耿艳霞 陈栋 鲁俊 陈明祺 张海东 周江（南京中医药大学附属医院，江苏南京210029）

·临床观察·

电针足三里穴对大鼠小肠缺血再灌注损伤后肠黏膜屏障修复的影响*

耿艳霞 陈栋 鲁俊 陈明祺 张海东 周江△
（南京中医药大学附属医院，江苏南京210029）

目的研究电针足三里穴对大鼠小肠缺血再灌注（I/R）损伤后肠黏膜屏障的保护作用。方法将24只大鼠随机分为4组，即正常组、模型组、假电针组、电针组，每组各6只。于缺血30min再灌注2 h时，分别取大鼠门静脉血和远端回肠标本，检测回肠组织病理学评分（Chiu′s），ELISA法检测血清中白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）浓度，Western blot法检测肠黏膜紧密连接蛋白ZO-1浓度。从回肠灌注FITC-Dextran-4溶液30min后，测算其在血清中的浓度，观察肠黏膜通透性的改变。结果与对照组比，I/R组和假电针组大鼠病理学Chiu′s评分和血清TNF-α、IL-6、FD4水平明显升高，ZO-1表达明显减少（P《0.05）；与I/R组和假电针组比，电针足三里可降低肠黏膜损伤评分，抑制血清TNF-α、IL-6和FD4水平（P《 0.05），促进ZO-1修复。结论电针足三里对大鼠小肠I/R损伤肠黏膜屏障具有保护作用。

电针缺血-再灌注损伤足三里穴肠屏障功能

【Abstract】Objective：To investigate the protection effectof electroacupuncture（EA）at Zusanli（ST36）on rat intestinal ischemia/reperfusion（I/R）injury.M ethods：Twenty-fourmale SD ratswere random ly divided into the control group（shame group），I/R group（themodel group），sham EA group（I/R+sham EA），and EA group（I/R+ EA），with 6 rats in each.Intestinal I/R ratmodel was based on superiormesenteric artery occlusion for 30 min and releasing for 2h，and distal ileum tissue and portal blood sampleswere taken for further detection.The pathological changes of ileum tissue were viewed and graded by Chiu′s score.Serum levels of IL-6 and TNF-αwere detected with ELISA method.Intestinalmucosal concentrations of tight junction protein ZO-1 were investigated with western blot assay.A solution of FITC-Dextran-4 solution was injected into a segment of terminal ileum for 30 min，and then the serum level of FD4 wasmeasured to assess the intestinal permeability.Results：Compared to the control group，Chiu′s score and serum TNF-α，IL-6，FD4 levels in I/R and sham EA group significantly increased，while ZO-1 expression significantly decreased.Compared with the I/R and shame EA group，EA at Zusanli（ST36）significantly promoted ZO-1 repair，and attenuated the pathological damage and serum levels of TNF-α，IL-6 and FD4.Conclusion：EA at Zusanli（ST36）can protect the intestinalmucosal barrier from I/R injury.

【Key words】Electroacupuncture；Ischemia/reperfusion injury；Zusanli（ST36）；Intestinal barrier function

肠道的缺血再灌注损伤常见于多种临床疾病，如严重创伤、烧伤、脓毒症、肠梗阻、肠移植、肠系膜动脉栓塞、失血性休克、腹主动脉手术等，是引起肠黏膜屏障功能受损的主要因素之一。肠上皮细胞结构和功能的破坏，将引起肠屏障功能障碍，肠黏膜通透性升高，细菌和内毒素易位，诱发全身炎症反应综合征（SIRS）甚至多脏器功能障碍综合征（MODS），是临床上经常遇到的难题。……