隔药饼灸对功能性胃肠病肝郁脾虚模型大鼠胃肠激素及胃肠动力的影响

Influence of herbal-cake-separated-moxibustion on gastrointestinal hormones and gastrointestinal motility in rats with functional gastrointestinal disorders and syndrome of liver stagnation and spleen deficiency

目的:观察隔药饼灸对功能性胃肠病(functional gastrointestinal disorders,FGIDs)肝郁脾虚模型大鼠胃肠激素及胃肠动力的影响,探讨隔药饼灸治疗FGIDs的可能作用机制.方法:将60只SD大鼠随机分为空白组、模型组、隔药饼灸组、逍遥散组和多潘立酮组5组,每组12只,除空白组外其余4组采用复合病因造模法(慢性束缚应激+过度疲劳+饮食失节)造模,连续21d;再按被试因素施加方法每天进行隔药饼灸和逍遥散、多潘立酮灌胃14d.实验结束后观测大鼠胃排空率、小肠推进率,取血清用ELISA法检测胃动素(motilin,MTL)、胃泌素(gastrin,Gas)和血管活性相关肠肽(vasoactive intestinal peptide,VIP)的水平.结果:隔药饼灸组、逍遥散组与多潘立酮组大鼠MTL、GAS和小肠推进率明显高于模型组,VIP含量和胃残留率明显低于模型组,差异均有高度统计学意义(MTL含量475.78pg/mL±77.27pg/mL,458.24pg/mL±63.02pg/mL,453.95pg/mL±54.04pg/mLvs397.93pg/mL±48.77pg/mL,P<0.05orP<0.01,GAS含量67.12pg/mL±9.08pg/mL,67.15pg/mL±8.75pg/mL,64.57pg/mL±8.68pg/mLvs57.34pg/mL±3.39pg/mL,P<0.01,小肠推进率60.19%±6.99%,60.55%±7.92%,62.04%±6.50%vs51.78%±5.57%,P<0.01,VIP含量155.71pg/mL±14.66pg/mL,151.79pg/mL±11.46pg/mL,147.03pg/mL±22.16pg/mLvs170.55pg/mL±16.83pg/mL,P<0.05orP<0.01,胃残留率31.13%±16.62%,35.55%±15.54%,30.79%±12.03%vs49.83%±11.25%,P<0.01),但3组间比较差异无统计学意义(P>0.05).结论:隔药饼灸组能和逍遥散组、多潘立酮组一样通过升高血清中MTL和GAS,降低VIP的水平从而达到促进胃排空和小肠推进的作用,这可能是其作用机制之一.

AIM： To observe the influence of herbal-cakeseparated moxibustion on gastric emptying, small intestinal transition and gastrointestinal hormones in rats with functional gastrointestinal disorders due to syndrome of liver stagnation and spleen deficiency and to explore the possible mechanism underlying the therapeutic effects of herbal-cake-separated-moxibustion against functional gastrointestinal disorders. METHODS： Sixty SD rats were randomly and equally divided into five groups： blank group, model group, herbal-cake-separated-moxibustion group, Xiaoyaosan group and domperidone group. Except for the blank group, the other four groups underwent modeling by applying chronic restraint stress ＋ excessive fatigue ＋ irregular food for 21 consecutive days. The herbal-cakeseparated-moxibustion group underwent herbal cake separated moxibustion for 14 d, while the Xiaoyaosan group and domperidone group were given Xiaoyaosan and domperidone by gavage for the same duration, respectively. At the end of the experiment, gastric emptying rate and small intestinal transit rate were determined, and serum levels of motilin （MTL）, gastrin （GAS） and vasoactive intestinal peptide （VIP） were measured by enzyme-linked immunosorbent assay. RESULTS： Serum VIP level and gastric emptying rate were significantly lower in the herbalcake-separated-moxibustion group, Xiaoyaosan group and domperidone group than in the mod-el group （VIP： 155.71 pg/mL ± 14.66 pg/mL, 151.79 pg/mL ± 11.46 pg/mL, 147.03 pg/mL ± 22.16 pg/mL vs 170.55 pg/mL ± 16.83 pg/mL, all P ＆lt; 0.05 or 0.01; gastric residual rate： 31.13% ± 16.62%, 35.55% ± 15.54%, 30.79% ± 12.03% vs 49.83% ± 11.25%, all P ＆lt; 0.01）, while serum levels of MTL and GAS and small intestinal transit rate were significantly higher in the three treatment groups than in the model group （MTL： 475.78 pg/mL ± 77.27 pg/mL, 458.24 pg/mL ± 63.02 pg/mL, 453.95 pg/mL ± 54.04 pg/mL vs 397.93 pg/mL ± 48.77 pg/mL, all P ＆lt; 0.05 or 0.01; GAS： 67.12 pg/mL ± 9.08 pg/mL, 67.15 pg/mL ± 8.75 pg/mL, 64.57 pg/mL ± 8.68 pg/mL vs 57.34 pg/mL ± 3.39 pg/mL, all P ＆lt; 0.01; small intestinal transit rate： 60.19% ± 6.99%, 60.55% ± 7.92%, 62.04% ± 6.50% vs 51.78% ± 5.57%, all P ＆lt; 0.01）. There were no significant differences in the above parameters among the three groups （all P ＆gt; 0.05）. CONCLUSION： Herbal cake-separated-moxibustion can promote gastric emptying and small intestinal transit possibly by increasing serum levels of MTL and GAS and reducing serum level of VIP.