeding volume at each point, once daily. In the combined treatment group, 1 h after gavage with 0.9% NaCl (1 mL), the interventions as the acupuncture group and the bloodletting group were adopted, once daily. All the interventions started on day 6 of modeling, lasting 2 weeks. After intervention completion, antigenic stimulation was performed in the rats of each group. Using ELISA, the levels of serum immunoglobulin E (IgE), tryptase (TPS), interleukin-4 (IL-4), interleukin-5 (IL-5), tumor necrosis factor-α (TNF-α) were detected. The diameter of the blue spots of the sensitized skin on the back was measured with ruler in each rat. The morphology of sensitized skin tissue was observed using HE staining, and the degranulation of mast cells was observed using Toluidine blue staining.
Compared with the blank group, in the model group, the levels of serum IgE, TPS, IL-4, IL-5 and TNF-α increased (<0.01), the diameter of blue spot on the sensitized part of the rat back was larger (<0.01), the degranulation rate of mast cells was elevated (<0.01), and there were obvious inflammatory cell infiltration and edema in the dermis of sensitized skin tissue on the rat back. Compared with the model group, the serum levels of IgE, TPS, IL-4, IL-5 and TNF-α were reduced in the positive drug group, the acupuncture group, the bloodletting group and the combined treatment group (<0.01, <0.05); skin blue spot diameter was smaller in the positive drug group and the combined treatment group (<0.05); the degranulation rate of mast cells decreased in the positive drug group, the acupuncture group, the bloodletting group and the combined treatment group (<0.01); and the dermal edema, inflammatory infiltration were attenuated in the positive drug group, the acupuncture group, the bloodletting group and the combined treatment group. Compared with the acupuncture group and the bloodletting group, the serum levels of IgE, TPS, IL-4, IL-5 and TNF-α, as well as the degranulation rate of mast cells in the sensitized tissue were lower in the positive drug group and the combined treatment group (<0.05).
Acupuncture combined with bloodletting effectively suppress mast cell degranulation in the sensitized skin tissue on the back of urticaria rats, and ameliorate the histopathological morphology. Its effect mechanism may be related to inhibiting the differentiation and proliferation of helper T cells 2 and regulating the humoral immune response.
观察针刺联合放血对荨麻疹大鼠血清炎症因子表达、致敏皮肤组织形态及肥大细胞脱颗粒的影响,探讨该疗法治疗荨麻疹的潜在机制。
42只SPF级SD大鼠,随机取6只制备致敏抗血清;其余36只随机分为空白组、模型组、阳性药物组、针刺组、放血组和联合治疗组(针刺 + 放血),每组6只。采用被动皮肤过敏反应法建立大鼠荨麻疹模型。阳性药物组给予氯雷他定(1 mg•kg)灌胃,每日1次。针刺组于0.9%氯化钠溶液(1 mL)灌胃1 h后,针刺“百会”(GV 20)、“中脘”(CV 12)及双侧“曲池”(LI 11)、“血海”(SP 10),留针15 min,每日1次。放血组于0.9%氯化钠溶液(1 mL)灌胃1 h后,在“大椎”(GV 14)及双侧“膈俞”(BL 17)放血,每穴出血量约0.1 mL,每日1次。联合治疗组于0.9%氯化钠溶液(1 mL)灌胃1 h后,采用针刺组和放血组的干预措施,每日1次。所有干预均于造模第6天开始,持续2周。干预结束后,对各组大鼠进行抗原刺激。采用ELISA法检测血清免疫球蛋白E(IgE)、类胰蛋白酶(TPS)白细胞介素 -4(IL -4)、白细胞介素 -5(IL -5)、肿瘤坏死因子 -α(TNF -α)水平。用直尺测量大鼠背部致敏皮肤蓝斑直径。采用HE染色观察致敏皮肤组织形态,甲苯胺蓝染色观察肥大细胞脱颗粒情况。
与空白组比较,模型组大鼠血清IgE、TPS、IL -4、IL -5及TNF -α水平升高(P<0.01),背部致敏部位蓝斑直径增大(P<0.01),肥大细胞脱颗粒率升高(P<0.01),背部致敏皮肤组织真皮层有明显炎性细胞浸润及水肿。与模型组比较,阳性药物组、针刺组、放血组及联合治疗组大鼠血清IgE、TPS、IL -4、IL -5及TNF -α水平降低(P<0.01,P<0.05);阳性药物组及联合治疗组皮肤蓝斑直径减小(P<0.05);阳性药物组、针刺组、放血组及联合治疗组肥大细胞脱颗粒率降低(P<0.01);阳性药物组、针刺组、放血组及联合治疗组真皮水肿、炎性浸润减轻。与针刺组和放血组比较,阳性药物组及联合治疗组致敏组织血清IgE、TPS、IL -4、IL -5及TNF -α水平及肥大细胞脱颗粒率降低(P<0.05)。
针刺联合放血可有效抑制荨麻疹大鼠背部致敏皮肤组织肥大细胞脱颗粒,改善组织病理形态。其作用机制可能与抑制辅助性T细胞2分化增殖、调节体液免疫反应有关。