目的观察降钙素基因相关肽(CGRP)和胆碱酯酶(AchE)在功能性排便障碍(FDD)大鼠模型结直肠中的表达,探讨FDD发生的可能机制。方法 SD大鼠随机分为空白对照组、低纤维饮食组、利多卡因组、模型组,空白对照组予以普通饲料饲养,其余组采用低...目的观察降钙素基因相关肽(CGRP)和胆碱酯酶(AchE)在功能性排便障碍(FDD)大鼠模型结直肠中的表达,探讨FDD发生的可能机制。方法 SD大鼠随机分为空白对照组、低纤维饮食组、利多卡因组、模型组,空白对照组予以普通饲料饲养,其余组采用低纤维饲料饲养;利多卡因组及模型组于饲养第63天,分别予以2 mL 2%利多卡因、0.1%亚甲蓝注射液肛周及直肠周围间隙注射1次。观察大鼠粪便性状、质量及排便功能;酶联免疫吸附试验(ELISA)检测结、直肠中AchE含量;实时荧光定量PCR(qPCR)检测结、直肠中CGRP mRNA的表达,免疫组化及Western blot法检测CGRP蛋白的表达。结果肛周注射后,与空白对照组相比,低纤维饮食组和利多卡因组的粪便干结、呈深褐色,模型组的粪便干硬、呈黑褐色,粪便质量均下降。模型组模拟球囊排出时间较其余组长,肛管直肠静息压较其余组低;结肠及直肠中AchE含量较空白对照组和低纤维饮食组低(P<0.05);结肠中CGRP m RNA表达水平高于空白对照组,与低纤维饮食组和利多卡因组差异无统计学意义;直肠中CGRP m RNA表达水平较其余组高;免疫组化检测CGRP蛋白表达高于其余组(P<0.05);而Western blot检测各组CGRP蛋白表达差异均无统计学意义。结论大鼠结直肠中CGRP及AchE的表达异常可能与FDD发生的神经机制有关。展开更多
Objective:To systematically evaluate and compare the effects of electro-acupuncture combined with biofeedback training and simple biofeedback training on the intervention of patients with functional defecation disorde...Objective:To systematically evaluate and compare the effects of electro-acupuncture combined with biofeedback training and simple biofeedback training on the intervention of patients with functional defecation disorder.Methods:Computer retrieval was performed to search randomized controlled trials about electroacupuncture combined with biofeedback training in the treatment of patients with functional defecation disoder from January 2000 to January 2019 via websites,including CNKI,Wanfang data knowledge service platform,CBM,VIP,Pub Med,EMBase,Cochrane Library,Web of Science,and Springerlink,JBI evidence-based Nursing database,RNAO,Nursing Consult,BIOSIS,Medline and so on.Screening was performed according to the inclusion and exclusion criteria,data were extracted,literature quality was evaluated,and Meta analysis was performed on the extracted data using Rev Man5.3 software.Results:Five studies including 363 subjects were included.The results of meta-analysis showed that the effective rate of electroacupuncture combined with biofeedback group(combined group)in the treatment of functional defecation disorder was higher than that of biofeedback group(control group)[RR=1.29,95%CI(1.17,1.42),P<0.00001],the difficulty score of defecation in combined group was lower than that of control group[MD=–0.71,95%CI(–1.22,–0.21),P=0.006],and anal rest pressure was lower than that of control group[MD=–0.44,95%CI(-0.80,–0.09),P=0.02].Tubing maximum systolic pressure is lower than the control group[MD=–2.06,95%CI(–3.60,–0.52),P=0.009).Conclusion:Acupuncture combined with biofeedback can effectively improve the defecation difficulty of patients with functional defecation disorder,as well as the anal resting pressure and the maximum anal systolic pressure.Due to the limitation of the number of included literatures and the heterogeneity among evaluation indexes,the evaluation of defecation difficulty score and anal dynamics still needs to be further evaluated under the support of clinical studies with more centers,high quality and large sample size.展开更多
文摘目的观察降钙素基因相关肽(CGRP)和胆碱酯酶(AchE)在功能性排便障碍(FDD)大鼠模型结直肠中的表达,探讨FDD发生的可能机制。方法 SD大鼠随机分为空白对照组、低纤维饮食组、利多卡因组、模型组,空白对照组予以普通饲料饲养,其余组采用低纤维饲料饲养;利多卡因组及模型组于饲养第63天,分别予以2 mL 2%利多卡因、0.1%亚甲蓝注射液肛周及直肠周围间隙注射1次。观察大鼠粪便性状、质量及排便功能;酶联免疫吸附试验(ELISA)检测结、直肠中AchE含量;实时荧光定量PCR(qPCR)检测结、直肠中CGRP mRNA的表达,免疫组化及Western blot法检测CGRP蛋白的表达。结果肛周注射后,与空白对照组相比,低纤维饮食组和利多卡因组的粪便干结、呈深褐色,模型组的粪便干硬、呈黑褐色,粪便质量均下降。模型组模拟球囊排出时间较其余组长,肛管直肠静息压较其余组低;结肠及直肠中AchE含量较空白对照组和低纤维饮食组低(P<0.05);结肠中CGRP m RNA表达水平高于空白对照组,与低纤维饮食组和利多卡因组差异无统计学意义;直肠中CGRP m RNA表达水平较其余组高;免疫组化检测CGRP蛋白表达高于其余组(P<0.05);而Western blot检测各组CGRP蛋白表达差异均无统计学意义。结论大鼠结直肠中CGRP及AchE的表达异常可能与FDD发生的神经机制有关。
基金Beijing Traditional Chinese Medicine Science and Technology Development Fund Project。
文摘Objective:To systematically evaluate and compare the effects of electro-acupuncture combined with biofeedback training and simple biofeedback training on the intervention of patients with functional defecation disorder.Methods:Computer retrieval was performed to search randomized controlled trials about electroacupuncture combined with biofeedback training in the treatment of patients with functional defecation disoder from January 2000 to January 2019 via websites,including CNKI,Wanfang data knowledge service platform,CBM,VIP,Pub Med,EMBase,Cochrane Library,Web of Science,and Springerlink,JBI evidence-based Nursing database,RNAO,Nursing Consult,BIOSIS,Medline and so on.Screening was performed according to the inclusion and exclusion criteria,data were extracted,literature quality was evaluated,and Meta analysis was performed on the extracted data using Rev Man5.3 software.Results:Five studies including 363 subjects were included.The results of meta-analysis showed that the effective rate of electroacupuncture combined with biofeedback group(combined group)in the treatment of functional defecation disorder was higher than that of biofeedback group(control group)[RR=1.29,95%CI(1.17,1.42),P<0.00001],the difficulty score of defecation in combined group was lower than that of control group[MD=–0.71,95%CI(–1.22,–0.21),P=0.006],and anal rest pressure was lower than that of control group[MD=–0.44,95%CI(-0.80,–0.09),P=0.02].Tubing maximum systolic pressure is lower than the control group[MD=–2.06,95%CI(–3.60,–0.52),P=0.009).Conclusion:Acupuncture combined with biofeedback can effectively improve the defecation difficulty of patients with functional defecation disorder,as well as the anal resting pressure and the maximum anal systolic pressure.Due to the limitation of the number of included literatures and the heterogeneity among evaluation indexes,the evaluation of defecation difficulty score and anal dynamics still needs to be further evaluated under the support of clinical studies with more centers,high quality and large sample size.
