针刺对术后胃肠功能紊乱大鼠胃肠传输功能及脑肠肽的影响

摘要 目的：探讨针刺三里穴、中脘对大鼠胃大部切除术后胃肠传输功能恢复的影响及可能的作用机制。方法：将60只 SD 大鼠随机分为空白组、模型组和针刺组，每组 20 只。造模成功后第3天开始，针刺组进行针刺足三里、中脘，连续治疗14天。于末次针刺结束后，各组记录进食量、体重等；后各组禁食24 h后进行胃残留率和小肠推进率测定，腹主动脉取血测定胃泌素、胃动素、食欲素A及食欲素1型受体。结果：造模前，三组大鼠体重和进食量差异无统计学意义，P>0.05。造模后3天，模型组及针刺组体重和进食量低于空白组，差异有统计学意义，P<0.05。针刺干预后，模型组体重和进食量低于空白组和针刺组，差异有统计学意义，P<0.05。针刺干预后，针刺组大鼠胃残留率、小肠推进率、胃泌素、胃动素、食欲素A及食欲素1型受体高于模型组，差异有统计学意义，P<0.05；模型组胃残留率、小肠推进率、胃泌素、胃动素、食欲素A及食欲素1型受体低于空白组，差异有统计学意义，P<0.05；针刺组与空白组胃残留率、小肠推进率、胃泌素、胃动素、食欲素A及食欲素1型受体差异无统计学意义，P>0.05。结论：针刺胃大部切除术后大鼠足三里穴、中脘穴，改善胃排空和小肠推进功能，促进术后胃肠功能的恢复，其作用机制可能为改变脑肠肽代谢，增加食欲素A水平，激活食欲素1型受体，促进胃泌素、胃动素分泌。

Effects of Acupuncture on Gastrointestinal Transport Function and Brain-gut Peptide in Postoperative Gastrointestinal Dysfunction Rats

ABSTRACT Objective: To investigate the effect and possible mechanism of acupuncture at Sanli point and Zhongwan on the recovery of gastrointestinal transmission function after subtotal gastrectomy in rats. Methods: 60 SD rats were randomly divided into blank group, model group and acupuncture group, with 20 rats in each group. On the third day after the successful modeling, the acupuncture group received acupuncture at Zusanli and Zhongwan for 14 consecutive days. Three days after the last acupuncture, food intake and body weight were recorded in each group. After fasting for 24 h, gastric residual rate and small intestine propelling rate were measured, and blood samples were taken from abdominal aorta to measure gastrin, motilin, orexin A and orexin type 1 receptor. Results: Before modeling, there were no significant differences in body weight and food intake among the three groups (P>0.05). The body weight and food intake of model group and acupuncture group were lower than that of blank group after 3 days modeling, and the difference was statistically significant (P<0.05). After acupuncture intervention, the body weight and food intake of the model group were lower than blank group and the acupuncture group, and the difference was statistical significance(P<0.05). After acupuncture intervention, the gastric residual rate, small intestine thrust rate, gastrin, motilin, orexin A and orexin type 1 receptor in the acupuncture group were higher than those in the model group, and the difference was statistically significant(P<0.05). The gastric residual rate, small intestine propulsion rate, gastrin, motilin, orexin A and orexin type 1 receptor in model group were lower than those in blank group, and the difference was statistically significant (P<0.05). There were no significant differences in gastric residual rate, small intestinal thrust rate, gastrin, motilin, orexin A and orexin 1 receptor between acupuncture group and blank group(P>0.05). Conclusion: The method of Acupuncture at Zusanli and Zhongwan points after subtotal gastrectomy can improve gastric emptyand intestinal propelling functions, and promote the recovery of postoperative gastrointestinal function. The mechanism could be changed the metabolism of brain-gut peptide, increased the level of orexin A, activate orexin type 1 receptor, and promoted the secretion of gastrin and motilin.