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目的:探讨腹泻型肠易激综合征(diarrhea-predominant irritable bowel syndrome,D-IBS)脾虚肝郁证与脑肠肽之间的关系。方法:采用灌服番泻叶联合束缚应激的方法建立腹泻型肠易激综合征大鼠模型,分别于建模前、建模第7,14,21,28天检测肠动力、内脏敏感性和5-羟色胺(5-hydroxytryptamine,5-HT),促肾上腺皮质激素释放激素(corticotropin-releasing hormone,CRH)的表达。应用Maclab/4e四导生理记录仪描记大鼠结肠运动曲线,计算结肠运动指数;采用直肠扩张腹壁撤退反射(AWR)评分评价大鼠的内脏敏感性;采用酶联免疫吸附测定法(ELISA),免疫组化法检测5-HT,CRH的含量;应用逆转录聚合酶链式反应(reverse transcription-PCR,RT-PCR)检测5-HT,CRH mRNA的表达量。结果:与建模前比较,建模第14,21,28天组大鼠结肠运动指数,AWR评分为3时的注水量、结肠和海马中5-HT,CRH及5-HT,CRH mRNA的表达均有显著差异(P<0.05,P<0.01);与建模第7天组比较,建模第21,28天组大鼠结肠运动指数、结肠运动指数变化率,AWR评分为3时的注水量、结肠和海马中5-HT,CRH及5-HT,CRH mRNA的表达差异显著(P<0.05,P<0.01);与建模第14天组比较,建模第21,28天组大鼠AWR评分为3时的注水量、结肠和海马中5-HT,CRH及5-HT,CRH mRNA的表达差异显著(P<0.05,P<0.01),建模第28天组大鼠结肠运动指数、结肠运动指数变化率有显著差异(P<0.05,P<0.01)。结论:5-HT,CRH与D-IBS脾虚肝郁证候密切相关,可能为D-IBS脾虚肝郁证病机的物质基础。
Objective: To investigate the relationship between diarrhea-predominant irritable bowel syndrome (D-IBS) and ghrelin. Methods: The model of diarrhea-predominant irritable bowel syndrome was established by irrigation and senna combined with restraint stress. The motility and visceral sensitivity of intestinal tract were detected before modeling, on the 7th, 14th, 21st and 28th day after modeling And 5-hydroxytryptamine (5-HT) and corticotropin-releasing hormone (CRH). Maccol / 4e four-lead physiology recorder was used to record the curve of colonic motion in rats, and the index of colonic motion was calculated. The visceral sensitivity was evaluated by rectal dilatation and abdomen reflex (AWR) score. Enzyme-linked immunosorbent assay (ELISA) The contents of 5-HT and CRH were detected by immunohistochemistry. The expression of 5-HT and CRH mRNA was detected by reverse transcription-PCR (RT-PCR). RESULTS: Compared with pre-modeling, the colonic motility index, water-injection volume at 3-hour AWR, 5-HT, CRH and 5-HT in the colon and hippocampus of rats on the 14th, (P <0.05, P <0.01) .Compared with the 7th day group, the changes of colon movement index, colonic locomotor index, AWR score 3 The expressions of 5-HT, CRH, 5-HT and CRH mRNA in water, colon and hippocampus were significantly different between the two groups (P <0.05, P <0.01) There was significant difference in the expression of 5-HT, CRH and 5-HT between the colon and hippocampus (P <0.05, P <0.01) when the rat AWR score was 3, The changes of exercise index and colon movement index were significantly different (P <0.05, P <0.01). Conclusion: 5-HT, CRH and D-IBS are closely related to syndrome of spleen-deficiency syndrome, which may be the material basis of pathogenesis of D-IBS.