交感神经激活在穴位贴敷促进胃溃疡大鼠溃疡愈合及胃功能改善中的作用

Involvement of sympathetic nerve activation in acupoint application induced improvement of gas-tric ulcer and motility in rats with gastric ulcer

目的:观察芥子油贴敷“梁门”对胃溃疡模型大鼠溃疡局部组织病理形态及胃功能等的影响,探讨穴位贴敷对胃溃疡的干预效应与交感神经的关系。方法:39只SD大鼠随机分为正常组(7只)、模型组(8只)、穴位贴敷组(8只)、胍乙啶组(8只)、胍乙啶+穴位贴敷组(8只),造模后各组随机选取1只进行模型验证。用乙酸滤纸敷于胃窦部制备胃溃疡模型。穴位贴敷组、胍乙啶+穴位贴敷组于造模后1 d用50%芥子油于“梁门”进行局部皮肤刺激,10 min/次,1次/d,连续9 d。胍乙啶组、胍乙啶+穴位贴敷组于造模当天给予胍乙啶溶液(40 mg/kg)腹腔注射,1次/d,连续10 d。于第0、1、3、7、9天记录大鼠体质量,并于第10天检测大鼠胃内压力蠕动波、胃平滑肌肌电,光镜下观察胃溃疡面积,HE染色法观察胃窦部组织病理学变化。结果:与正常组比较,模型组大鼠体质量比值、胃内压力蠕动波频率、胃肌电慢波频率降低(P<0.001,P<0.05),溃疡面积增大(P<0.05),胃组织病理学总评分及各项评分(上皮细胞损伤、黏膜下层水肿、出血性损伤、炎性细胞浸润)均升高(P<0.001)。与模型组比较,穴位贴敷组大鼠体质量比值、胃内压力蠕动波频率、胃肌电慢波频率及胃肌电快波积分均升高(P<0.05,P<0.001),溃疡面积缩小(P<0.05),胃组织病理学总评分、上皮细胞损伤评分、黏膜下层水肿评分、出血性损伤评分、炎性细胞浸润评分均降低(P<0.001,P<0.05);胍乙啶组大鼠胃内压力蠕动波频率降低(P<0.05)。与穴位贴敷组比较,胍乙啶组大鼠体质量比值、胃内压力蠕动波频率、胃肌电慢波频率及胃肌电快波积分均降低(P<0.05,P<0.001),溃疡面积增大(P<0.05),胃组织病理学总评分、上皮细胞损伤评分、黏膜下层水肿评分、出血性损伤评分、炎性细胞浸润评分均升高(P<0.001,P<0.05);胍乙啶+穴位贴敷组大鼠体质量比值、胃内压力蠕动波频率、胃肌电慢波频率均降低(P<0.05,P<0.001,P<0.01),溃疡面积增大(P<0.05),胃组织胃溃疡病理学总评分、黏膜下层水肿评分、出血性损伤评分、炎性细胞浸润评分均升高(P<0.001,P<0.05)。结论:芥子油贴敷“梁门”可缓解乙酸造成的胃溃疡损伤,改善溃疡状态下胃节律性收缩活动,该效应可能由交感神经介导。

Objective To observe the effect of mustard oil application at“Liangmen”(ST21)on gastric ulcer(GU)and gastric motility and its association with the sympathetic nerve activity in rats with GU,so as to provide experimental basis for im-provement of GU by acupoint application.Methods Thirty-nine male SD rats were randomly divided into control(n=7),model,acupoint application(AA),medication(guanethidine,an adrenergic sympathetic antagonist)and AA+medication groups(n=8in each of the latter 4groups).The GU model was made by applying acetic acid-immersed filter paper onto the gastric an-trum.For rats of the AA and AA+medication groups,50%mustard oil was applied to left ST21for 10min,once a day,for 9con-secutive days.Rats of the medication and AA+medication groups received intraperitoneal injection of guanethidine solution(40mg/kg)beginning from the modeling day on,once a day for 10consecutive days.The rat’s body weight of each group was recorded on the 0t h,1 st,3 rd,7 th and 9t h day.The intragastric peristaltic wave frequency and the myoelectrical activity(frequency of slow waves,and integration of fast waves)of the gastric smooth muscle were recorded by using PowerLab data acquisition sys-tem.The gastric ulcer area was measured after the rats were executed,and histopathological changes of gastric antrum tissues(histopathological score including epithelial cell injury,submucosal edema,hemorrhagic injury,inflammatory cell infiltration score)were observed after H.E.staining.Results Compared with the control group,the body weight ratio,frequency of gas-tric peristaltic waves and slow wave frequency of gastric smooth muscle were significantly decreased(P<0.001,P<0.05),while the ulcer area,total histopathological score,epithelial cell injury score,submucosal edema score,hemorrhagic injury score and inflammatory cell infiltration score were significantly increased in the model group(P<0.05,P<0.001).Relevant to the model group,the AA group had a significant increase in the body weight ratio,frequency of gastric peristaltic waves,slow wave frequency,integration of fast waves(P<0.05,P<0.001),and a considerable decrease in the ulcer area,total histopathologi-cal score,epithelial cell injury score,submucosal edema score,hemorrhagic injury score and inflammatory cell infiltration score(P<0.05,P<0.001),and the medication group has a significantly decrease in the frequency of gastric peristaltic waves(P<0.05).In comparison with the AA group,the body weight ratio,frequency of gastric peristaltic waves and slow wave frequency of gastric smooth muscle in both medication and AA+medication groups,and the integration of fast waves in the medication group were obviously lower(P<0.05,P<0.001,P<0.01),whereas the levels of ulcer area,total pathological score,submucosal edema score,hemorrhagic injury score and inflammatory cell infiltration score in both medication and AA+medication groups,and the epithelial cell injury score in medication group were significantly higher(P<0.05,P<0.001).Conclusion Application of mustard oil at acupoint ST21can effectively remit GU caused by acetic acid and regulate gastric rhythmic contraction,which was mediated by sympathetic nerve.