李晗　李昆珊　吴璐一　周志刚　黄任佳　吴焕淦　刘雅楠　黄艳　马晓芃　刘慧荣　陆嫄

摘要 目的：維生素D（VD）缺乏与溃疡性结肠炎（UC）发病相关，针灸对UC有显著的疗效，起效机制尚未完全阐明，因此我们从维生素D受体（VDR）及与VDR相关的p53信号通路角度，观察针灸对UC大鼠调节的作用机制。方法：采用3%DSS制备UC大鼠模型。将大鼠随机分为正常组，模型组，电针组，隔药灸组和维生素D组。对双侧天枢穴采用电针或隔药灸干预1周，维生素D灌胃1周。分析大鼠结肠黏膜形态并评分，采用免疫组织化学法和QPCR检测结肠VDR蛋白和mRNA的表达，Western blotting检测结肠p53、PUMA和Caspase-3蛋白的水平。结果：与正常组比较，模型组组织病理学评分显著升高，经电针、隔药灸和VD干预后各组显著降低;与正常组比较，模型组VDR蛋白和mRNA表达显著降低，p53、PUMA和Caspase-3蛋白表达显著升高，与模型组比较，电针组、隔药灸组和维生素D组的VDR蛋白和mRNA表达显著升高，p53、PUMA和Caspase-3蛋白表达显著降低。结论：电针、隔药灸可以显著改善UC大鼠结肠黏膜炎性反应，该效应可能与针灸对VDR及下游p53信号通路的调节作用有关。

关键词 溃疡性结肠炎;针刺;艾灸;维生素D受体;p53信号通路

Study on the Regulatory Effects of Acupuncture on Vitamin D Receptor and p53 Signal Pathway in Ulcerative Colitis Rats

LI Han1，2，LI Kunshan1，WU Luyi1，ZHOU Zhigang3，HUANG Renjia1，WU Huangan1，LIU Yanan4，HUANG Yan1，4，MA Xiaopeng1，4，LIU Huirong1，4，LU Yuan1，4

（1 Key Laboratory of Acupuncture-Moxibustion and Immunological Effects，Shanghai University of Traditional Chinese Medicine，Shanghai 200030，China; 2 The Center of Neck And Low Back Pain，Changzhou Hospital of Traditional Chinese Medicine，Changzhou Affiliated Hospital of Nanjing University of Traditional Chinese Medicine，Changzhou 213002，China; 3 International Education College，Jiangxi University of Traditional Chinese Medicine，Nanchang 330004，China; 4 Department of Acupuncture and Moxibustion Immunization Laboratory，Shanghai Research Institute of Acupuncture and Median，Shanghai 200030，China）

Abstract Vitamin D deficiency has closely relationship with ulcerative colitis（UC）.Acupuncture has significant effects on UC，and the mechanism of action has not yet been fully elucidated.Therefore，we are to observe the regulatory mechanism of acupuncture on UC rats from the perspective of vitamin D receptor（VDR）and the p53 signaling pathway related to VDR.Methods：The UC rat model was prepared with 3% DSS.The rats were randomly divided into a normal group，a model group，an electroacupuncture group，a medicine-separated moxibustion group and a vitamin D group.Electroacupuncture or medicine-separated moxibustion was used to intervene in bilateral Tianshu points for one week，and vitamin D was given for gavage for one week.The morphology of the rat colon mucosa was analyzed and scored.The expression of VDR protein and mRNA in the colon was detected by immunohistochemistry and QPCR，and the levels of p53，PUMA and Caspase-3 protein in the colon were detected by western blotting.Results：Compared with the normal group，the histopathological score of the model group was significantly increased，and the groups were significantly reduced after electroacupuncture，medicine-separated moxibustion，and VD intervention; compared with the normal group，the expression of VDR protein and mRNA in the model group was significantly reduced.The expression of p53，PUMA and Caspase-3 protein was significantly increased.Compared with the model group，the expression of VDR protein and mRNA in the electroacupuncture group，the medicine-separated moxibustion group and the vitamin D group were significantly increased，and the expression of p53，PUMA and Caspase-3 protein was significantly decreased.Conclusion：Electroacupuncture and medicine-separated moxibustion can significantly improve the inflammatory response of colonic mucosa in UC rats.This effect may be related to the regulation of VDR and downstream p53 signaling pathway by acupuncture.

Keywords Ulcerative colitis; Acupuncture; Moxibustion; Vitamin D receptor; p53 signaling pathway

中图分类号：R245文献标识码：Adoi：10.3969/j.issn.1673-7202.2020.15.012

溃疡性结肠炎（Ulcerative Colitis，UC）是一种目前病因未明的慢性非特异性肠道疾病，临床表现为持续或反复发作的腹泻、粘液脓血便伴腹痛、里急后重和不同程度的全身症状[1]。UC的治疗主要采用氨基水杨酸制剂和糖皮质激素[2]，临床上已经取得了较好的治疗效果，但是不良反应的报道也屡见不鲜。针灸作为中医学重要的治疗方法，对UC的辅助治疗有确切的疗效[3-6]，但起效机制尚未完全阐明。……