针刺对结肠吻合术后Cajal间质细胞修复与再生的影响

Acupuncture improves the repair and regeneration of interstitial cells of Cajal in rats after enteroenterostomy

目的:探讨针刺促进术后肠道动力恢复的机制.方法:30只SD大鼠随机分为空白组、模型组(行结肠吻合术)、针刺组.针刺组予每日针刺双侧足三针(足三里、三阴交、太冲),连续3d.观察大鼠排便情况,测量小肠推进率,观察结肠组织Cajal间质细胞(interstitial cells of Cajal,ICC)超微结构和胆碱能神经-ICC-平滑肌细胞网络结构.结果:针刺组术后首次排便时间较模型组提前,小肠推进率提高(2.00d±0.47d vs 2.50d±0.53d,66.30%±4.21% vs 46.33%±5.56%,P<0.05).与空白组比较,模型组ICC超微结构损伤明显,胆碱能神经-ICC-平滑肌细胞网络结构紊乱,ICC和小泡乙酰胆碱转移体(VAChT)阳性神经纤维数量明显减少(18.67±6.11 vs 32.33±5.51,18.67±3.79 vs 20.67±3.21,P<0.05)荧光强度减弱(35.00±9.54 vs 58.67±10.21,20.33±5.13 vs 34.67±6.81,P<0.05).而针刺组ICC超微结构损伤较模型组轻,网络样结构维持,ICC和VAChT阳性神经纤维的数量较模型组增多(30.33±3.21 vs 18.67±6.11,23.00±4.58 vs 18.67±3.79,P<0.05),荧光强度增强(56.67±9.45 vs 35.00±9.54,36.00±8.19 vs 20.33±5.13,P<0.05).结论:针刺能促进结肠吻合术后肠动力的恢复,这可能与其具有修复ICC超微结构,促进ICC细胞及其网络结构再生的功能有关.

AIM：To explore the mechanism by which acupuncture promotes intestinal motility.METHODS：Thirty Sprague-Dawley rats were randomly divided into blank group,model group（receiving colocolic anastomosis） and acupuncture group.The acupuncture group underwent acupuncture at Zusanli,Sanyinjiao and Taichong daily for three continuous days.After acupuncture treatment,defecation was observed and intestinal propulsive rate was measured.Tissue samples of the colon which was 2 cm below the caecum were taken to observe the ultrastructure of interstitial cells of Cajal（ICC） and the Ache-ICC-SMC network.RESULTS：In the acupuncture group,the time to first postoperative passage of feces was short-ened and intestinal propulsive rate was improved compared with the model group [（2.00 ± 0.47） d vs（2.50 ± 0.53） d,（66.30 ± 4.21）% vs（46.33 ± 5.56）%,both P 〈0.05].Compared with the blank group,the damage of ICC ultrastructure in the model group was more significant while that in the acupuncture group was milder.In the model group,the ENS-ICC-SMC structure was disorganized,and the number of ICC and their fluorescence intensity were greatly decreased compared with the blank group [（18.67 ± 6.11） vs（32.33 ± 5.51）,（35.00 ± 9.54） vs（58.67 ± 10.21）,both P〈 0.05].In contrast,in the acupuncture group,the damage of the network structure was milder,and the number of ICC and their fluorescence intensity were increased compared with the model group [（30.33 ± 3.21） vs（18.67 ± 6.11）,（56.67 ± 9.45） vs（35.00 ± 9.54）,both P 〈0.05].Similar results were also obtained for the number of VAChT-positive nerve fibres [（18.67 ± 3.79） vs（20.67 ± 3.21）,（20.33 ± 5.13） vs（34.67 ± 6.81）,（23.00 ± 4.58） vs（18.67 ± 3.79）,（36.00 ± 8.19） vs（20.33 ± 5.13）,all P 〈0.05].CONCLUSION：Acupuncture can improve intestinal motility in rats after abdominal operation perhaps by improving the repair and regeneration of ICC.