王宽 刘慧荣 吴焕淦 张英英 翁志军 秦秀娣 赵继梦 吴璐一

摘要  目的：從维生素D参与免疫调节作用角度探讨隔药灸治疗UC的作用机制。方法：采用4%葡聚糖硫酸钠制备UC大鼠模型。将动物随机分为：正常组、模型组、隔药灸组和SASP组。观察各组大鼠DAI评分、结肠大体形态损伤评分及结肠组织病理学（HPS）评分、大鼠血清及结肠组织25（OH）D3、VDR浓度;检测大鼠结肠组织炎性细胞因子IFN-γ、TNF-α的表达和大鼠结肠组织VDR、RXRα mRNA的表达;分析25（OH）D3与治疗后DAI评分、结肠IFN-γ、TNF-α表达之间的相关性。结果：隔药灸显著降低UC大鼠DAI评分、结肠大体形态损伤评分及HPS评分（ P <0.05）;隔药灸显著升高UC大鼠血清和结肠中25（OH）D3、VDR浓度（ P <0.05），以及结肠组织中VDR、RXRαmRNA表达（ P <0.05）;隔药灸降低UC大鼠结肠组织中IFN-γ、TNF-α表达水平（ P <0.05）。大鼠血清25（OH）D3浓度与治疗后DAI评分呈负相关，结肠25（OH）D3浓度分别与结肠IFN-γ、TNF-α表达呈显著负相关。结论：隔药灸可抑制UC大鼠结肠IFN-γ、TNF-α的表达，升高其血清和结肠中的维生素D及其受体的浓度;UC大鼠肠道炎症与低浓度的维生素D呈负相关。

关键词  隔药灸;溃疡性结肠炎;25羟基维生素D3;维生素D受体;γ干扰素;肿瘤坏死因子-α

Study on the Effects of Vitamin D Participation in Herb-partitioned Moxibustion of Rats with Ulcerative Colitist

WANG Kuan1，LIU Huirong1，WU Huangan1，ZHANG Yingying1，WENG Zhijun1，QIN Xiudi1，ZHAO Jimeng1，WU Luyi2

（1 Key Laboratory of Acupuncture-Moxibustion and Immunological Effects，Shanghai University of Traditional Chinese Medicine，Shanghai 201203，China; 2 Shanghai Qigong Research Institure，Shanghai University of Traditional Chinese Medicine，Shanghai 201203，China）

Abstract Objective： From the perspective of vitamin D′s participation in immune regulation，the mechanism of herb-partitioned moxibustion in the treatment of UC was discussed. Methods： The UC rat model was prepared with 4% dextran sodium sulfate.The animals were randomly divided into：a normal group，a model group，a herb-partitioned moxibustion group and a SASP group.Observe the DAI score，gross morphological damage score of the colon，and histopathology（HPS）score of each group of rats，the concentration of 25（OH）D3 and VDR in rat serum and colon tissue; detect the inflammatory cytokine IFN-，TNF-α in rat colon tissue and the expression of TNF-α and the expression of VDR and RXRα mRNA in rat colon tissue; analyze the correlation between 25（OH）D3 and DAI score，colon IFN-γ and TNF-α expression after treatment. Results： Herb-partitioned moxibustion significantly reduced the DAI score，gross morphological damage score and HPS score of UC rats（ P <0.05）; herb-partitioned moxibustion significantly increased the concentration of 25（OH）D3 and VDR in the serum and colon of UC rats（ P <0.05），and the expression of VDR and RXRαmRNA in colon tissue（ P <0.05）; herb-partitioned moxibustion reduced the expression levels of IFN-γ and TNF-α in colon tissue of UC rats（ P <0.05）.The serum 25（OH）D3 concentration in rats was negatively correlated with the DAI score after treatment，and the colonic 25（OH）D3 concentration was significantly negatively correlated with the expression of colon IFN-γ and TNF-α. Conclusion： Herb-partitioned moxibustion could inhibit the expression of IFN-γ and TNF-α，and significantly increase the concentration of vitamin D and its receptors in the serum and colon; intestinal inflammation in UC rats is negatively correlated with low concentrations of vitamin D.

Keywords  Herb-partitioned Moxibustion; Ulcerative Colitis; 25（OH）D3; Vitamin D receptor; IFN-γ; TNF-α

中图分类号：R245.8 文献标识码：A  doi： 10.3969/j.issn.1673-7202.2020.14.007

溃疡性结肠炎（Ulcerative Colitis，UC）属炎症性肠病（Inflammatory Bowel Disease，IBD）范畴。UC是一种以反复发作的腹痛、腹泻，伴黏液脓血便和不同程度的全身症状为主要临床表现的慢性非特异性炎症性肠道疾病，主要发生在直肠、结肠黏膜和黏膜下层等部位，主要表现为溃疡形成，隐窝脓肿或炎性反应，杯状细胞减少以及各类炎性反应细胞浸润等非特异性病理改变。该病为消化内科常见疑难病，病程漫长，且逐年加重，久治难愈。目前UC的病因和发病机制仍不完全清楚，临床对于UC也缺乏特异性的治疗手段，而中医针灸可有效改善UC的炎性反应表现，对治疗UC具有一定的优势[1-3]。

新近的流行病学调查研究显示[4-5]，IBD的发生正呈现出全球化的变化趋势，在亚洲及亚太地区国家，UC的发生较CD更为普遍，而且随着人类生活水平的不断提高，UC患者病例的报道数量也不断增多，UC的发病率和患病率已经呈现出了逐年上升的趋势[6]。……