电针对严重功能性便秘患者血浆NOS和5-HT含量的影响及意义

Electro-acupuncture regulates plasma NOS and 5-HT levels in patients with severe functional constipation

目的:通过观察电针对严重功能性便秘患者血浆一氧化氮合酶(nitric oxide synthase,NOS)和5-羟色胺(5-hydroxytryptamine,5-HT)含量的影响,探讨电针治疗严重功能性便秘的可能机制.方法:将符合纳入标准的60例病例采用中央随机系统随机分为电针治疗组和sham电针治疗组.通过比较治疗前后的便秘临床评分(cleveland clinic score,CCS)方面的变化及测定血浆NOS和5-HT的水平,观察两组对严重功能性便秘的治疗效果.结果:治疗后,电针组临床疗效和症状积分的评定量化后经卡方检验,治疗效果优于s h am电针组(P<0.01).电针组治疗后严重功能性便秘患者血浆中NOS和5-HT的含量水平比治疗前分别降低和升高明显(NOS:0.83 ng/m L±0.22 ng/m L vs 1.70 ng/m L±0.08 ng/m L,P<0.01;5-HT:496.97 ng/m L±25.53 ng/mL vs 394.36 ng/mL±20.38 ng/m L,P<0.01),且电针组治疗效果明显高于sham电针组(NOS:0.83 ng/m L±0.22 ng/m L vs 1.04ng/m L±0.19 ng/m L,P<0.01;5-HT:496.97n g/m L±25.53 n g/m L v s 452.29 n g/m L±20.19 ng/m L,P<0.01),两组比较差异有统计学意义.结论:电针治疗严重功能性便秘的作用机制可能与调节肠黏膜中NOS和5-HT的表达有关.

AIM： To observe the effect of electro-acupuncture on plasma levels of nitric oxide synthase（NOS） and 5-hydroxytryptamine（5-HT） in patients with severe functional constipation, and to explore the underlying mechanism.METHODS： Sixty patients with severe functional constipation were randomly divided into two groups to receive electro-acupuncture（EA group） or sham electro-acupuncture（sham EA group）, respectively. Cleveland clinic score（CCS） score and plasma NOS and 5-TH levels were compared between the two groups before and after treatment, and the therapeutic effect on severe functional constipation was assessed.R E S U LT S ： After treatment, the clinical curative effect was better in the EA group than in the sham EA group（P 〈 0.01）, and plasma levels of NOS and 5-HT were significantly reduced in the EA group（NOS： 0.83 ng/m L ± 0.22 ng/m L vs 1.70 ng/m L ± 0.08 ng/m L, P 〈 0.01; 5-HT： 496.97 ng/m L ± 25.53 ng/m L vs 394.36 ng/m L ± 20.38 ng/m L, P 〈 0.01） and sham EA group（NOS： 0.83 ng/m L ± 0.22 ng/m L vs 1.04 ng/m L ± 0.19 ng/m L, P 〈 0.01; 5-HT： 496.97 ng/m L ± 25.53 ng/m L vs 452.29 ng/m L ± 20.19 ng/m L, P 〈 0.01）. The improvement or reduction was moresignificant in the EA group than in the sham EA group. CONCLUSION： Electro-acupuncture exerts its therapeutic effects possibly by regulating expression of NOS and 5-HT in the intestinal mucosa of patients with severe functional constipation.