Exploring the mechanism of electroacupuncture at different acupoints on acute colitis rats based on JAK2/STAT3/SOCS1 signaling pathway

Objective:To investigate the mechanism of JAK2/STAT3/SOCS1 signaling pathway in electroacupuncture of different acupoints on acute colitis rats.Methods:36 SPF SD rats were randomly divided into 6 groups,with 6 rats in each group.The rat model of acute colitis was prepared by enema with glacial acetic acid solution.After the model was established,electroacupuncture was given to each acupoint group,with density wave,frequency 2Hz-50 Hz,intensity 2 mA,muscle tremor as the degree 20 min/time,1 time/day,for 3 consecutive days.Observe the general condition of rats;the pathological changes of colonic mucosa in rats were observed by HE method.The contents of serum interleukin-4(IL-4)and interleukin-8(IL-8)were detected by ELISA.Western blot and RT-PCR were used to detect the expression of JAK2,STAT3,SOCS1 protein and mRNA in rat colon tissue.Results:In contrast to the normal group,the overall condition of the model group was worse,the colonic mucosa was severely damaged,even necrotic,and the ulcer surface was obvious.The content of IL-4 in serum was obviously reduced,and the content of IL-8 was obviously go up(P<0.01).The protein content of JAK2,STAT3 and the expression of JAK2,STAT3 mRNA in colon tissue of rats were obviously go up,while the protein content of SOCS1 and the expression of SOCS1 mRNA were obviously reduced(P<0.01).In contrast to the model group,the general condition of rats in each acupoint group was significantly improved,the damage and necrosis of colonic mucosa and ulcer surface were obviously alleviated,the content of IL-4 in serum was obviously go up,and the content of IL-8 was significantly decreased(P<0.01).The protein content of JAK2,STAT3 and the expression of JAK2,STAT3 mRNA in colon tissue of rats were obviously reduced,while the protein content of SOCS1 and the expression of SOCS1 mRNA were obviously go up(P<0.05,P<0.01).Comparison of different acupoint groups,the colonic mucosal injury in the Zusanli group was significantly reduced,the content of serum IL-4 was significantly increased,and the content of IL-8 was significantly decreased(P<0.05,P<0.01).The protein content and mRNA expression of JAK2 and STAT3 in colon tissue were significantly down-regulated,while the protein content and mRNA expression of SOCS1 were significantly go up(P<0.05,P<0.01).Conclusion:Electroacupuncture at each acupoint can improve the damage of colonic mucosa and reduce the inflammatory response.The therapeutic effect of Zusanli(ST36)is better than that of Tianshu(ST25),Dachangshu(BL25)and Shangjuxu(ST37).The mechanism may be related to the regulation of JAK2/STAT3/SOCS1 signaling pathway related proteins and inflammatory cytokines IL-4 and IL-8.

Effects of oral tacrolimus as a rapid induction therapy in ulcerative colitis

AIM:To determine the efficacy and safety of rapid induction therapy with oral tacrolimus without a meal in steroid-refractory ulcerative colitis(UC)patients.METHODS:This was a prospective,multicenter,observational study.Between May 2010 and August 2012,49 steroid-refractory UC patients(55 flare-ups)were consecutively enrolled.All patients were treated with oral tacrolimus without a meal at an initial dose of 0.1mg/kg per day.The dose was adjusted to maintain trough whole-blood levels of 10-15 ng/m L for the first 2 wk.Induction of remission at 2 and 4 wk after tacrolimus treatment initiation was evaluated using Lichtiger’s clinical activity index(CAI).RESULTS:The mean CAI was 12.6±3.6 at onset.Within the first 7 d,93.5%of patients maintained high trough levels(10-15 ng/m L).The CAI significantly decreased beginning 2 d after treatment initiation.At 2wk,73.1%of patients experienced clinical responses.After tacrolimus initiation,31.4%and 75.6%of patients achieved clinical remission at 2 and 4 wk,respectively.Treatment was well tolerated.CONCLUSION:Rapid induction therapy with oral tacrolimus shortened the time to achievement of appropriate trough levels and demonstrated a high remission rate 28 d after treatment initiation.Rapid induction therapy with oral tacrolimus appears to be a useful therapy for the treatment of refractory UC.

