“标本配穴”艾灸与针刺对腹泻型肠易激综合征大鼠肠道敏感性和自主神经功能影响的比较

Comparison of the effects of moxibustion and acupuncture of combined “Biao-Ben”acupoints on intestinal sensitivity and autonomic nervous system function in rats with diarrhea-predominant irritable bowel syndrome

目的:基于“标本配穴”探讨艾灸与针刺治疗腹泻型肠易激综合征(IBS-D)模型大鼠的效应差异。方法:SD大鼠随机分为正常组、模型组、艾灸组与针刺组,每组各10只。通过急-慢性应激刺激联合番泻叶灌胃28 d的方法制备IBS-D大鼠模型。艾灸组大鼠予以艾灸双侧“足三里”“关元”“内关”,针刺组予以针刺“足三里”“关元”“内关”,两组均15 min/次,每日1次,治疗21 d。观察各组大鼠稀便率,自制气囊导管测定大鼠肠道疼痛阈值、容量阈值,旷场实验观察大鼠活动总路程和方格间穿行次数,电生理记录仪采集大鼠心电图,并分析心率变异性(HRV)的时域指标R-R间期平均值的标准差(SDANN)和相邻R-R间期>50 ms的个数占总窦性心搏个数百分比(PNN50),HE染色法观察结肠组织病理形态学变化,ELISA法检测血清白细胞介素-6(IL-6)、IL-8和肿瘤坏死因子α(TNF-α)的含量。结果:与正常组比较,模型组大鼠稀便率升高(P<0.05),旷场实验活动总路程及方格间穿行次数减少(P<0.05),疼痛阈值及容量阈值降低(P<0.05),SDANN、PNN50降低(P<0.01,P<0.05),血清IL-6、IL-8及TNF-α的含量显著升高(P<0.05)。与模型组比较,艾灸组与针刺组的稀便率降低(P<0.05),旷场实验活动总路程及方格间穿行次数增加(P<0.05),疼痛阈值及容量阈值升高(P<0.05),SDANN、PNN50升高(P<0.05),血清IL-6、IL-8及TNF-α含量降低(P<0.05)。与针刺组比较,艾灸组治疗后稀便率降低(P<0.05),旷场实验活动总路程及方格间穿行次数增加(P<0.05),疼痛阈值及容量阈值升高(P<0.05),SDANN、PNN50升高(P<0.05),血清IL-6、IL-8及TNF-α含量降低(P<0.05)。各组大鼠结肠组织未见明显病理形态改变。结论:“标本配穴”艾灸更能有效调节IBS-D模型大鼠HRV及血清IL-6、IL-8、TNF-α含量。基于“标本配穴”的选穴方法,艾灸对IBS-D的治疗效果优于针刺。

Objective To compare the effects of moxibustion and acupuncture of combined“Biao-Ben”acu⁃points(Biao indicates pathogenic factors of disease,Ben refers to body constitution)on a rat model of irritable bowel syndrome with diarrhea(IBS-D).Methods Forty female SD rats were randomly divided into 4 groups:normal group,model group,moxibustion group,and acupuncture group,with 10 rats in each group.The IBS-D rat model was estab⁃lished by administering acute-chronic stress combined with folium sennae gavage for 28 days.Rats in the moxibustion group received moxibustion at bilateral“Zusanli”(ST36),“Guanyuan”(CV4),and“Neiguan”(PC6),while those in the acupuncture group received acupuncture at the same acupoints,both for 15 min every time,once a day.The treat⁃ments were administered for 21 days.The loose stool rate was observed.Colonic pain threshold and colonic distension threshold were measured by a self-made balloon catheter.Total distance traveled and grid crossing numbers were ob⁃served by open field test.Heart rate variability(HRV)time domain indexes SDANN and PNN50 were acguired by using electrophysiological recorder.Histopathological changes in the colon tissue were observed after HE staining.Contents of interleukin-6(IL-6),IL-8,and tumor necrosis factor-alpha(TNF-α)in serum were detected by ELISA.Results Com⁃pared with the normal group,rats in the model group showed increased loose stool rate(P<0.05),decreased pain threshold and distension threshold(P<0.05),reduced total distance traveled and grid crossing numbers in the open field test(P<0.05),decreased HRV time domain indexes SDANN and PNN50(P<0.01,P<0.05),and elevated levels of se⁃rum IL-6,IL-8,and TNF-αcontents(P<0.05).Compared with the model group,the moxibustion group and acupuncture group showed decreased loose stool rate(P<0.05),increased total distance traveled and grid crossing numbers in the open field test(P<0.05),increased pain threshold and distension threshold(P<0.05),increased SDANN and PNN50(P<0.05),and decreased levels of serum IL-6,IL-8,and TNF-αcontents(P<0.05).Compared with the acupuncture group,the moxibustion group showed further decreased loose stool rate(P<0.05),increased total distance traveled and grid crossing numbers in the open field test(P<0.05),increased pain threshold and distension threshold(P<0.05),increased SDANN and PNN50(P<0.05),and decreased levels of serum IL-6,IL-8,and TNF-αcontents(P<0.05).No significant pathological changes were observed in the colon tissue of rats in each group.Conclusion Moxibustion of combined“Biao-Ben”acupoints is more effective in regulating HRV and serum IL-6,IL-8,and TNF-αcontents in the IBS-D rat model.Based on the combined“Biao-Ben”acupoints method,moxibustion has better therapeutic effects on IBS-D than acupuncture.