针刺对便秘型肠易激综合征患者血浆5-HT、NPY和CGRP的影响

裴丽霞; 朱莉; 陈璐; 吴晓亮; 周俊灵; 耿昊; 孙建华

针刺对便秘型肠易激综合征患者血浆5-HT、NPY和CGRP的影响

1.
南京中医药大学附属医院，江苏南京 210029
2.
南京中医药大学第二临床医学院，江苏南京 210023

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出版历程
- 收稿日期: 2015-03-15
- 修回日期: 2015-05-10
- 刊出日期: 2015-09-10

Influence of Acupuncture on Plasma 5-HT， NPY and CGRP in Patients with Constipation-predominant Irritable Bowel Syndrome

1.
The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China
2.
The Second Clinical Medical College of Nanjing University of Chinese Medicine, Nanjing, 210023, China

摘要

摘要: 目的观察针刺对便秘型肠易激综合征（IBS-C）患者血浆中5-羟色胺（5-HT）、神经肽Y（NPY）和降钙素基因相关肽（CGRP）水平的影响，从脑-肠轴的角度阐述针刺治疗IBS-C的效应机制。方法 60例IBS-C患者随机分为针刺组和西药组。针刺组30例，予针刺治疗，取天枢、足三里、上巨虚、太冲、三阴交、印堂、百会，每日1次，每周5次，4周为1个疗程；西药组30例，予口服乳果糖口服溶液，15 mL每次，每日3次，4周为1个疗程。观察2组治疗前后临床症状改善情况。同时采集2组患者治疗前后及30名健康志愿者外周静脉血，采用Elisa法检测患者血浆中的5-HT、CGRP和NPY的水平，探讨针刺对IBS-C患者血浆5-HT、NPY和CGRP的影响。结果 ①针刺及西药均能显著改善IBS-C患者的临床症状（P<0.01），针刺组疗效均优于西药组（P<0.01）。②2组IBS-C患者血浆5-HT、NPY和CGRP水平均明显高于健康志愿者，差异有统计学意义（P<0.01）。治疗后2组IBS-C患者血浆5-HT、NPY和CGRP水平均下降，针刺组患者血浆5-HT、NPY和CGRP水平较治疗前有显著差异（P<0.01）；西药组患者血浆5-HT、NPY水平较治疗前也有显著差异（P<0.01），CGRP水平与治疗前比较无统计学意义（P>0.05）。2组治疗后组间比较血浆5-HT、NPY无统计学差异（P>0.05），血浆CGRP有统计学差异（P<0.01），针刺组下降趋势优于西药组。结论 ①针刺可显著改善IBS-C患者的临床症状，疗效均优于西药组。②IBS-C患者血浆5-HT、NPY和CGRP水平均升高，说明脑肠肽水平异常与IBS-C症状密切相关。③针刺能明显降低患者血浆5-HT、NPY和CGRP水平，缓解腹痛与腹部不适程度，表明针刺对IBS-C患者血浆脑肠肽水平的良性调控作用可能是其治疗本病的效应机制之一。
- 针刺 /
- IBS-C /
- 5-HT /
- NPY /
- CGRP
Abstract: OBJECTIVE To explore the acupuncture treatment mechanism of constipation-predominant irritable bowel syndrome(IBS-C) from the perspective of brain-gut axis， by observing the plasma 5HT， CGRP and NPY level before and after the treatment. METHODS 60 patients with IBS-C were randomly divided into two groups. 30 cases in the acupuncture group(AG) were treated by acupuncture five times a week， with such acupoints as Tianshu， Zusanli， Shangjuxu， Taichong， Sanyinjiao， Yintang， Baihui being selected. The other 30 cases in the medicine group(MG) were treated with lactulose oral solution， 15 ml per time for three times a day. After 4 weeks treatment， enzyme-linked immunosorbent assay (ELISA) was used to detect the plasma 5HT， NPY and CGRP level of 30 healthy volunteers and the two treatment groups and observe the improvement of clinical symptoms. RESULTS ①Both groups could significantly improve the clinical symptoms in patients with IBS-C (P<0.01)，while the curative effect in the AG was superior to that in the MG (P<0.01). ②The levels of 5-HT， NPY and CGRP in patients with IBS-C of two treatment groups were significantly higher than those in healthy volunteers， and the difference was statistically significant (P<0.01). The plasma 5-HT， NPY and CGRP levels all went down in both groups after treatment， and the differences of 5-HT， NPY and CGRP levels were significant when compared to the levels before treatment in AG(P<0.01). The differences of 5-HT，NPY levels were also significant when compared to the levels before treatment in MG(P<0.01)， while there was no significant difference on CGRP(P<0.01). There were no significant differences of 5-HT and NPY levels between these two groups after treatment (P>0.05)， but the difference of CGRP was highly statistically significant(P<0.01). The downward trend of 5-HT，NPY and CGRP level was better in the AG. CONCLUSION ①Acupuncture treatment can significantly improve the clinical symptoms in patients with IBS-C， and the theraputic effect is superior to that in the MG. ②The increase of 5-HT， NPY and CGRP level in patients with IBS-C after treatment suggests a close relationship between the abnormal level of brain-gut peptide and IBS syndrome. ③Acupuncture treatment can decrease the plasma levels of 5-HT， NPY and CGRP， alleviate the degree of abdominal pain and discomfort， which indicates that benign regulation of brain-gut peptide level in patients with IBS-C by acupuncture may be one of the effective mechanisms in treatmenting this disease.
- acupuncture /
- IBS-C /
- 5-HT /
- NPY /
- CGRP

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