Electroacupuncture ST36 prevents postoperative intra-abdominal adhesions formation
Electroacupuncture ST36 prevents postoperative intra-abdominal adhesions formation
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DOI：
10.1016/j.jss.2014.12.043
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发表时间：
2015-05-01
影响因子：
2.2
通讯作者：
Hu, Sen
中科院分区：
文献类型：
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作者：
Du, Ming-Hua;Luo, Hong-Min;Hu, Sen
背景：我们最近证明电针（EA）ST36 在腹腔粘连形成的早期发挥抗炎作用。有证据表明 EA ST36 的抗炎作用涉及通过迷走神经的胆碱能抗炎途径依赖性机制。然而，针刺预防术后腹腔粘连形成的确切效果和准确的迷走神经调节尚未得到充分评价。 材料与方法：对接受盲肠和腹壁粘连病变手术的Sprague-Dawley大鼠随机分为如下六组：（a）EAN：EA非通道腧穴； (b) EA：腹部病变后的 EA ST36； (c) VGX/EA：腹部病变后进行迷走神经切断术（VGX），然后进行 EA ST36； (d) VGX/EAN：腹部病变后VGX，然后EAN； (e) α-BGT/EA：在EA ST36之前腹腔注射α-银环蛇毒素(α-BGT，胆碱能烟碱受体α7亚基的拮抗剂)，以及(f) α-BGT/EAN组：在EAN之前注射α-BGT。腹部手术病灶后7天，评估粘连组织中肿瘤坏死因子-α（TNF-α）和血管内皮生长因子（VEGF）的水平，宏观观察和组织病理学评估粘连形成，并通过血小板内皮细胞粘附分子-1的免疫组化染色评估血管生成。 结果：EA ST36 降低了术后 7 天粘连组织匀浆中 TNF-α 和 VEGF 的水平，而在 EA ST36 之前进行迷走神经切断术或腹腔注射 α-BGT 可逆转其抑制作用。在非通道穴位进行电针，无论是否进行迷走神经切断术，或电针前腹腔注射α-BGT，对TNF-α和VEGF水平均无抑制作用。 EA ST36减轻了粘连形成，肉眼观察和组织病理学粘连评分均显着低于EAN组（分别为1.56+/-0.29与3.00+/-0.82、1.35+/-0.4与3.91+/-0.8，均P<0.05）。与EAN组相比，EA ST36显着减少血管生成，表现为粘连组织中CD31阳性微血管密度降低。结论：EA ST36可能通过激活胆碱能抗炎机制，减轻术后局部炎症反应，减弱血管生成，部分缓解粘连形成。 (C) 2015 Elsevier Inc. 保留所有权利。
Background: We have recently proved electroacupuncture (EA) ST36 exerted an anti-inflammatory effect in the early phase of intra-abdominal adhesion formation. Evidences indicate that the anti-inflammatory effect of EA ST36 involves a cholinergic anti-inflammatory pathway-dependent mechanism via the vagus nerve. However, the exact effects and accurate vagal modulation of acupuncture in prevention of postoperative intra-abdominal adhesion formation has not been thoroughly evaluated.Materials and methods: Sprague-Dawley rats subjected to abdominal adhesion lesions operation at the cecum and abdominal wall were randomly divided into six groups as follows: (a) EAN: EA non-channel acupoints; (b) EA: EA ST36 after abdominal lesions; (c) VGX/EA: vagotomy (VGX) after abdominal lesions, then EA ST36; (d) VGX/EAN: VGX after abdominal lesions, then EAN; (e) alpha-BGT/EA: intraperitoneal injection of alpha-bungarotoxin (alpha-BGT, an antagonist of alpha 7 subunit of cholinergic nicotinic receptor) before EA ST36, and (f) alpha-BGT/ EAN group: alpha-BGT injection before EAN. Seven days after abdominal surgical lesions, the levels of tumor necrosis factor-alpha (TNF-alpha) and vascular endothelial growth factor (VEGF) in the adhesive tissue were evaluated, macroscopic observation and histopathologic evaluation of adhesion formation and assessment of angiogenesis by immunohistochemical staining of platelet endothelial cell adhesion molecule-1 (CD31) were performed.Results: EA ST36 reduced TNF-alpha and VEGF levels in adhesive tissue homogenates 7 d after surgery, whereas vagotomy or intraperitoneal injection of alpha-BGT before EA ST36 reversed its suppressive effects. EA at non-channel acupoints with or without vagotomy or intraperitoneal injection of alpha-BGT before EA had no suppressive effects on TNF-alpha and VEGF levels. EA ST36 alleviated the adhesion formation, with both of macroscopic and histopathologic adhesion scores significantly lower than those of the EAN group (1.56 +/- 0.29 versus 3.00 +/- 0.82, 1.35 +/- 0.4 versus 3.91 +/- 0.8, respectively, both P < 0.05). Compared with the EAN group, EA ST36 significantly decreased angiogenesis evidenced by reduced CD31 positive microvessel density in adhesive tissue.Conclusions: EA ST36 might reduce the postoperative local inflammatory response, attenuate the angiogenesis, and alleviate the adhesion formation partly via activating the cholinergic anti-inflammatory mechanism. (C) 2015 Elsevier Inc. All rights reserved.