调神健脾针法对腹泻型肠易激综合征患者TLR 2/4、MYD 88、NF-κb的影响

Effect of Regulating Mind and Strengthening Spleen Needling on TLR 2/4,MYD88 and NF-κB in Patients with Diarrheal Irritable Bowel Syndrome

目的研究针刺对腹泻型肠易激综合征患者(IBS-D)TLR 2/4、MYD 88、NF-κb的影响,探讨针灸治疗IBS-D的机制。方法选取30例IBS-D患者为针刺组,30例健康志愿者为健康对照组。针刺组予调神健脾针法治疗,每周治疗3次,共治疗18次,每次30 min。穴位取百会、印堂,太冲、足三里、三阴交、天枢、上巨虚。健康对照组为空白对照,不予任何处理。观察IBS-D患者针刺治疗前后IBS症状严重度(IBS-SSS)、ZUNG氏抑郁评分量表(SDS)、ZUNG氏焦虑评分量表(SAS)评分变化,并进行IBS-SSS等级疗效评定;比较IBS-D患者与健康志愿者Toll样受体家族2/4(TLR 2/4)、髓样分化因子88(MYD 88)、NF-κb mRNA和蛋白表达差异;以及IBS-D患者针刺治疗前后TLR 2/4、MYD 88、NF-κb mRNA和蛋白表达变化。结果IBS-D患者针刺治疗后IBS-SSS、SDS、SAS均明显低于治疗前(P<0.05);IBS-D患者针刺治疗前TLR 2/4、MYD 88、NF-κb mRNA和蛋白表达均高于健康志愿者(P<0.05);IBS-D患者针刺治疗后TLR 2/4、MYD 88、NF-κb mRNA及蛋白表达较治疗前明显降低(P<0.05)。结论针刺可以显著缓解IBS-D相关临床症状,其作用机制可能与调节TLR 2/4、MYD 88、NF-κb表达有关。

Objective To study the effects of acupuncture on Toll-like receptors(TLR)2/4,myeloid differentiation factor 88(MYD88)and nuclear factor kappa B(NF-κB)in patients with diarrheal irritable bowel syndrome(IBS-D)and explore the mechanism of acupuncture treatment of IBS-D.Methods Thirty IBS-D patients were selected as the acupuncture group and 30 healthy volunteers as the control group.The acupuncture group were treated with regulating mind and strengthening spleen needling three times a week,a total of 18 times,30 minutes for each time.The acupoints included Baihui(GV20),Yintang(GV29),Taichong(LR3),Zusanli(ST36),Sanyinjiao(SP6),Tianshu(ST25)and Shangjuxu(ST37).The control group was a blank control group without any treatment.IBS Symptom Severity rating Scale(IBS-SSS),Self-Rating Depression Scale(SDS)and Self-Rating Anxiety Scale(SAS)were observed before and after acupuncture treatment in IBS-D patients,and the efficacy of IBS-SSS grade was evaluated.The differences in mRNA and protein expressions of TLR 2/4,MYD88 and NF-κB between IBS-D and healthy volunteers as well as the changes in mRNA and protein expressions of TLR 2/4,MYD88 and NF-κB in IBS-D patients before and after acupuncture were compared.Results Compared with those before treatment,scores of IBS-SSS,SDS and SAS in IBS-D patients after acupuncture treatment were decreased(P<0.05).Compared with those of the healthy volunteers,the mRNA and protein expressions of TLR 2/4,MYD88 and NF-κB were high in IBS-D patients before acupuncture treatment(P<0.05).The mRNA and protein expressions of TLR 2/4,MYD88 and NF-κB after acupuncture treatment were significantly decreased in IBS-D patients(P<0.05).Conclusion Acupuncture can significantly alleviate IBS-D related clinical symptoms,and the mechanism of action may be associated with the regulation of the expressions of TLR 2/4,MYD88 and NF-κB.