针刺对术后结肠ICCs修复微环境中MPO表达的影响

发布时间：2018-04-13 22:25

本文选题：针刺 + 腹部术后　；参考：《广州中医药大学》2016年硕士论文

【摘要】：背景胃肠动力功能紊乱是外科腹腔手术后常见的并发症,随着病情进展,可能会引起肠麻痹、肠梗阻、肠粘连等并发症,严重者可引起全身性多器官功能障碍(multiple organdisfunction syndrome, MODS),甚至多器官功能衰竭(multiple organ failure,MOF)。髓过氧化物酶(MPO),MPO不仅能特异性地标记中性粒细胞,而且能够较好的反应中性粒细胞活性。在肠道急性炎症发生时,MPO作为炎症介质参与MPO能直接参与炎症反应。国内已有学者研究表明,MPO活性的表达与肠道炎症的严重程度呈正相关。已有研究证实针刺治疗能改善患者术后的结肠转运时间(colonic transit time,CTT),调节胃动素、胃泌素等多种胃肠激素和细胞因子水平,从而改善胃肠动力障碍,减少炎症因子的产生,减轻术后肠道的炎症反应。但针刺在调控外科术后胃肠动力功能紊乱-减轻并发症发病率方面的机制仍不十分明确。基于祖国医学“肚腹三里留”、“合治内腑”的理论,本研究通过制造腹腔结肠吻合术大鼠模型,观察针刺对大鼠肠道cajal细胞修复的影响,探究针刺改善胃肠功能障碍,防治术后胃肠动力功能紊乱,是本实验研究目的。目的采用靳三针组穴中的“足三针”远部取穴治疗腹腔结肠吻合术大鼠模型术后胃肠运动功能紊乱的实验研究,观察针刺对术后结肠ICCs修复微环境中MPO表达的影响,旨在从胃肠Cajal细胞微环境MPO表达着手研究针刺足三针调整外科术后胃肠功能紊乱的的相关机制。方法将由广州中医药大学实验动物中心提供的雌雄各半,健康的SPF级成年SD大鼠30只按随机数字表法平均分成3组。除正常组10只以外,其余大鼠均需造模,行腹腔结肠吻合术,造模成功后,随机将造模成功的大鼠分为针刺组和模型组,针刺组大鼠每日给予针刺足三针穴组,每日针刺1次,每次15min。模型组和正常组每天同一时间行空抓15min,降低人为固定的影响因素。从造模成功第二天开始每天对各大鼠的排便粒数进行记录并收集大便,待实验日期到期后,统一称重并作记录。术后3d灌墨汁后处死大鼠,观察并计算小肠推进率,取结肠组织按南京建成公司生产的酶联免疫分析(ELISA)试剂盒说明检测结肠组织的MPO表达,记录数据。结果1.①首次排便时间：通过对比模型组与针刺组的首次排便时间得出,针刺组术后首次排便时间明显优于模型组。②术后大鼠排便粒数变化：术后第一至三天排便粒数模型组与正常组、针刺组与正常组均有显著性差异(P＜0.01)。针刺组与模型组比较,术后第一天即出现显著性差异(P＜0.05)。2.针刺组大鼠的小肠推进率较模型组大鼠明显提高。3.针刺组大鼠的结肠组织中的MPO表达水平较模型组大鼠明显降低(P＜0.05)。结论1.针刺足三针能有效提高结肠吻合术模型大鼠的小肠推进率,改善其小肠运动功能。2.针刺足三针可有效减轻结肠吻合术模型大鼠肠道炎症反应,从而降低其结肠组织中MPO的活性。
[Abstract]:Background Gastrointestinal motility disorder is a common complication after abdominal surgery. As the disease progresses, it may lead to intestinal paralysis, intestinal obstruction, intestinal adhesion and other complications.Severe multiple organ dysfunction may cause multiple organdisfunction syndromes, mods, and even multiple organ failure.Myeloperoxidase (MPO) MPO can not only specifically label neutrophils, but also react to neutrophil activity.MPO, as an inflammatory mediator, is involved in the inflammatory response of MPO directly during the occurrence of acute inflammation in the intestine.There is a positive correlation between the expression of MPO and the severity of intestinal inflammation.It has been proved that acupuncture can improve the colonic transit time after operation, regulate the levels of motilin, gastrin and other gastrointestinal hormones and cytokines, thus improve gastrointestinal motility disorder and reduce the production of inflammatory factors.Reduce postoperative intestinal inflammation.However, the mechanism of acupuncture in regulating gastrointestinal motility disorder-reducing the incidence of complications after surgery is still unclear.Based on the theory of "three li of abdominal cavity" and "treatment of internal organs" in traditional Chinese medicine, this study observed the effect of acupuncture on the repair of intestinal cajal cells in rats by making a rat model of celiac colonic anastomosis, and explored the improvement of gastrointestinal dysfunction by acupuncture.Prevention and treatment of postoperative gastrointestinal motility disorder is the purpose of this experiment.Objective to observe the effect of acupuncture on the expression of MPO in the microenvironment of colon ICCs repair after abdominal colon anastomosis in rats with abdominal colonic anastomosis by using "foot three acupuncture" in the distal part of Jin's three-needle group to treat the gastrointestinal motility disorder after abdominal colon anastomosis, and to observe the effect of acupuncture on the expression of MPO in the microenvironment of colon ICCs repair after operation.The aim of this study was to investigate the mechanism of gastrointestinal dysfunction after three-needle acupuncture in gastrointestinal Cajal microenvironment.Methods 30 healthy adult SD rats of SPF grade were divided into 3 groups according to the random digital table method, which were provided by the Experimental Animal Center of Guangzhou University of traditional Chinese Medicine.15 minutes at a time.The model group and the normal group were subjected to 15 minutes of air capture at the same time every day to reduce the influence factors of artificial fixation.The defecation grains of each rat were recorded and collected every day from the second day after the successful establishment of the model. After the experimental date expired, the rats were weighed and recorded uniformly.After 3 days of operation, the rats were sacrificed and the intestinal propelling rate was observed and calculated. The colonic tissues were examined for the expression of MPO and recorded according to the Elisa kit produced by Nanjing Chengzheng Company.Results 1.1 the first defecation time was obtained by comparing the first defecation time between the model group and the acupuncture group.The first defecation time in the acupuncture group was significantly better than that in the model group (P < 0.01). The number of defecation grains in the model group was significantly different from that in the normal group and that in the acupuncture group and the normal group on the first to third day after operation (P < 0.01).There was a significant difference between the acupuncture group and the model group on the first day after operation (P < 0.05).The propelling rate of small intestine in acupuncture group was significantly higher than that in model group.The expression of MPO in colon of acupuncture group was significantly lower than that of model group (P < 0.05).Conclusion 1.Acupuncture of foot three needles can effectively improve the intestinal propulsion rate and improve the small intestinal motor function of colon anastomosis model rats.Acupuncture of foot three-needle can effectively reduce the inflammatory reaction of intestinal tract and decrease the activity of MPO in colonic tissue of colonic anastomosis rats.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R245

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