重型脑创伤后足三里电针刺激联合嗜酸乳杆菌对胃肠动力作用及机制研究

Electro-Acupuncture Combined with Lactobacillus Acidophilus for Severe Craniocerebral Injury Study on Effect and Mechanism of Gastrointestinal Dysfunction

目的探究嗜酸乳杆菌联合电针对大鼠重型颅脑创伤(traumatic brain injury,TBI)后胃肠动力障碍机制以及治疗机理。方法选取成年SD大鼠45只,用改良自由落体撞击法进行重型TBI模型建立,平均分为5组:对照组、单纯损伤组、电针组、嗜酸乳杆菌组、联合组。对照组仅进行开骨窗处理;单纯损伤组:经过改良自由落体撞击法制备TBI模型[1-2];嗜酸乳杆菌组:在单纯损伤组的基础上,造模后进行灌胃嗜酸乳杆菌,喂菌量为1×1010cfμ,1次/d,连续1周;电针组:造模后4 h进行电针刺激足三里穴持续30 min,1次/d,连续1周[3-5]。联合组:在单纯损伤组基础上先给予大鼠灌胃嗜酸乳杆菌,再进行电针足三里穴连续1周。利用湿重测量法检测脑部含水量,检测胃排空率及小肠推进率,酶联免疫放射法测定胃动素(MTL)、胃泌素(Gas)。Western blot法观察cx43蛋白。结果与对照组相比,单纯损伤组大鼠脑含水量均升高,差异有统计学意义(P<0.05),单纯损伤组胃排空率明显降低(P<0.05);与单纯损伤组相比,电针组、嗜酸乳杆菌组、联合组大鼠胃排空率升高,差异有统计学意义(P<0.05)。单纯损伤组MTL水平高于对照组,Gas水平降低,差异有统计学意义(P<0.05),联合组Gas水平升高,差异有统计学意义(P<0.05)。与单纯损伤组相比,联合组小肠组织中不同时间点Cx43蛋白升高,差异有统计学意义(P>0.05)。结论大鼠颅脑受损后存在胃肠动力障碍,电针足三里结合灌胃嗜酸乳杆菌对TBI后胃肠功能障碍的改善效果优于单独采用一种方法。

Objective To explore the mechanism and treatment of gastrointestinal motility disorder after severe traumatic brain injury(TBI)in rats by Lactobacillus acidophilus combined with electroacupuncture.Methods Forty-five adult SD rats were divided into five groups:control group,simple injury group,electro-acupuncture group,Lactobacillus acidophilus group and combined group.The control group was only treated with bone window opening.In the simple injury group,TBI model was prepared by improved free fall impact method.In the Lactobacillus acidophilus group,on the basis of the simple injury group,Lactobacillus acidophilus was given orally after the establishment of the model.The amount of Lactobacillus acidophilus was 1×1010cfμ,once a day.The electro-acupuncture group used electro-acupuncture at Zusanli(ST36)for 30 minutes,once a day,continuously for 1 week after the establishment of the model.The combined groupwas given Lactobacillus acidophilus by gastric perfusion on the basis of simple injury group,and then used electro-acupuncture at Zusanli(ST36)for one week.Brain water content,gastric emptying rate and small intestinal propulsion rate were measured by wet weight measurement.Motilin(MTL)and gastrin(Gas)were measured by ELISA.Western blot was used to observe the expression of Cx43 protein.Results Compared with the control group,the brain water content of rats in the simple injury group increased significantly(P<0.05),and the gastric emptying rate of rats in the simple injury group decreased significantly(P<0.05).Compared with the simple injury group,the gastric emptying rate of rats in the electro-acupuncture group,Lactobacillus acidophilus group and combined group increased significantly(P<0.05).The level of MTL in the simple injury group was higher than that in the control group,and the level of Gas was lower(P<0.05).The level of Gas in the combined group was higher(P<0.05).Compared with the simple injury group,the Cx43 protein in the combined group increased at different time points,and the difference was statistically significant(P>0.05).Conclusion Gastrointestinal dysfunction exists after brain injury in rats.The effect of electro-acupuncture at Zusanli(ST36)combined with gastric lavage of Lactobacillus acidophilus on gastrointestinal dysfunction after TBI is better than that of single method.