Frequency and prognostic role of mucosal healing in patients with Crohn's disease and ulcerative colitis after one-year of biological therapy

AIM: To assess the endoscopic activity before and after a one-year period of biological therapy and to evaluate the frequency of relapses and need for retreatment after stopping the biologicals in patients with Crohn&#x02019;s disease (CD) and ulcerative colitis (UC).

A study of acupoint specificity and mechanism of electroacupuncture intervention on chronic colitis in rats based on PI3K/AKT/mTOR signaling pathway

Objective:This study aimed to elucidate the differences in effects and mechanisms of action of electric-needle therapy at Tian Shu(ST25),Da Chang Shu(BL25),Zu San Li(ST36)and Shang Ju Xu(ST37)acupoints on chronic experimental colitis in rats through the PI3K/AKT/mTOR signaling pathway.Methods:Sixty pathogen-free SD rats were randomly assigned to six groups:the normal,model,Tian Shu(ST25),Da Chang Shu(BL25),Zu San Li(ST36)and Shang Ju Xu(ST37)groups,each with 10 rats.Chronic colitis was induced in rats by combining immunization and local stimulation.After model establishment,electrical needle intervention combined with dispersing wave of 2 Hz/50 Hz with a current intensity of 2 mA once daily for 20 min was applied on acupoints of each group.Subsequently,the inflammation of colonic mucosa and serum levels of inflammatory factors(IL-23,IL-17,IL-10)were observed;ELISA was used to detect mRNA expressions of PI3K,Akt and mTOR in colitic tissues by RT-PCR as well as protein content of p-PI3k/PI3K,p-Akt/Akt,and p-mTOR/mTOR in colitic tissues by Western blotting.Result:Compared with the normal group,the model rats showed a poor general condition,serious damage to the colonic mucosa with a large number of inflammatory cells infiltration.The serum IL-23 and IL-17 expressions were significantly increased(P<0.01),while the serum IL-10 expression was significantly decreased(P<0.01);the mRNA and protein expressions of PI3K,Akt,mTOR and p-PI3K,p-Akt and p-mTOR were significantly increased(P<0.05,P<0.01).Compared with the model group,the pathological slices of rats in each acupoints intervention group showed obvious improvement of colitis inflammatory reaction and tissue damage;the serological levels of IL-23 and IL-17 were significantly reduced(P<0.01),while the serology level of IL-10 was significantly increased(P<0.01);the expressions of PI3K,Akt,mTOR mRNA and p-PI3K,p-Akt,p-mTOR proteins were significantly decreased(P<0.05,P<0.01).Compared with Tian Shu(ST25),Da Chang Shu(BL25),Zu San Li(ST36)groups,the recovery degree of mucosa layers in Shang Ju Xu(ST37)group was closer to that of normal group,and the curative effect was relatively the best;in terms of serological levels of IL-23 and IL-17,the Shang Ju Xu(ST37)group was significantly lower(P<0.05),while the level of IL-10 was significantly higher(P<0.01);the expressions of PI3K,Akt,mTOR mRNA and p-PI3K,p-Akt,p-mTOR proteins were significantly decreased(P<0.05,P<0.01).Conclusion:Results indicate that electrical acupuncture at Tian Shu(ST25),Da Chang Shu(BL25),Zu San Li(ST36)and Shang Ju Xu(ST37)show similar effects in relieving the colitis-induced damage in the mucosa of chronic colitis rats,as well as inflammatory response.Among them,Shang Ju Xu(ST25)has a superior overall effect in treating chronic colitis compared to Tian Shu(ST25),Da Chang Shu(BL25)and Zu San Li(ST36).The mechanism may be related to inhibition of PI3K/Akt/mTOR signaling pathway.

