摘要：
目的:观察热敏灸对肠易激综合征(IBS)大鼠促肾上腺皮质激素释放激素(CRH)、促肾上腺皮质激素(ACTH)、皮质酮(CORT)的影响,探讨热敏灸治疗IBS的可能作用机制.方法:56只SD雄性大鼠按随机数字表随机分为空白组(8只)、模型组(8只)、艾灸组(32只)和米非司酮组(RU-486组,8只).空白组正常饲养,模型组、RU-486组与艾灸组采用慢性不可预见性刺激法建立IBS模型,造模21 d.造模结束后,艾灸组灸"命门"穴,每日1次,每次40 min,共14 d,每隔5 min检测大鼠尾温并记录,根据大鼠尾温变化分热敏灸组和非热敏灸组,两组各随机抽取8只;RU-486组予RU-486灌胃处理,空白组、模型组与艾灸组灌服同等换算体积0.9%NaCl溶液14 d.观察各组大鼠一般状况、体质量、行为学、小肠推进率、内脏敏感性变化,ELISA法检测大鼠血清CRH、ACTH、CORT含量,光学显微镜观察结肠形态学变化.结果:①造模后,大鼠表现为静卧少动、神态怠倦、毛发枯槁、耳郭色泽变暗淡、粪便时干时稀等;体质量增长缓慢;大鼠穿格数、站立数明显减少;内脏敏感性增高、小肠推进率下降;结肠组织显微镜下未见明显炎性细胞浸润.②干预后,与空白组相比,RU-486组体质量、内脏敏感性差异无统计学意义(均P>0.05),但小肠推进率明显下降(P0.05).与模型组相比,RU-486组干预后体质量升高、内脏敏感性改善(P0.05);热敏灸组与非热敏灸组干预后体质量、内脏敏感性、小肠推动率均明显优于模型组(P0.05).结论:热敏灸可能通过调节下丘脑-垂体-肾上腺轴(HPA轴),降低血清CRH、ACTH、CORT含量,改善胃肠运动功能,从而达到治疗IBS的目的.%Objective To observe the effects of heat-sensitive moxibustion on corticotropin releasing hormone (CRH), adrenocorticotrophic hormone (ACTH) and corticosterone (CORT) in rats with irritable bowel syndrome (IBS), and to explore the possible mechanism of heat-sensitive moxibustion on IBS.MethodsAccording to random number table, 56 SD male rats were randomly divided into a blank group (n=8), a model group (n=8), a moxibustion group (n=32), and a mifepristone group (RU-486 group,n=8). The rats in the blank group were treated with normal feeding; the rats in the model group, RU-486 group and moxibustion group were treated with chronic non-predictable stimulation for 21 days to establish IBS model. After model establishment, the rats in the moxibustion group were treated with moxibustion at"Mingmen" (GV 4) for 40 min, once a day for 14 days; the tail temperature was recorded every 5 min; according to the change of tail temperature, the rats were divided into a heat-sensitive moxibustion group and a non-heat-sensitive moxibustion group, and 8 rats were randomly selected in the two groups. The rats in the RU-486 group were treated with gastric administration of RU-486 for 14 days, while the rats in the blank group, model group and moxibustion groups were treated with identical volume of 0.9% NaCl. The rat general condition,body mass,behavioristics, intestinal propulsive rate and visceral sensitivity were observed in each group; ELISA method was used to detect serum CRH,ACTH and CORT; optical microscope was applied to observe the morphological changes of colon.Results(1) After model establishment, rats were in rest state, fatigued, with withered hair and dim ear; the stool was dry or watery; the body mass were slowly increased; the number of crossed grid and standing frequency were significantly reduced; visceral sensitivity was increased and intestinal propulsion rate was decreased; no obvious inflammatory cell infiltration was observed under microscope. (2) After intervention, compared with the blank group, the body mass and visceral sensitivity in the RU-486 group were not significantly different (bothP>0.05), but the intestinal propulsion rate was decreased significantly (P0.05). Compared with the model group, the body mass and visceral sensitivity were improved in the RU-486 group (P0.05). The body mass, visceral sensitivity and intestinal propulsion rate of the heat-sensitive moxibustion group and the non-heat-sensitive moxibustion group were superior to those of the model group (P0.05).Conclusion Heat-sensitive moxibustion could reduce the contents of CRH, ACTH and CORT through the HPA axis, and improve the function of gastrointestinal motility to treat IBS.
