针刺对去势雌兔干眼症模型的炎症因子及MUC5AC、MUC19表达的影响

The Effect of Acupuncture on the Expressions of Inflammatory Factors,MUC5AC and MUC19 in Ovariectomized Rabbits with Xeroma

目的:观察针刺对去势雌兔干眼症模型的炎症因子及MUC5AC、MUC19表达的影响。方法:60只新西兰雌兔(60眼,均为右眼),随机分为空白组、模型对照组、针刺组和药物组,每组15只。除空白组外,其余3组均采用双侧卵巢切除术制造去势雌兔干眼症模型。其中针刺组给予针刺睛明、攒竹、阳白、丝竹空、瞳子髎,药物治疗组给予苯甲酸雌二醇200μg/kg皮下注射,每周3次,4周为1个疗程。分别于治疗前、治疗后1周、2周及4周收集泪液检测IL-6、TNF-α、LF、MUC5AC、MUC19的浓度,并于治疗后采用荧光免疫组织化学法检测结膜组织中MUC5AC、MUC19的表达及泪腺形态学变化。结果:模型对照组IL-6、TNF-α水平较空白组显著升高,LF、MUC5AC、MUC19水平显著降低,差异具有显著统计学意义(P<0.01);针刺组不仅能够显著降低去势雌兔干眼症模型泪液IL-6、TNF-α水平,升高LF、MUC5AC、MUC19水平,还能显著升高角膜组织中MUC5AC、MUC19的阳性表达率,促进腺泡内物质的排空,促进泪腺的分泌,且明显优于药物组。结论:针刺治疗一方面可以抑制IL-6、TNF-α的促炎活性、增加LF水平达到抑菌作用,从而抑制眼表的炎症反应;另一方面通过促进杯状细胞及睑板腺对黏蛋白的合成和分泌,提高泪液中黏蛋白的表达,恢复泪膜的稳定性,从而恢复眼表的正常结构和功能。

Objective： To observe the effect of acupuncture on the expressions of inflammatory factors,MUC5 AC and MUC19 in the ovariectomized rabbit with xeroma. Methods： 60 female New Zealand white rabbits（ 60 eyes,right eye） were randomly divided into the blank group,the model group,the acupuncture group and the medication group,with 15 rabbits in each group. The xeroma models were established by bilateral oophorectomy in the other three groups except the blank group. Points of BL1,BL2,GB14,TE23,and GB1 were applied in the acupuncture group; Estradiol Benzoate（ 200 g/kg） was used through subcutaneous injection in the medication group,the intervention was three times a week for four weeks. Tear fluid were collected for the detection of IL-6,TNF-α,LF,MUC5 AC and MUC19 before treatment,one week after treatment,two weeks after treatment,and four weeks after treatment respectively; the expressions of MUC5 AC and MUC19 in the conjunctival tissues and the morphology changes of lacrimal gland were observed with immunohistochemistry method after treatment. Results： IL-6 and TNF-α were significantly increased,whereas LF,MUC5 AC,and MUC19 were significantly decreased in the model group compared to the blank group,and the difference was statistically significant（ P〈 0. 01）; the levels of IL-6 and TNF-α in tears were decreased,whereas LF,MUC5 AC,and MUC19 in tears were increased,the positive expressions of MUC5 AC and MUC19 in the conjunctival tissues were increased in the acupuncture group after treatment in comparison with the control group,promoting intra acinar material emptying and lacrimal secretion,which was significantly superior to the medication group. Conclusion： Acupuncture treatment,on one hand,can inhibit activity of IL-6 and TNF-α,and increase LF level to achieve the antibacterial effect of ocular surface; on the other hand,it can promote goblet cells and Meibomian glands to produce and secrete the sticky proteins,enhance the expressions of the sticky protein in tears,and stabilize lacrimal film to restore the normal structure and function of ocular surface.