Moxibustion regulates inflammatory mediators and colonic mucosal barrier in ulcerative colitis rats

AIM: To observe the efficacy and mechanism of grain-sized moxibustion at different acupoints in a rat model of ulcerative colitis (UC). METHODS: Sprague-Dawley rats were randomly divided into control, UC model, grain-sized moxibustion at a single acupoint (CV 12), grain-sized moxibustion at two acupoints (CV 12 and CV 4), grain-sized moxibustion at three acupoints (CV 12, CV 4, and ST 36), and medication groups (n = 8/group). The UC model was established by enema of trinitrobenzene sulfonic acid. Direct moxibustion was used once a day for 7 d. Disease activity index (DAI) was evaluated before and after the treatment. Morphologic changes of intestinal tissue were observed under an optical microscope. The expression of tumor necrosis factor (TNF)-alpha and p38 mitogen-activated protein kinase (p38MAPK) in colonic tissue was detected using Western blot, and the levels of occludin and zonula occludens-1 (ZO-1) mRNAs were detected using reverse transcription PCR. RESULTS: Compared with the control group, the intestinal mucosae were incomplete in the model group, glandular structures were irregular, and submucosae were edematous, hyperemic, and infiltrated with inflammatory cells. The DAI scores and expression of TNF-alpha and p38MAPK were increased significantly in the model group compared to controls (Ps < 0.01), while the mRNA levels of occludin and ZO-1 were reduced significantly (Ps < 0.01). Compared with the model group, colonic mucosa and the arrangement of glands were complete and regular in the treatment groups. DAI scores and the expression of TNF-alpha and p38MAPK were reduced significantly in moxibustion groups compared to controls (Ps < 0.01), while the mRNA levels of occludin and ZO-1 were increased significantly (Ps < 0.01). The improvements in the above indices in the three acupoints group and the medication group were superior to those in the single and two acupoints groups (all P < 0.05). CONCLUSION: Reduction of TNF-alpha and p38MAPK and increased expression of occludin and ZO-1 in colonic tissue represent a potential mechanism for improved intestinal mucosal tissue repair with grain-sized moxibustion.

Moxibustion activates mast cell degranulation at the ST25 in rats with colitis

AIM: To investigate the effects of moxibustion on the morphology and function of mast cells (MC) at Tianshu (ST25) in rats with trinitro-benzene-sulfonic acid (TNBS)-induced colitis. METHODS: A total of 53 male Sprague-Dawley rats were randomly divided into a normal group and experimental group. In the experimental group, a rat model of TNBS-induced colitis was established, and the rats were then randomly divided into a model group, moxi-bustion group, moxibustion plus disodium cromoglycate (M + DC) group and moxibustion plus normal saline (M+ NS) group. Rats in the moxibustion group received suspended moxibustion at bilateral ST25 for 10 min, once a day for 7 d. Rats in the M + DC and M + NS groups were pretreated with disodium cromoglycate and normal saline at bilateral ST25, respectively, and were then concurrently subjected to the same treatment as rats in the moxibustion group. The hematoxy- lin-eosin staining method was used to observe histology of the colon and the toluidine blue-improved method was used to observe mast cells at ST25 acupoint areas. RESULTS: An improvement in colonic injury in the moxibustion group was observed and the degranulation ratio of MC at ST25 acupoint was markedly higher in the moxibustion group than in the model group (45.91 ± 11.41 vs 32.58 ± 8.28, P < 0.05). After inhibition of degranulation of MC at ST25 by disodium cromoglycate, no improvement in colon tissue injury was observed. CONCLUSION: Moxibustion exerted its effect on healing impaired colonic mucosa in rats with TNBS-induced colitis by increasing the degranulation ratio of local MC, but had little effect on the morphology of MC at ST25 acupoint.

Influence of catgut implantation at acupoints on splenic lymphocyte nuclear factor (NF-κB p65) and correlated signaling molecules (β2AR) in rats with experimental colitis

Objective To investigate the mechanisms of catgut implantation at acupoints on ulcerative colitis. Methods Eighteen SD rats were randomly divided into a normal control group （NC）, a model group （MO） and a catgut implantation group （CI） with 6 rats in each group. Animals in group MO and group CI were treated by trinitro-benzene-sulfonic acid （TNBS） to establish model with colitis. No other treatment was given to the rats in group MO, but catgut was implanted at ＂Shàngjùxū＂ （上 巨虚 ST 37）, ＂Tiānshū＂ （天枢 ST 25） and ＂Dàchángshū＂ （大肠俞 BL 25） in the rats in group CI. The symptoms of diarrhea and bloody stool, and changes in histopathology were detected 15 days after the treatment. Expressions of splenic lymphocyte nuclear factor κB p65（NF-κB p65）and correlated signaling molecules（β2AR）were detected by the western blot method. Results Diarrhea and mucus bloody purulent stool were soon controlled, and mucous injures were obviously improved in group CI. The NF-κB p65 value of splenic lymphocytes was signifi cantly increased （P0.01） and expression of β2AR remarkably reduced in group MO （P0.01）, compared with group NC. But, the NF-κB p65 value was significantly decreased （P0.01） and expression of β2AR remarkably increased in group CI （P 0.01） , compared with group MO. Conclusion Catgut implantation at acupoints is obviously effective in treating experimental colitis. Modulation of NF-κB p65 and the correlated signaling molecules β2AR may be involved in the mechanisms.

