隔药灸脐对原发性痛经大鼠神经-内分泌-免疫网络调节的经穴效应特异性研究

Herbal-cake-partitioned moxibustion of “Shenque” (CV8) has a relative specific effect in relieving abdominal pain and in regulating neuroendocrine-immune network in primary dysmenorrhea rats

目的:比较神阙穴与相同神经节段非任脉穴位治疗原发性痛经的差异性,探讨药物在隔药灸脐治疗过程中的作用。方法:将雌性Wistar大鼠随机分为正常组、模型组、隔药灸大横组、艾炷灸脐组和隔药灸脐组,每组8只。皮下注射苯甲酸雌二醇注射液(第1、10天0.5mg/只,第2～9天0.2mg/只)联合腹腔注射缩宫素(2U/只,末次给药24h后)制备痛经大鼠模型。隔药灸大横组采用隔药灸"大横"穴,艾炷灸脐组采用艾炷灸"神阙"穴,隔药灸脐组采用隔药灸"神阙"穴,均每日1次,每次7壮,连续10d。治疗结束后,观察30min内各组大鼠扭体次数,ELISA法测定各组大鼠血浆中β-内啡肽(β-EP)水平和子宫组织前列腺素E2(PGE2)、前列腺素F2α(PGF2α)含量,MTT法检测脾脏自然杀伤(NK)细胞活性。结果:与正常组比较,模型组大鼠30min内扭体次数明显增加(P<0.01),提示造模成功;血浆β-EP及子宫组织中PGE2含量均明显降低(P<0.01),子宫组织中PGF2α含量明显升高(P<0.01),脾脏NK细胞活性明显降低(P<0.01)。经治疗后,与模型组比较,3个治疗组大鼠扭体次数均明显降低(P<0.01),血浆β-EP及子宫组织中PGE2含量明显升高(P<0.05,P<0.01),子宫组织中PGF2α含量明显降低(P<0.05,P<0.01),脾脏NK细胞活性明显升高(P<0.01)。与隔药灸大横组及艾炷灸脐组比较,隔药灸脐组扭体次数减少更显著(P<0.05,P<0.01),血浆中β-EP、子宫组织中PGE2含量升高更显著(P<0.01,P<0.05),PGF2α含量降低更明显(P<0.05,P<0.01);与隔药灸大横组比较,隔药灸脐组脾脏NK细胞活性升高更显著(P<0.05)。结论:隔药灸脐对胞宫的效应具有特异性,其特异性体现为循经性和相对性;在神经内分泌方面药物是影响神阙穴效应的因素之一。

Objective To observe the effect of herbal-cake-partitioned moxibustion(HCPM)of"Shenque"(CV8)and"Daheng"(SP15)on abdominal pain,plasmaβ-endorphin(β-EP),uterine prostaglandin E2(PGE2)and prostaglandin F2α(PGF2α)levels,as well as splenetic natural killer cell(NK cell)activity in primary dysmenorrhea(PD)rats,so as to explore the specificity of acupoint function and the underlying mechanisms of moxibustion in relieving dysmenorrhea.Methods A total of 40 female rats were randomized into blank control,model,CV8-direct moxibustion,CV8-HCPM and SP15-HCPM groups(n=8 rats in each).The PD model was established by subcutaneous injection of estradiol benzoate injection(0.2-0.5 mg/rat)for 10 consecutive days and intraperitoneal injection of oxytocin(2 U)24 hafter the last subcutaneous injection.Moxibustion or herbal-cake(composed of Radix Angelicae Sinensis,Rhizoma Chuanxiong,Radix Paeoniae Rubra,Cortex Cinnamomi,etc.)-partitioned moxibustion was applied to CV8,SP15 or umbilicus respectively for 7 moxa-cones every time,once daily for 10 successive days.The rats of the control and model groups were also restrained as those in the moxibustion groups.The writhing times within 30 minutes was recorded and the contents of plasmaβ-EP,uterine PGE2 and PGF2αwere detected by ELISA,and NK cell activity was detected using MTT.Results Compared with the control group,the writhing times and the content of PGF2αin the uterus tissue were significantly increased in the model group(P<0.01),while the contents of plasmaβ-EP,uterine PGE2 and splenetic NK cell activity were significantly decreased(P<0.01).In comparison with the model group,the writhing times and uterine PGF2αcontent were obviously down-regulated in the SP15-HCPM,CV8-direct moxibustion and CV8-HCPM groups(P<0.05,P<0.01),and the contents of plasmaβ-EP and uterine PGE2,and splenetic NK cell activity were significantly increased(P<0.05,P<0.01).The therapeutic effects of CV8-HCPM group were significantly superior to those of SP15-HCPM and CV8-direct moxibustion groups in lowering writhing times and PGF2αlevel,and in up-regulatingβ-EP,PGE2(P<0.05,P<0.01).The NK cell activity of CV8-HCPM group was significantly increased compared with that in the SP15-HCPM group(P<0.05).No significant differences were found between the SP15-HCPM and CV8-direct moxibustion groups in the levels of writhing times,plasmaβ-EP and uterine PGE2,PGF2αcontents and splenetic NK cell activity(P>0.05).Conclusion Moxibustion of both CV8 and SP15 can relieve abdominal pain in PD rats,which may be closely associated with its effect in suppressing PD-induced decrease of plasmaβ-EP and uterine PGE2 levels and splenetic NK cell activity and increase of uterine PGF2α.The therapeutic effect of CV8-HCPM is obviously better than that of SP15-HCPM and CV8-direct moxibustion.