针刺促进结直肠癌术后胃肠动力恢复的miRNA相关机制探讨

Study on Micro RNA-related Mechanism of Acupuncture in Promoting Postoperative Gastrointestinal Motility of Patients with Colorectal Cancer

【目的】探讨针刺促进结直肠癌术后胃肠动力恢复的miRNA相关机制。【方法】将30例结直肠癌术后胃肠动力障碍患者随机分为针刺组和对照组,每组各15例。对照组给予常规对症支持治疗,针刺组在对照组常规治疗的基础上,于术后1~5 d每日给予针刺双侧"足三针"(足三里、三阴交、太冲)治疗。观察2组患者术后首次排气、排便时间,评定疗效,并采用聚合酶链式反应(PCR)法检测血清miR-19a和癌组织miR-222表达量。【结果】(1)针刺组总有效率为80.0%,对照组为46.7%,针刺组的疗效优于对照组(P<0.05)。(2)针刺组的术后首次排气时间和首次排便时间均较对照组明显缩短,差异均有统计学意义(P<0.05)。(3)针刺组血清miR-19a在术后第5天较第1天明显下降(P<0.05),且其对血清miR-19a表达量的下降作用明显优于对照组(P<0.05)。(4)2组的癌组织miR-222表达量与术后首次排气时间均呈正相关(P<0.05),无效患者的癌组织miR-222表达量高于其他有效患者(P<0.05)。【结论】针刺能调节术后血清miR-19a水平,促进结直肠癌术后胃肠动力恢复;结直肠癌术后胃肠动力的恢复及其针刺疗效受到癌组织miR-222影响。

Objective To study the micro RNA-related mechanism of acupuncture in promoting postoperative gastrointestinal motility of patients with colorectal cancer. Methods Thirty cases of postoperative gastrointestinal motility disorder patients with colorectal cancer were randomly divided into acupuncture group and control group,15 cases in each group. The control group received conventional symptomatic and supportive therapy, and acupuncture group received acupuncture at bilateral foot triple points of Zusanli,Sanyinjiao,Taichong daily on postoperative day 1-5 on the basis of conventional therapy for the control group. Time for the first anal exsufflation and time for the first defecation after operation were observed for the evaluation of clinical efficacy. Meanwhile,miR-19 a expression level in serum and miR-222 expression level in the cancer tissue were detected by polymerase chain reaction（PCR）. Results（1） The total effective rate of acupuncture group was 80.0%, and that of the control group was 46.7%,the difference being significant（P 0.05）.（2）Time for the first anal exsufflation and time for the first defecation after operation in acupuncture group were shorter than those in the control group,the difference being significant（P 0.05）.（3） Serum miR-19 a expression level in acupuncture group was decreased obviously on postoperative day 5 compared to day 1（P 0.05）, and the decrease in acupuncture group was superior to that in the control group（P 0.05）.（4）The expression of miR-222 in the cancer tissuewas positively relevant to time for postoperative first anal exsufflation in both groups（P 0.05）,and the expression level in ineffective patients was higher than that in effective patients（P 0.05）. Conclusion Acupuncture can regulate serum miR-19 a expression level and promote the recovery in postoperative gastrointestinal motility of patients with colorectal cancer. The recovery of postoperative gastrointestinal motility in patients with colorectal cancer and the acupuncture effect are affected by miR-222 expression in the cancer tissue.