基于转录组学数据探讨针刺“足三里”或“内关”改善溃疡性结肠炎的腧穴功效差异

目的观察针刺“足三里”或“内关”对溃疡性结肠炎(Ulcerative colitis,UC)模型小鼠的干预效应,并利用转录组学分析病变组织结肠和非病变组织心脏在接受针刺干预后基因转录表达的异同之处,以期探讨两个腧穴是否存在功效差异。方法硫酸葡聚糖钠盐(Dextran sulfate sodium salt,DSS)诱导法建立UC小鼠模型,造模成功后,小鼠被随机分为模型组,足三里组及内关组,每组9只。足三里组及内关组分别于“足三里”、“内关”进行针刺干预,每次30 min,每天1次,连续干预5天,空白组和模型组只捆绑不针刺。观察各组小鼠的一般情况,计算疾病活动指数(Disease activity index,DAI),通过HE染色观察结肠组织形态变化,并利用转录组测序技术,分别对各组小鼠的结肠组织进行测序和生物学分析,从病变组织角度比较研究两个穴位是否存在腧穴功效差异。同时取各组心脏组织进行比较分析,从非病变组织角度探讨两个穴位的效应是否存在差异。结果与空白组相比,模型组DAI评分显著升高(P<0.001),HE染色结果显示伴有明显病理损伤;针刺足三里或内关后,UC小鼠的DAI评分均显著降低(P<0.05),病理损伤明显改善。转录组测序及生物信息学分析结果显示,针刺足三里或内关对病变部位结肠组织的影响涉及多个基因,相似变化的差异基因(co-DEGs)有825个,主要富集到白细胞及趋化因子等通路;只受足三里影响的差异基因(ST36only-DEGs)有168个,富集到胃酸分泌等通路;只受内关影响的差异基因(PC6 only-DEGs)有325个,富集到细胞因子-细胞因子受体相互作用等通路。非病变组织心脏中co-DEGs为95个,主要富集到防御反应的正向调节、对白细胞介素-1的反应等通路;ST36 only-DEGs为28个;PC6 only-DEGs为114个,富集到心血管疾病等通路。结论针刺“足三里”与“内关”均能改善UC小鼠的症状和结肠病理变化。但通过转录组学分析发现,两个穴位对病变部位结肠组织和非病变部位心脏组织的基因转录影响存在一定差异,提示分布部位不同的腧穴在宏观功效上有一定共性,但在微观层面上,存在一定的差异性。

基于“通因通用”理论温通经络竹刮疗法联合穴位贴敷治疗大肠湿热型溃疡性结肠炎的临床疗效

目的观察基于“通因通用”理论温通经络竹刮疗法联合穴位贴敷治疗大肠湿热型溃疡性结肠炎(UC)的临床疗效。方法将80例大肠湿热型UC患者按照随机数字表法分为2组,对照组40例予常规管理联合中药保留灌肠方案,观察组40例在对照组基础上予温通经络竹刮疗法联合穴位贴敷干预。2周后比较2组中医症状评分、Mayo评分及内镜评分、免疫功能指标(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))、炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、IL-10、IL-1β]及生活质量的结果差异。结果2组干预后各项中医症状评分均降低(P<0.05),且观察组干预后均低于对照组(P<0.05)。2组干预后Mayo评分及内镜评分均降低(P<0.05),且观察组干预后均低于对照组(P<0.05)。2组干预后TNF-α、IL-6、IL-1β水平均降低(P<0.05),IL-10均升高(P<0.05),且观察组干预后TNF-α、IL-6、IL-1β水均低于对照组(P<0.05),IL-10高于对照组(P<0.05)。2组干预后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均升高(P<0.05),且观察组干预后均高于对照组(P<0.05)。2组干预后各项生活质量评分均升高(P<0.05),且观察组干预后均高于对照组(P<0.05)。结论温通经络竹刮疗法联合穴位贴敷能够改善大肠湿热型UC患者的临床症状,保护患者肠道黏膜,减轻炎症反应,调节免疫功能,提高患者生活质量。

