针刺八髎穴通过调节肠道菌群-肥大细胞-瞬时受体电位香草酸亚型1轴减轻肠易激综合征的内脏高敏感性

Electroacupuncture at Baliao Points Attenuates Visceral Hypersensitivity in Irritable Bowel Syndrome via Gut-Microbiota-Mast Cell-TPRV1 Axis Modulation.

作者信息

Sun Meng-Yang, Xing Hai-Hui, Lin Xu, Cheng Bang-Guo, Liu Xue, Ni Min

机构信息

Nanjing Hospital of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China.

Lianyungang Clinical Medical School of Nanjing Medical University, Lianyungang, China.

出版信息

Neurogastroenterol Motil. 2025 Aug 31:e70137. doi: 10.1111/nmo.70137.

DOI:10.1111/nmo.70137

PMID:40887796

Abstract

BACKGROUND

Visceral hypersensitivity (VH) is a key pathophysiological feature of irritable bowel syndrome (IBS), contributing to chronic abdominal pain and discomfort. While electroacupuncture (EA) has demonstrated efficacy in alleviating IBS symptoms, the mechanisms underlying its effects at the Baliao acupoint remain unclear.

METHODS

In this translational study, we enrolled 40 IBS patients (gender-balanced, aged 30-60 years) who received standardized EA treatment at Baliao acupoints, with pain intensity assessed using visual analogue scale (VAS) scoring. An IBS rat model was established using acetic acid enema combined with restraint stress. Rats received EA at Baliao or sham acupuncture for 2 weeks. Visceral sensitivity was assessed via abdominal withdrawal reflex (AWR), while mast cell (MC) numbers, histamine and substance P (SP) release, and tight junction proteins (ZO-1, occludin) were quantified. Gut-microbiota composition was analyzed by 16S rDNA sequencing, and the alterations of TRPV1 neuron and MAPK signaling were evaluated via immunofluorescence and Western blot.

RESULTS

EA at Baliao significantly attenuated VH in both IBS patients (reduced VAS scores, difference -3.000 ± 0.4264) and rats (lower AWR scores, difference 1.050 ± 0.2630), compared to the sham group. Treatment with EA restored gut microbial diversity, promoting beneficial taxa (Bifidobacterium, Akkermansia) while suppressing pathobionts (Helicobacter, Prevotella). Moreover, EA inhibited MC degranulation, reducing histamine (↓40%, p < 0.01) and SP (↓28%, p < 0.05), and enhanced intestinal barrier integrity via ZO-1/occludin upregulation. Crucially, EA suppressed TRPV1+ neuron activation in the colon and dorsal root ganglia, disrupting MC-neuron crosstalk through TRPV1/MAPK pathway modulation.

CONCLUSION

EA (Baliao) alleviates VH by modulating gut microbiota, inhibiting MC activation, and blocking TRPV1 positive neuron mediated signal transmission. These findings highlight its potential as a non-pharmacological therapy for IBS, targeting multiple pathological axes.

摘要

背景

内脏高敏感性（VH）是肠易激综合征（IBS）的关键病理生理特征，可导致慢性腹痛和不适。虽然电针（EA）已被证明可有效缓解IBS症状，但其在八髎穴发挥作用的机制仍不清楚。

方法

在这项转化研究中，我们招募了40例IBS患者（性别均衡，年龄30 - 60岁），他们在八髎穴接受标准化电针治疗，使用视觉模拟量表（VAS）评分评估疼痛强度。采用醋酸灌肠联合束缚应激建立IBS大鼠模型。大鼠在八髎穴接受电针或假针刺治疗2周。通过腹部退缩反射（AWR）评估内脏敏感性，同时对肥大细胞（MC）数量、组胺和P物质（SP）释放以及紧密连接蛋白（ZO-1、闭合蛋白）进行定量分析。通过16S rDNA测序分析肠道微生物群组成，并通过免疫荧光和蛋白质印迹法评估TRPV1神经元和MAPK信号通路的改变。

结果

与假手术组相比，八髎穴电针显著减轻了IBS患者的VH（VAS评分降低，差值为 - 3.000 ± 0.4264）和大鼠的VH（AWR评分降低，差值为1.050 ± 0.2630）。电针治疗恢复了肠道微生物多样性，促进了有益菌属（双歧杆菌属、阿克曼氏菌属）的生长，同时抑制了病原菌（幽门螺杆菌、普雷沃菌属）。此外，电针抑制了MC脱颗粒，降低了组胺（降低40%，p < 0.01）和SP（降低28%，p < 0.05），并通过上调ZO-1/闭合蛋白增强了肠道屏障完整性。至关重要的是，电针抑制了结肠和背根神经节中TRPV1 + 神经元的激活，通过TRPV1/MAPK信号通路调节破坏了MC-神经元的相互作用。