基于VN-MP-ACh通路研究电针改善重症急性胰腺炎肠道功能障碍的迷走-肠神经作用机制

尽早减轻肠道炎症、恢复肠道动力是改善重症急性胰腺炎(SAP)预后的关键。目前研究表明电针对肠道的调节主要通过神经途径实现，但同时将外源性自主神经和肠道内在神经丛结合考虑的研究甚少。我们团队前期研究发现电针足三里穴可增加SAP大鼠迷走神经(VN)放电，促进肠道蠕动；并可能激活胆碱能抗炎通路，减轻肠道及胰腺损伤。我们推断——电针足三里可能通过兴奋VN腹腔支激活肠肌间神经丛(MP)，增加神经递质乙酰胆碱(ACh)的释放，ACh一方面与巨噬细胞上的α7nAChR结合减轻肠道炎症；另一方面激动肠道平滑肌上的M3受体促进肠道动力。本课题拟记录SAP大鼠VN-MP-ACh通路中的神经电活动，检测神经递质、炎症介质的表达及肠道动力的变化，比较胰腺病理损伤及死亡率等，探讨电针足三里对VN-MP-ACh通路的影响，揭示其改善SAP肠道功能障碍的迷走-肠神经机制，为SAP“从肠论治”提供新靶点和临床策略。

The key to improve the prognosis of severe acute pancreatitis(SAP) is alleviating intestinal inflammation and restoring intestinal motility as soon as early. Research has now shown that the regulating effect of electroacupuncture is mainly depending on neural pathway, but few studies have considered the combination of exogenous autonomic nerve and internal plexus of the gut. We have previously demonstrated that electroacupuncture ST-36 affect intestinal peristalsis via increasing vagus nerve(VN) discharge, and may activate the cholinergic anti-inflammatory pathway to alleviate intestinal and pancreatic damage. Thus, we hypothesize that electroacupuncture ST-36 activate myenteric plexus(MP) by stimulating VN, and then acetylcholine(ACh)-based neurotransmitters are released, which not only bind to α7nAChR of macrophages to ease the inflammation, but also bind to M3 receptor of intestinal smooth muscles to recover intestinal motility. Our subject intends to record the neural electrical activity in the VN-MP-ACh pathway in SAP rats, detect the expression of neurotransmitters, inflammatory factors and changes in intestinal dynamics, compare the histological score of the pancreas and mortality of SAP to explore the effect of electroacupuncture ST-36 on the VN-MP-ACh pathway, reveal the vagal-enteric nervous mechanism improving prognosis of SAP and provide a new target and clinical strategy for the "treatment from the intestine" of SAP.