电针对腹泻型肠易激综合征患者结肠黏膜5-HT、5-HT3R表达的影响

Effect of Electro-acupuncture on Expressions of 5-HT and 5-HT3 Receptor in Colorectal Mucosa of Patients with Diarrhea-Predominant Irritable Bowel Syndrome

目的:观察电针对腹泻型肠易激综合征患者结肠黏膜5-HT、5-HT3R表达的影响,探讨其作用机制。方法:分别选取给予电针治疗(选取中脘、天枢、气海等穴,针刺后加电刺激,4周为1个疗程)16例和西药治疗(口服地衣芽孢杆菌和黛力新片)15例的腹泻型IBS患者治疗前后的乙状结肠黏膜组织,采用免疫组化法观察两组患者结肠黏膜5-HT、5-HT3R表达情况。结果:电针组和西药组两组患者治疗前结肠黏膜5-HT、5-HT3R阳性面积和光密度(OD)表达均较正常人有显著性升高(P<0.01,P<0.01);两组患者治疗后均较治疗前有显著性降低(P<0.01,P<0.01),电针组治疗后结肠黏膜5-HT、5-HT3R阳性面积表达则较西药组明显降低,两组间比较差异有统计学意义(P<0.05,P<0.05)。结论:电针可能通过显著降低腹泻型IBS患者结肠黏膜5-HT、5-HT3R表达,进而减弱神经介导的胃肠道运动与分泌,提高内脏痛阈,消除肠道过敏,由此改善胃肠道运动功能状态和内脏高敏感性而达到其治疗之目的。

Objective ： To investigate the effects of electro - acupuncture on the expressions of 5 - HT and 5 - HT3 re- ceptor（ 5 -HT3R）in colorectal mucosa of patients with diarrhea- predominant irritable bowel syndrome（ D -IBS）and e- lucidate their acting mechanism. Methods ： The biopsies of sigmoid colon were from D - IBS patients before and after the treatments. 16 patients were given electro- acupuncture therapy for 4 weeks（Zhongwan- RN12,bilateral points Tianshu - ST 25, Qihai - RN6 ）while 15 patients were given western medicine （orally took BnfiUus licheniformis and Deanxit） , the expressions of 5 - HT and 5 - HT3R were detected by immunohistochemistry. Results ： The positive areas and optical den- sities （OD）of 5 -HT and 5 -HT3R were significantly higher in IBS patients than those in normal controls （ P 〈 0.01, P 〈 0.01 ） ;decrease in each group was significantly observed after treatment（ P 〈 0.01, P 〈0.01 ） ,while the positive ar- ea and OD of 5 - HT and 5 - HT3R in electro - acupuncture group were significantly lower than that in western medicine group（ P 〈0.05, P 〈0.05 ）. Conclusions： Electro- acupuncture could alleviate entero- sensitivity and encelialgia to improve the gastrointestinal tract function and visceral hypersensitivity of IBS patients by effectively reducing the 5 - HT and 5 - HT3R expressions in colorectal mucosa of D - IBS patients.