穴位贴敷联合乌梅丸加减治疗寒热错杂型溃疡性结肠炎的临床效果

目的探索穴位贴敷联合乌梅丸加减对寒热错杂型溃疡性结肠炎患者的临床疗效、免疫功能、粪钙卫蛋白(FC)及血常规的影响。方法选取2019年1月至2021年1月徐州市中医院收治的60例寒热错杂型溃疡性结肠炎患者作为研究对象,按照就诊先后顺序分为对照组和观察组,各30例。对照组服用乌梅丸加减,观察组在对照组基础上联合穴位贴敷。比较两组临床疗效、溃疡性结肠炎活动度指数评分、外周血T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平、FC、全血细胞计数。结果两组治疗后临床有效率、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05),两组治疗后Sutherland疾病活动指数评分、CD8^(+)水平、FC低于治疗前,且治疗后观察组低于对照组,差异有统计学意义(PP<0.05)。两组治疗前后白细胞(WBC)、红细胞(RBC)、血红蛋白(Hb)计数比较,差异无统计学意义(P>0.05)。结论穴位贴敷联合乌梅丸加减安全有效,对于寒热错杂型溃疡性结肠炎不能耐受水杨酸制剂患者可以改善患者临床症状,减轻炎症反应,增强免疫功能。

基于Nrf2/HO-1信号通路探讨穴位埋线抑制脾肾阳虚夹瘀型溃疡性结肠炎大鼠氧化应激损伤作用机制

目的观察穴位埋线对脾肾阳虚夹瘀型溃疡性结肠炎(UC)模型大鼠Nrf2/HO-1信号通路相关蛋白表达的影响,探讨穴位埋线治疗UC的可能机制。方法SPF级SD雄性大鼠随机分为空白组、模型组、柳氮磺吡啶(SASP)组和穴位埋线组,每组10只。除空白组外,其余各组通过腺嘌呤、番泻叶分阶段灌胃联合冰水浴+2,4,6-三硝基苯磺酸与乙醇混合试剂灌肠建立脾肾阳虚夹瘀型UC大鼠模型。穴位埋线组选取双侧“足三里”“天枢”“肾俞”“脾俞”“大肠俞”“膈俞”穴位埋线治疗,7d/次,共2次,SASP组予柳氮磺吡啶混悬液灌胃,空白组和模型组予生理盐水灌胃,1次/d,连续14d。称量大鼠体质量、观察大便性状和便血情况;测量大鼠结肠长度,观察结肠黏膜损伤情况,对结肠黏膜损伤指数(CMDI)进行评分;HE染色观察结肠组织病理形态变化;生化法测定大鼠血清丙二醛(MDA)含量及超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-Px)活性;RT-PCR和Westernblot分别检测结肠组织Kelch样ECH关联蛋白1(Keap1)、核因子E2相关因子2(Nrf2)、血红素加氧酶-1(HO-1)mRNA和蛋白表达。结果与空白组比较,模型组大鼠体质量下降(P<0.01),结肠长度缩短(P<0.01),结肠黏膜形成明显溃疡面,隐窝结构丧失,腺体排列紊乱,大量炎性细胞浸润,CMDI评分升高(P<0.01),血清MDA含量增加,SOD、CAT、GSH-Px活性降低(P<0.01),结肠组织Keap1 mRNA和蛋白表达升高,Nrf2、HO-1 mRNA和蛋白表达降低(P<0.01);与模型组比较,SASP组和穴位埋线组大鼠体质量增加(P<0.01),结肠长度增加(P<0.01),结肠黏膜病理损伤明显减轻,CMDI评分降低(P<0.01),血清MDA含量降低,SOD、CAT、GSH-Px活性升高(P<0.01),结肠组织Keap1mRNA和蛋白表达降低,Nrf2、HO-1mRNA和蛋白表达升高(P<0.01)。SASP组和穴位埋线组各指标差异无统计学意义(P>0.05)。结论穴位埋线可减轻UC大鼠结肠黏膜病理损伤,其机制可能与激活Nrf2/HO-1信号通路、抑制氧化应激反应有关。

