1、耳电针缓解功能性消化不良大鼠胃部高敏的效应规律及对神经生长因子的影响周静珠1，程宏亮2，陈欢1，徐万里1，朱伟坚1，周帅1，张朝晖1(1 南京医科大学第一附属医院，江苏 南京 210029;2 南京中医药大学附属医院，江苏 南京 210029)摘要 目的观察耳电针在降低功能性消化不良(FD)大鼠胃部高敏感性中的作用规律，并探讨其对神经生长因子(NGF)的影响。方法实验一:将 16 只 10 d 龄 SD 雄性幼鼠随机分为对照组和耳电针组，每组 8 只。耳电针组幼鼠通过三硝基苯磺酸灌肠诱导 FD 胃部高敏模型，第 8周龄时选取双侧耳穴“胃”穴进行连续 5 d 电针刺激;对照组幼鼠仅给予生理盐水灌
2、肠。分别记录2 组大鼠第 8 周龄干预前颈部斜方肌肌电积分、腹部回撤反射评分和耳电针组大鼠单次耳电针后、5 次耳电针后及耳电针结束后第 3，5，10 天颈部斜方肌肌电积分，分析耳电针的即时效应、累加效应和维持效应。实验二:将 40 只 10 d 龄 SD 雄性幼鼠随机分为对照组、模型组、耳电针组、电针对照组，每组 10 只。除对照组外，其余组幼鼠通过三硝基苯磺酸灌肠诱导 FD 胃部高敏模型。第 8周龄时，耳电针组选取双侧耳穴“胃”穴、电针对照组选取双侧耳垂进行连续 5 d 电针刺激。干预结束后处死各组大鼠，HE 染色观察各组胃底及远端结肠的病理改变，ELISA 法检测血浆去甲肾上腺素(NE)水
3、平，T PC 和 Western blot 法检测胃底 NGFmNA 和蛋白表达情况。结果耳电针组大鼠第 8 周龄电针前胃部球囊扩张压力为 60 和 80 mmHg 时的肌电积分和腹部回撤反射评分均显著高于对照组(P 均 0 05)。胃部球囊扩张压力为 60 和 80 mmHg 时，单次耳电针后的肌电积分均明显低于第 8 周龄电针前(P 均 0 05)，5 次耳电针后的肌电积分均明显低于单次耳电针后(P 均 0 05)，耳电针结束后第 3 天的肌电积分与 5 次耳电针后比较差异均无统计学意义(P 均 0 05)，耳电针结束后第 5 天的肌电积分仍明显低于第 8 周龄电针前(P 均 0 05)，
4、耳电针结束后第 10 天的肌电积分与第 8 周龄电针前比较差异均无统计学意义(P 均 0 05)。各组大鼠胃底、结肠 HE 染色均未见明显炎症反应。模型组和电针对照组大鼠血浆 NE 水平、胃底组织中 NGFmNA 和蛋白相对表达量均明显高于对照组(P 均 0 05)，耳电针组大鼠血浆 NE 水平、胃底组织中 NGF mNA 和蛋白相对表达量均明显低于模型组和电针对照组(P 均 0 05)。结论耳电针可有效缓解功能性消化不良大鼠胃部高敏，多次干预效果更显著，且有一定的维持效应，其镇痛机制可能与调控血浆 NE 和胃底 NGF 表达有关。关键词 耳穴疗法;功能性消化不良;内脏高敏;神经生长因子doi
5、:10 3969/j issn 1008 8849 2022 22 004 中图分类号 332 文献标识码 A 文章编号 1008 8849(2022)22 3083 07 作者简介 周静珠，女，硕士，副主任中医师，研究方向为功能性胃肠病的诊治。基金项目 江苏省自然科学基金项目(BK20191065)Effect laws of ear electroacupuncture in relieving gastric hypersensitivity in rats with functionaldyspepsia and its effect on nerve growth factorZHO
6、U Jingzhu1，CHENG Hongliang2，CHEN Huan1，XU Wanli1，ZHU Weijian1，ZHOU Shuai1，ZHANG Zhaohui1(1 The First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，Jiangsu，China;2 Affiliated Hospital ofNanjing University of Traditional Chinese Medicine，Nanjing 210029，Jiangsu，China)Abstract:Objecti
7、ve It is to observe the laws of ear electroacupuncture in reducing gastric hypersensitivity in rats withfunctional dyspepsia(FD)，and to explore its effect on nerve growth factor(NGF)Methods Experiment I:Sixteen10-day-old male SD rats were randomly divided into control group and ear electroacupunctur
8、e group，with 8 rats in each3803现代中西医结合杂志 Modern Journal of Integrated Traditional Chinese and Western Medicine 2022 Nov，31(22)group The young rats in the ear electroacupuncture group were given trinitrobenzene sulfonic acid by enema to induce FDgastric hypersensitivity models The EMG scores of cervi
9、cal rhomboid muscle and abdominal retraction reflex scores of therats at the 8 th week of age in the two groups before the intervention，and the EMG scores of cervical rhomboid muscle ofrats in the ear acupuncture group after once ear acupuncture，5 times ear acupuncture and on the 3 rd，5 th and 10 th
10、 dayafter the end of ear acupuncture were recorded respectively，to analyze the immediate，cumulative and maintenance effectsof ear acupuncture Experiment II:Forty 10-day-old male SD rats were randomly divided into control group，modelgroup，ear electroacupuncture group and electroacupuncture control gr
11、oup，with 10 rats in each group The FD gastric hy-persensitivity model was induced by enema with trinitrobenzene sulfonic acid in the pups of all groups except the controlgroup At the age of 8 weeks，the ear acupuncture group selected bilateral ear acupuncture points“stomach”and the con-trol group sel
12、ected bilateral ear lobes for 5 d of continuous electroacupuncture stimulation After the intervention，the rats ineach group were executed，and the pathological changes of gastric fundus and distal colon were observed by HE staining，plasma norepinephrine(NE)level was measured by ELISA，and mNA and prot
13、ein expression of gastric fundic nervegrowth factor(NGF)were detected by T-PC and Western blot esults The EMG scores and abdominal retraction re-flex scores of the rats in the ear electroacupuncture group were significantly higher than those in the control group at 60 and80 mmHg of gastric balloon d
14、ilatation pressure before ear electroacupuncture at the 8 th week of age(P 0 05)The EMGscores after once ear electroacupuncture were significantly lower than those before electroacupuncture at the 8 th week of ageat gastric balloon dilatation pressures of 60 and 80 mmHg(all P 0 05)，the EMG scores af
15、ter 5 times ear electroacu-puncture were significantly lower than those after once(all P 0 05)，the differences between the EMG scores on the 3 rdday after the end of the ear electroacupuncture and after 5 times ear electroacupuncture were not statistically significant(allP 0 05)，and the EMG scores o
16、n the 5 th day after the end of the ear electroacupuncture were still significantly lowerthan those before ear electroacupuncture at the 8 th week of age(all P 0 05)，and the differences between the EMGscores on the 10th day after the end of the ear electroacupuncture and those before the electroacupuncture at 8 th week ofage were not statistically significant(all P 0 05)No obvious inflammatory reaction was found in HE staining of stom-ach fundus and colon of rats in each group The level of plasm