慢性胃炎家兔耳穴组织学和超微结构变化的观察

Changes of histology and ultrastructure of otopoint “Stomach” area in rabbits with chronic gastritis

目的:观察慢性胃炎家兔耳"胃"穴的组织学和超微结构改变,探讨在疾病状态下耳穴结构改变与耳穴诊治机制的关系。方法:新西兰兔随机分为对照组和模型组,每组10只。模型组采用5%水杨酸钠溶液灌胃制作慢性胃炎模型,1次/d,持续5周。采用苏木精-伊红(HE)染色法观察两组家兔胃黏膜、耳"胃"穴和对照穴的病理情况,采用透射电镜观察两组家兔耳"胃"穴超微结构改变。结果:HE染色显示,对照组家兔胃黏膜光滑,未见或少见炎性细胞;模型组可见胃黏膜出血、糜烂,局部上皮腺体排列稍紊乱,黏膜层有大量淋巴细胞浸润,部分有成堆淋巴细胞聚集灶。模型组胃黏膜病理学评分显著高于对照组(P<0.01)。光镜下对照组耳"胃"穴和模型组对照穴的皮肤均未见明显变化;模型组耳"胃"穴出现表皮角质层增生和脱落、棘层和基底层增生,真皮组织增生和炎性细胞浸润等组织学变化。电镜下对照组耳"胃"穴超微结构未见明显改变;模型组耳"胃"穴可见表皮角质形成细胞线粒体肿胀、空泡化,角蛋白丝聚集减少,局部细胞间隙增宽,桥粒结构不清,真皮成纤维细胞活化,有髓神经线粒体增多等超微结构改变。结论:慢性胃炎状态下,家兔耳"胃"穴出现组织损伤和组织增生并见的组织学和超微结构改变,提示耳穴-脏腑的特异性联系,耳穴结构改变是耳穴阳性反应的基础,为耳穴诊治机制提供了形态学依据。

Objective To observe the histological and ultrastructural changes of the otopoint"Stomach"(MA-IC)area in chronic gastritis rabbits so as to provide a foundation for auricular acupoint diagnosis and treatment.Methods A total of 20 New Zealand rabbits(half male and half female)were randomly and equally divided into control and model groups.The chronic gastritis model was established by gavage of 5%sodium salicylate each day for 5 weeks,while the rabbits of the control group received gavage of clear water at the same volume.Morphological changes of the tissues of gastric mucosa,otopoint"Stomach"and auricular control point were observed under light microscope after staining with hematoxylin-eosin(H.E.),and given scores(0-3 points)according to the levels of inflammatory cells.The ultrastructural changes of the otopoint"Stomach"tissue were observed under transmission electronic microscope(TEM).Results H.E.staining revealed smoothness of the gastric smooth muscle with no or a few of inflammatory cells in the control group,and appearance of gastric mucosal hemorrhage and erosion,slightly disordered epithelial glands and infiltration of a large number of lymphocytes in the mucosal layer with some clustered lymphocyte aggregation foci in the model group.The pathological score of gastric mucous in the model group was significantly higher than that in the control group(P<0.01).Under light microscope,no obvious changes were observed in the skin of the otopoint"Stomach"of the control group and the control point of the model group,whereas hyperplasia and abscission in the epidermic cuticle and spinous layer and basal layer,dermal tissue and inflammatory cell infiltration were observed in the otopoint"Stomach"of the model group.Results of TEM observation showed no significant changes in the ultrastructure of the otopoint"Stomach"in the control group,and swollen and vacuolated epidermal keratinocyte mitochondria,reduced keratin filament aggregation,widened local cell space,unclear desmosome structure,activation of the dermal fibroblasts,and an increase of the myelinated nerve mitochondria in the"Stomach"region in the model group.Conclusion The otopoint"Stomach"tissue has structural damage and hyperplasia in chronic gastritis rabbits,suggesting a special correlation between the otopoint"Stomach"and gastric tissue,hence,providing a morphological basis for otopoint diagnosis and treatment.