电针不同特定穴对慢性结肠炎大鼠的效应差异性研究

目的 探讨电针慢性结肠炎大鼠天枢、大肠俞、足三里、上巨虚对结肠炎症的效应差异及机制。方法 60只SD大鼠饲养1周后,随机分为正常组、模型组和天枢组、大肠俞组、足三里组、上巨虚组各10只。除正常组外,其余组大鼠采用免疫复合致敏法建立慢性结肠炎模型,各腧穴组于造模结束后行相应穴位电针干预,参数为2 Hz/50 Hz,电流强度2 mA,20 min/次,1次/d,连续干预10 d;正常组、模型组只在相同时间以相同方式进行固定。根据大鼠体重、大便情况、便血情况计算疾病活动指数(DAI)评分,根据结肠黏膜损伤情况计算结肠黏膜损伤指数(CMDI)评分;HE染色观察结肠组织病理形态;ELISA法检测血清白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)水平;Western blot法检测结肠组织中基质金属蛋白酶-1(MMP-1)、基质金属蛋白酶-2(MMP-2)蛋白表达量。结果 与正常组比较,模型组大鼠DAI评分、CMDI评分、血清TNF-α水平及结肠黏膜组织中MMP-1、MMP-2蛋白相对表达量均明显升高(P均<0.05),血清IL-10水平明显降低(P<0.05),结肠组织大量炎性细胞浸润;与模型组比较,各腧穴组大鼠一般状况及结肠组织损伤明显改善,DAI评分、CMDI评分、血清TNF-α水平及结肠黏膜组织中MMP-1、MMP-2蛋白相对表达量均明显降低(P均<0.05),血清IL-10水平均明显升高(P均<0.05);上巨虚组上述各指标改善情况均明显优于天枢组、大肠俞组和足三里组(P均<0.05)。结论 电针天枢、大肠俞、足三里、上巨虚均可改善慢性结肠炎大鼠结肠黏膜损伤,减轻肠道炎症反应,且电针上巨虚的干预效应可能存在相对特异性。

揿针八髎穴联合肠露灌肠液治疗溃疡性结肠炎的临床效果

目的:观察揿针八髎穴联合肠露灌肠液治疗溃疡性结肠炎的临床效果。方法:选取2020年1月—2023年6月厦门市中医院脾胃科及肛肠科收治的70例溃疡性结肠炎患者为研究对象,均给予基础治疗美沙拉秦肠溶片口服,按照随机数表法将其分为观察组(采用肠露灌肠液+揿针八髎穴)和对照组(采用肠露灌肠液),各35例,疗程均为2周。分析两组临床疗效、中医症候积分、炎症指标及不良反应。结果:观察组总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组及对照组的中医症候积分均较治疗前下降,观察组中医症候积分较对照组下降更明显,差异有统计学意义(P<0.05)。治疗后,观察组及对照组的C反应蛋白(CRP)、红细胞沉降率(ESR)、粪便钙卫蛋白(FC)均较治疗前下降,观察组的CRP、ESR、FC较对照组下降更明显,差异有统计学意义(P<0.05)。两组不良反应发生情况比较,差异无统计学意义(P>0.05)。结论:揿针八髎穴联合肠露灌肠液可协同促进溃疡性结肠炎的炎症缓解,改善患者临床症状,提高临床疗效。

