腹部推拿疗法对便秘型肠易激综合征家兔模型结肠动力调控机制的研究

Study on Mechanism of Colonic Dynamic Regulation in Rabbits with Constipation-Type IBS Model

目的验证腹部推拿对肠易激综合征(irritable bowel syndrome,IBS)便秘模型家兔胃肠动力障碍的调节作用,观察腹部推拿对便秘型IBS家兔粪便性质、血浆中P物质(SP),血管活性肠肽(VIP)的含量、结肠平滑肌细胞Ca^(2+)浓度和平滑肌组织中L型Ca^(2+)通道mRNA表达的影响。方法实验家兔随机分为正常对照组、模型对照组、腹部推拿组,每组10只。采取冰水灌胃应激法建立IBS模型。腹部推拿组给予揉关元穴、揉气海穴操作,每方法施术5 min。以上治疗均为每天1次,连续28 d。观察家兔粪便性质、测定血浆中SP、VIP含量、肠平滑肌细胞Ca^(2+)浓度及组织中L型Ca^(2+)通道mRNA表达变化。结果与正常组比较,实验家兔造模后其粪便性质评分,血浆中SP、VIP含量均显著降低(P<0.01),而结肠平滑肌细胞Ca^(2+)浓度、L型Ca^(2+)通道mRNA表达显著增高(P<0.01)。经过治疗干预后,腹部推拿组与模型对照组比较,家兔的粪便性质评分,血浆中SP、VIP含量均显著升高(P<0.01,P<0.05),而结肠平滑肌细胞Ca^(2+)浓度、L型Ca^(2+)通道mRNA表达较模型对照组降低(P<0.05)。结论腹部推拿干预便秘型IBS的机制可能与其调节结肠组织中L型Ca^(2+)通道mRNA表达,改善结肠平滑肌细胞Ca^(2+)浓度有关,血中的神经递质SP、VIP可能是脑肠轴的中间介质反馈腹部推拿的良性刺激。

Objective To verify the regulating effect of abdominal Tuina on irritable bowel syndrome(IBS)constipation model rabbits with gastrointestinal motility disorder and observe the effect of abdominal Tuina on fecal properties and plasma substance P(SP)in constipated IBS rabbits.The influence of the content of vasoactive intestinal peptide(VIP),the Ca^(2+)concentration of colonic smooth muscle cells and the expression of L-type Ca^(2+)channel mRNA in smooth muscle tissue.Methods Experimental rabbits was randomly divided into normal control group,model control group and abdominal Tuina group,with 10 rabbits in each group.Thee ice water gavage stress method was used to establish IBS model.In the abdominal Tuina group,rubbing Guanyuan(RN4)and Qihai(RN6)were performed for 5 minutes for each time.The above treatment was once a day for 28 consecutive days.We observed the characteristics of rabbit feces,determined the plasma SP and VIP contents,intestinal smooth muscle cell Ca^(2+)concentration and tissue L-type Ca^(2+)channel mRNA expression changes.Results Compared with those of the normal group,the fecal character score of the experimental rabbits after modeling,the SP and VIP contents in plasma were significantly reduced(P<0.01),while the colonic smooth muscle cell Ca^(2+)concentration and L-type Ca^(2+)channel mRNA expression were significantly increased(P<0.01).After treatment intervention,comparing the abdominal Tuina group with the model control group,the fecal property score of the rabbits,the SP and VIP contents in plasma were significantly increased(P<0.01,P<0.05),while the colonic smooth muscle cell Ca^(2+)concentration and L-type expression of Ca^(2+)channel mRNA were lower than those of the model control group(P<0.05).Conclusion The mechanism of abdominal Tuina to interfere with constipated IBS may be related to regulating the expression of L-type Ca^(2+)channel mRNA in colon tissue and improving the Ca^(2+)concentration of colonic smooth muscle cells.The neurotransmitters SP and VIP in the blood may be the intermediate mediators of the brain-gut axis feedback to the abdomen benign stimulus of Tuina.