基于腧穴局部皮肤免疫及物质代谢研究艾灸与针刺作用的始动机制

The different clinical effect of Moxibustion and Acupuncture is determined by the different local stimulation on acupoints by the two methods, it is of great significance to clarify the difference between the two mechanisms for the clinical choice.The local skin of acupoint is the most important aspect of the effect of Acupuncture, in order to study the different mechanism between Moxibustion and Acupuncture, we should proceed from the different responses to the local skin of acupoint by Acupuncture and Moxibustion. Therefore, we take the skin immune system and the material metabolism as the breakthrough point in this study, and choose Crohn disease as our research carrier which is closely related to the body's immune system and have good therapeutic effect on Acupuncture and Moxibustion, observing the effects of immune cells(Keratinocyte, Merkel cells, mast cells, T lymphocytes, natural killer cells, et al.), immune related factors(TNF-α、IL-1β、IL-6、IL-10、IL-18, et al.), neuropeptide(Calcitonin gene related peptide, neuropeptide Y, histamine, bradykinin, et al.) and metabolic patterns, dfferential metabolites, and metabolic pathway of Characteristic Metabolites on the local skin of Zusanli by Moxibustion and Acupuncture between the normal rat and the rat model of Krohn's disease, and to explain the difference of local initiating mechanism between Acupuncture and Moxibustion from the angle of skin immunity and material metabolism respectively.

艾灸与针刺对腧穴局部刺激方式的不同决定了其临床作用的异同，阐明两者作用机制的差异对临床选择性应用艾灸或针刺疗法具有重要意义。腧穴局部皮肤是针灸作用的首要环节，研究艾灸与针刺作用机制的异同，首先应该从艾灸与针刺时腧穴局部皮肤响应的异同着手。因此，本研究以皮肤免疫系统及物质代谢为切入点，选择与机体免疫密切相关且针灸疗效显著的克罗恩病为研究载体，通过观察艾灸与针刺对正常及克罗恩病肠纤维化大鼠模型足三里局部皮肤免疫细胞（角质细胞、梅克尔细胞、肥大细胞、T淋巴细胞、自然杀伤细胞等）、免疫相关因子（TNF-α、IL-1β、IL-6、IL-10、IL-18等）、神经肽（降钙素基因相关肽、神经肽Y、组胺、缓激肽等）及代谢模式、差异性代谢物、特征性代谢物涉及的代谢通路的影响，分别从皮肤免疫及物质代谢角度阐释艾灸与针刺局部始动机制的差异。

艾灸与针刺对腧穴局部刺激方式的不同决定了其临床作用的异同，阐明两者作用机制的差异对临床选择性应用艾灸或针刺疗法具有重要意义。腧穴局部皮肤是针灸作用的首要环节，研究艾灸与针刺作用机制的异同，首先应该从艾灸与针刺时腧穴局部皮肤响应的异同着手。本研究以皮肤免疫系统及物质代谢为切入点，选择与机体免疫密切相关且针灸疗效显著的克罗恩病为研究载体，通过观察艾灸与针刺对正常及克罗恩病肠纤维化大鼠模型天枢穴局部皮肤免疫相关因子（CGRP、NPY、TNF-α、IL-1β、IL-18、IL-10、IL-6等）、神经肽（组胺、缓激肽等）及代谢模式、差异性代谢物、特征性代谢物涉及的代谢通路的影响，分别从皮肤免疫及物质代谢角度阐释艾灸与针刺局部始动机制的差异。.结果提示：1.艾灸与针刺均能提高克罗恩病模型大鼠天枢穴局部皮肤中CGRP、TNF-α、IL-10和IL-18的表达量，降低IL-6的表达量，艾灸与针刺对上述因子的调节作用无显著性差异；2.艾灸与针刺均能降低天枢穴局部皮肤中组胺和缓激肽的表达，艾灸与针刺对组胺的调节作用无显著性差异，艾灸对缓激肽的调节作用优于针刺；3.生理状态下，艾灸可以降低腧穴局部皮肤中细胞膜的稳定性，促进蛋白质的合成及对周围神经递质的调控，增强腧穴局部皮肤中细胞凋亡的发生；针刺倾向于促进蛋白质的分解及对周围神经递质的调控并有能量的消耗。4.病理状态下，艾灸对腧穴局部皮肤中紊乱的神经递质及能量代谢有调节作用，而针刺主要调节腧穴局部皮肤中紊乱的神经递质。.通过本研究，初步证实艾灸与针刺对腧穴局部皮肤中缓激肽和物质代谢的调节作用具有差异性。