安肠消溃穴位埋线法联合美沙拉嗪治疗肾脾阳虚型溃疡性结肠炎患者的疗效及对其血清炎症因子、免疫功能的影响

目的探讨安肠消溃穴位埋线法联合美沙拉嗪治疗肾脾阳虚型溃疡性结肠炎(Ulcerative colitis,UC)的效果及对血清炎症因子、免疫功能的影响。方法选取2020年10月—2022年9月期间张家港市中医医院门诊收治的UC患者90例作为研究对象,依据简单随机数字表法分为对照组和研究组,每组各45例。对照组采取美沙拉嗪肠溶片治疗,研究组在对照组基础上采取安肠消溃穴位埋线法。治疗4周后,观察比较两组患者治疗效果、治疗安全性及治疗前后中医证候积分、内镜评分、炎症因子[肿瘤坏死因子-α(Tumor necrosis factor-alpha,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)、干扰素-γ(Interferon-gamma,IFN-γ)]、免疫功能(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))水平。结果(1)中医证候积分:治疗后两组患者主症与次症分值均较治疗前降低,差异有统计学意义(P<0.05);且研究组主症与次症分值均较对照组明显降低,差异有统计学意义(P<0.05)。(2)内镜评分:治疗后两组患者内镜评分较治疗前下降,且研究组内镜评分较对照组明显降低,差异有统计学意义(P<0.05)。(3)治疗效果:治疗后研究组临床总有效率95.56%(43/45)明显高于对照组82.22%(37/45),差异有统计学意义(P<0.05)。(4)炎症因子:治疗后两组患者血清TNF-α、IL-6、IFN-γ水平均较治疗前降低,差异有统计学意义(P<0.05);且研究组血清TNF-α、IL-6、IFN-γ水平均较对照组明显降低,差异有统计学意义(P<0.05)。(5)免疫功能:治疗后两组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均较治疗前升高,差异有统计学意义(P<0.05);且研究组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均较对照组明显升高,差异有统计学意义(P<0.05)。(6)安全性:治疗期间,两组患者均未发生不良反应,且治疗后血脂、肝功能、血常规等检查未见异常。结论安肠消溃穴位埋线法联合美沙拉嗪治疗肾脾阳虚型UC可缓解患者临床症状,下调炎症因子表达,改善免疫功能,提升整体治疗效果,且具有安全性。

基于“脑-肠轴”理论探讨疏肝理脾汤联合穴位埋线对肝郁脾虚型溃疡性结肠炎的疗效

目的从“脑-肠轴”角度分析疏肝理脾汤联合穴位埋线对肝郁脾虚型溃疡性结肠炎(UC)的疗效。方法选取2020年1月至2023年1月在江西中医药大学附属医院肛肠科住院的80例UC患者。按照随机数字表法分为观察组40例(予疏肝理脾汤口服以及穴位埋线治疗)与对照组40例(予美沙拉嗪肠溶片口服),观察比较两组治疗前后临床疗效、黏膜愈合率、中医证候评分、改良Mayo评分、脑肠肽指标。结果治疗后,观察组临床疗效、黏膜愈合率优于对照组(P<0.05);两组中医证候评分、改良Mayo评分均较前显著降低,且观察组优于对照组(P<0.01);观察组血清5-羟色胺、P物质均较前显著降低、血管活性肠肽较前升高,且观察组优于对照组(P<0.01)。两组均未发生明显不良反应。结论疏肝理脾汤联合穴位埋线治疗UC临床效果显著,能有效调节患者脑肠肽指标,减轻黏膜病变程度,提高生活质量。

基于JAK2/STAT3/SOCS1信号通路探讨电针不同腧穴对急性结肠炎大鼠的作用机制

目的:探讨JAK2/STAT3/SOCS1信号通路在电针不同腧穴对大鼠急性结肠炎的作用机制。方法:将36只SPF级SD大鼠随机分为6组,每组6只。除正常组外,其余各组用冰乙酸溶液灌肠制备急性结肠炎大鼠模型,在造模结束后给予各腧穴组电针治疗,疏密波,频率2~50 Hz,强度2 mA,以肌肉震颤为度,20 min/次,1次/d,连续3 d。观察大鼠一般情况;HE法观察大鼠结肠组织黏膜病理学变化;ELISA法检测血清白介素-4(IL-4)、白介素-8(IL-8)的含量;Western blot和RT-PCR法检测大鼠结肠组织JAK2、STAT3、SOCS1蛋白及mRNA的表达。结果:与正常组相比,模型组大鼠整体状况差,结肠黏膜严重受损、甚则坏死,溃疡面明显,血清IL-4的含量明显降低、IL-8的含量明显升高(P<0.01),结肠组织中JAK2、STAT3蛋白及mRNA表达均明显升高、SOCS1蛋白及mRNA表达均明显降低(P<0.01);与模型组比较,各腧穴组大鼠一般情况明显好转,结肠黏膜损伤坏死、溃疡面明显减轻,血清IL-4的含量明显升高、IL-8的含量明显降低(P<0.01);结肠组织中JAK2、STAT3蛋白及mRNA表达明显下降、SOCS1蛋白及mRNA表达则明显升高(P<0.05);足三里组与天枢、大肠俞、上巨虚穴比较,结肠黏膜损伤显著减轻,血清IL-4的含量显著升高、IL-8的含量显著降低(P<0.05);结肠组织中JAK2、STAT3蛋白及mRNA表达显著下降、SOCS1蛋白及mRNA表达则显著升高(P<0.05)。结论:电针各腧穴均能改善结肠组织黏膜的损伤,减轻炎症反应。其中足三里穴治疗效应总体优于天枢、大肠俞、上巨虚穴,其作用机制可能通过调JAK2/STAT3/SOCS1信号通路相关蛋白及炎性细胞因子IL-4、IL-8有关。

