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第43卷第6期
·796 · 南 京 医 科 大 学 学 报 2023年6月
acupuncture at bilateral auricular point“stomach”once a day,five days a week for two weeks. The earlobe of the sham auricular
acupuncture group was needled without electricity. After the treatment,the behavioral and gastric emptying rates were measured,and
the protein and mRNA levels of CRF and c⁃Kit were respectively detected by ELISA and qRT⁃PCR in gastric sinus tissue. Results:In
the open field test,the entries into the central area(CE),the percentage of time entering the central area(CT%)and the percentage of
distance entering the central area(CD%)were significantly lower in the model group compared with the control group(all P < 0.05).
CE,CT% and CD% were significantly higher in the auricular electroacupuncture group compared with the model group(all P < 0.05).
In the forced swimming test,the percentage of floating time(FT%)was significantly higher in the model group compared with the
control group(P < 0.05),and FT% were significantly lower in the auricular electroacupuncture group compared with the model group
(P < 0.05). Compared with the control group,the gastric emptying rate of rats in the model group was significantly lower,and the
mRNA and protein expression levels of CRF in the gastric sinus were significantly higher(P < 0.05),and the mRNA and protein
expression levels of c⁃Kit were significantly lower(P < 0.05). Compared with the model group and the sham auricular acupuncture
group,the gastric emptying rate of rats in the auricular acupuncture group was significantly higher,and the mRNA and protein
expression levels of CRF in the gastric sinus were significantly lower(P < 0.05),and the mRNA and protein expression levels of c⁃Kit
were significantly higher(P < 0.05). Conclusion:Low ⁃ frequency auricular electroacupuncture can improve gastric motility and
depression⁃like behavior in diabetic gastroparesis rats,and its mechanism may be related to regulating the expression of related factors
in gastric antrum tissue.
[Key words] auricular acupuncture;diabetic gastroparesis;gastric motility;depression;corticotropin⁃releasing hormone factor
[J Nanjing Med Univ,2023,43(06):795⁃801]
胃轻瘫是糖尿病患者的常见并发症,其主要表 24 ℃温度、40%~50%湿度和 12 h 光/暗循环的条件
现为餐后饱胀、上腹部不适和/或腹胀,其发病特点 下,适应性喂养 1 周后进入实验。所有实验操作遵
[2]
[1]
为胃排空延迟 ,并且合并明显焦虑抑郁情绪 。 循《动物实验的伦理准则与指南》并获得南京医科
Cajal 间质细胞(interstitial cells of Cajal,ICC)是 大学伦理委员会审批(IACUC⁃2105064)。
胃肠道的起搏细胞,在维持正常胃肠动力中起到了 1.2 方法
重要作用 [3-4] 。促肾上腺皮质释放激素因子(cortico⁃ 1.2.1 分组与造模
tropin releasing factor,CRF)是经典的应激压力相关 所有大鼠随机分为空白对照组、模型组、耳电
因子,研究发现它通过外周 CRF1 受体引起结肠动 针组、假耳针组,每组各9只。采用一次性腹腔注射
力异常,从而减少ICC数量和降低ICC功能 。本团 链脲佐菌素(streptozotocin,STZ)溶液(Sigma 公司,
[5]
队前期研究发现,电针耳穴“胃”能够促进糖尿病模 美国)(55 mg/kg)的方法建立糖尿病大鼠模型 [10-11] 。
[6]
型大鼠胃窦 ICC 的修复 ;在内脏高敏感大鼠模型 STZ 溶液由柠檬酸钠缓冲液配制,空白对照组腹腔
中,也发现2 Hz低频耳电针可以调节下丘脑CRF及 注射柠檬酸钠缓冲液,其余3组腹腔注射STZ溶液,
[7]
其受体的 mRNA 表达,缓解内脏敏感性 。耳电针 STZ注射72 h后,使用快速血糖仪和血糖试纸(雅培
作为一种体表刺激,可能通过刺激耳迷走神经分 公司,美国)检测血糖,其随机血糖>16.6 mmol/L 的
支来调节自主神经功能,从而改善消化道症状与 大鼠为符合条件的糖尿病大鼠。饲养6周后,耳电针
情绪障碍 [8-9] 。本研究通过建立糖尿病胃轻瘫大鼠 组和假耳针组分别进行相应的耳针干预2周,第9周
模型,观察低频耳电针对其抑郁样行为学、胃动力 时大鼠进行行为学测试与取材。
以及胃窦组织 ICC 和 CRF 的表达,初步探讨耳电针 1.2.2 耳电针干预
对糖尿病胃轻瘫的脑胃调控机制。 从第 7 周开始对动物进行耳电针干预。2.0%~
2.5%异氟烷吸入 1 min 后,动物被装置固定。参考
1 材料和方法
本课题组前期研究 [6,12] ,空白对照组和模型组同步抓
1.1 材料 取固定,不进行针刺刺激。耳电针组使用0.20 mm×
36 只清洁级健康成年雄性6周龄Sprague⁃Daw⁃ 25.00 mm 规格的一次性无菌针灸针刺入双侧耳穴
ley(SD)大鼠购自上海斯莱克实验动物有限责任公 “胃”,连接电针仪,大鼠恢复清醒状态后开始电刺
[7]
司,许可证号:SCXK(沪)2017⁃0005。所有大鼠均在 激。根据课题组前期研究设置电针刺激参数 :连