基于结肠神经-c-kit-ICC通路探讨深刺天枢穴治疗慢传输型便秘的作用机制

Our research team of applicant has implemented long-term researches on acupuncture for chronic functional constipation. During the 11th and 12th five-year national science and technology support plans, according to several RCTs, it was found that the deep-acupuncture at Tianshu (ST25) was safe and had a greater degree than some other way to promote colon transmission in slow transit constipation (STC). And the effectiveness could last at least 12 weeks after stopping acupuncture treatment. As for the limitation of clinical trials, the mechanism needs further research. We believe that deep-acupuncture with penetrating the peritoneum could stimulating the colon directly and improve the colon nerve hypoplasia via nervous-humoral regulation and enhance the intestinal power. In this study, we will choose the STC rat model to explore the mechanism of long-term improvement for STC by deep acupuncture at ST25, via improving colon nerve structure, synapse recurrent and c-kit express, to activate the ICC phenotypic reversion, which may provide mechanism verification for clinical trial result.

在长期进行针刺治疗慢性功能性便秘研究中，本研究团队通过国家“十一五”、“十二五”科技支撑计划多个针灸临床试验发现，深刺天枢穴安全并且较其他刺激方式能够更大程度促进结肠传输治疗慢传输型便秘，并且在针刺停止后，仍有至少12周的后续疗效，但是由于临床试验的局限，其作用机制有待进一步探索。我们认为，深刺天枢穴突破腹膜，可经由针体直接刺激肠壁，通过神经-体液调节，改善长期便秘造成的结肠神经发育不良并提高肠道动力。本研究拟以慢传输型便秘大鼠模型探索深刺天枢穴刺激结肠，改善结肠神经结构，促进突触重塑及c-kit表达，激活动力相关ICC表型逆转并长期改善便秘的机制，为临床试验的结果提供机制基础补充和验证。