灌肠联合穴位贴敷在湿热型溃疡性结肠炎患者护理中的应用效果及对肠道功能的影响

目的 分析灌肠联合穴位贴敷在湿热型溃疡性结肠炎患者护理中的应用效果。方法 选取徐州市中医院收治的湿热型溃疡性结肠炎患者84例,时间为2021年1月至2023年12月,按照随机数表法分为对照组(n=42)和观察组(n=42)。两组均给予常规治疗,对照组患者实施常规护理干预,观察组在常规护理基础上增加灌肠联合穴位贴敷干预。比较两组患者干预前后症状积分、病情严重程度评分、溃疡性结肠炎内镜活动度评分和干预有效率。结果 干预后,观察组症状积分均低于对照组,差异有统计学意义(P <0.05)。干预后,观察组病情严重程度评分、溃疡性结肠炎内镜活动度评分低于对照组,差异有统计学意义(P <0.05)。观察组干预总有效率高于对照组,差异有统计学意义(P <0.05)。结论 湿热型溃疡性结肠炎患者给予灌肠联合穴位贴敷干预效果显著,可减轻患者临床症状,改善病情,促进肠道功能恢复。

穴位埋线治疗慢传输型便秘的临床研究

目的 :寻找治疗慢传输型便秘或混合型便秘的最佳疗法。方法 :观察组采用大肠俞、天枢、中极、足三里穴位埋线方法 ,对照组口服中药四磨汤治疗。每天记录排便时间及排便量 ,随访 3个月。结果 :观察组 87例中 81例治疗后排便均有改善 (93 1% ) ,于第 1次排便后即可通畅排便 ,排便次数≥ 1次 / 2天 ,治愈 6 8例 (78 2 % )。对照组 94例服药期间 93例可较正常排便 (排便次数≥ 1次/ 2天 ) ,但停药后 7天内 6 6例逐渐恢复至治疗前情况 ,其余病例 15天内除 1例外亦均恢复到治疗前情况 ,有效率 (1 1% ) ;显效及治愈数为 0。结论 :穴位埋线法治疗便秘简便易行 。

穴位埋线对溃疡性结肠炎大鼠ANCA作用的实验研究

目的:观察穴位埋线对溃疡性结肠炎的疗效,并探讨其作用机理。方法:用2,4二硝基氯苯法造模,造模结束后,第20天将造模组随机分为模型组、柳氮磺胺吡啶(SASP)治疗组和穴位埋线治疗组。SASP组用4.5%柳氮磺胺吡啶悬液胃饲治疗,穴埋组采用“足三里”“上巨虚”穴内埋线治疗。用间接免疫荧光法检测抗中性粒细胞胞浆抗体(ANCA),病理组织切片技术观察病变。结果:溃疡性结肠炎的实验大鼠ANCA阳性率达62.5%,各组间差异有显著意义(P<0.05),通过治疗后,两组ANCA阳性率均降低(P<0.05,P<0.01)。结论:穴位埋线治疗溃疡性结肠炎疗效确切,其作用机理可能与降低NACA有关。

穴位贴敷加穴位注射防治支气管哮喘的临床研究

目的 :观察穴位贴敷加穴位注射防治支气管哮喘的疗效。方法 :将 117例患者随机分成治疗组 6 2例和对照组 5 5例进行对照观察。结果 :治疗组临床疗效的总有效率明显高于对照组 ,P <0 0 1,患者免疫功能和生命质量指标明显改善。结论 :穴位贴敷加穴位注射防治支气管哮喘疗效显著、确切 。