肺与大肠俞募配穴电针改善急性胰腺炎大鼠胃肠动力—减轻肺损伤的机理

发布时间：2018-12-07 20:20

【摘要】：背景：急性肺损伤(acute lung injury, ALI)是重症急性胰腺炎(severe acute pancreatitis, SAP)常见的并发症,其发生与胃肠功能障碍密切相关。既往研究已经证实,针刺可通过调节胃肠激素水平,改善SAP大鼠胃肠功能障碍,以减轻肺部炎症损伤。但肺与大肠两经俞募配穴电针治疗急性胰腺炎(acute pancreatitis, AP)相关性ALI的机理及最佳针刺配穴不清。目的：基于中医理论“肺与大肠相表里”,以SAP最常发生的肠道功能障碍和肺损伤为切入点,选择肺与大肠的俞募配穴来研究俞募配穴电针改善胃肠功能、防治ALl的机理,以探索俞募配穴治疗SAP的疗效原理和最佳穴位配伍。方法：40只雄性Sprague-Dawley (SD)大鼠,随机分为空白组、模型组、俞穴电针组、募穴电针组和俞募配穴电针组(每组8只)。电针治疗组及模型组均采用3.5%牛磺胆酸钠逆行胰胆管微量泵泵入法制备SAP模型,造模成功2h后开始给予电针治疗,24h内给予三个电针治疗组电针治疗各3次,两次电针治疗间隔时间为7h,留针时间为40min(俞穴电针组：双侧肺俞与大肠俞留针40min；募穴电针组：双侧中府穴与天枢穴留针40min；俞募电针组：双侧肺俞与大肠俞留针20min,双侧中府穴与天枢穴留针20mmin)。空自组和模型组给予同等时间的捆绑处理。造模后36h采集标本：心血2m1,取上清液,用ELISA测血清淀粉酶(amylase, AMY)、胆囊收缩素(cholecystokinin, CCK)、血管活性肠肽(vasoactive intestinal peptide, VIP)、胃动素(motilin, MTL)和二胺氧化酶(Diamine Oxidase, DAO);取肺、胰腺、大肠组织测炎症损伤因子,用ELISA测组织髓过氧化物酶(myeloperxidase, MPO)和丙二醛(malondialdehyde, MDA),做病理切片,行病理评分。结果：电针治疗后,三个电针治疗组肺、胰腺、大肠MPO、MDA和血清AMY、VIP均较模型组明显降低(P0.05),血清MTL明显升高(P0.05),且俞募配穴电针组大鼠肺、胰腺、大肠病理评分和血清CCK、DAO较模型组明显降低(P0.05)。在血清VIP、MTL,肺及大肠组织MPO、MDA等方面,三个电针治疗组组间两两比较,有统计学差异,俞募配穴电针组优于单纯的俞穴电针组或募穴电针组。结论：肺与大肠两经俞募穴电针都能通过调节胃肠激素、促进胃肠运动,改善胃肠功能障碍以减轻肺损伤,且俞募配穴电针疗效更优。
[Abstract]:Background: acute lung injury (acute lung injury, ALI) is a common complication of severe acute pancreatitis (severe acute pancreatitis, SAP). Previous studies have shown that acupuncture can alleviate lung inflammation by regulating gastrointestinal hormone levels and improving gastrointestinal dysfunction in SAP rats. However, the mechanism of electroacupuncture on (acute pancreatitis, AP) associated ALI and the optimal acupuncture of acupoints in the treatment of acute pancreatitis were not clear, but the two meridians of lung and large intestine were combined with acupoint electroacupuncture. Objective: based on the theory of "lung and large intestine" and taking the intestinal dysfunction and lung injury that occur most frequently in SAP as the starting point, the author chose the point of Shu-fu-pairing of lung and large intestine to study the mechanism of improving gastrointestinal function and preventing and treating ALl by electroacupuncture of Yu-fu-pin. Objective: to explore the principle of therapeutic effect and the best combination of acupoints in the treatment of SAP. Methods: forty male Sprague-Dawley (SD) rats were randomly divided into three groups: blank group, model group, electroacupuncture group at Shu point, electroacupuncture group at Jun acupoint and electroacupuncture group at Shufu point (8 rats in each group). The SAP model was made by injecting 3.5% sodium taurocholate retrograde pump into the pancreaticobiliary duct in both the electroacupuncture group and the model group. Two hours after the establishment of the model, electroacupuncture was given, and three electroacupuncture treatments were given in each of the three electroacupuncture groups within 24 hours. The interval between two electroacupuncture treatments was 7 hours and the time of retention was 40min (Shu-point electroacupuncture group: bilateral Feshu and large intestine Yu for 40 minutes; The control group was divided into two groups: bilateral Zhongfu point and Tianshu point for 40 minutes, Shu group for 20 minutes and bilateral Zhongfu point and Tianshu point for 20mmin). Empty self-group and model group are given the same time binding. Samples were collected at 36 h after modeling. The supernatant was taken from the supernatant of cardiac blood. Serum amylase, (amylase, AMY), cholecystokinin (cholecystokinin, CCK), vasoactive intestinal peptide (vasoactive intestinal peptide, VIP), motilin (motilin, MTL) (vasoactive intestinal peptide, VIP),) and diamine oxidase (Diamine Oxidase,) were measured by ELISA. DAO); Inflammatory injury factors were measured in lung, pancreas and large intestine. Myeloperoxidase (myeloperxidase, MPO) and malondialdehyde (malondialdehyde, MDA),) were measured by ELISA. Results: after electroacupuncture treatment, MPO,MDA and AMY,VIP in lung, pancreas, large intestine and serum in three electroacupuncture groups were significantly lower than those in model group (P0.05), serum MTL was significantly increased (P0.05). The pathological score and serum CCK,DAO of the model group were significantly lower than that of the model group (P0.05). In serum VIP,MTL, lung and large intestine tissue MPO,MDA, there was statistical difference among the three electroacupuncture treatment groups. The Shu-Fu point electroacupuncture group was better than the simple Yu acupoint electroacupuncture group or the Jun acupoint electroacupuncture group. Conclusion: both the two channels of lung and large intestine can reduce lung injury by regulating gastrointestinal hormones, promoting gastrointestinal motility and improving gastrointestinal dysfunction.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R245.97

【参考文献】