穴位埋线经轴索反射对变应性鼻炎神经源性炎症的调控机制

In one of our former clinical trial to treatment allergic rhinitis (AR) with Catgut Implantation at Acupoint, it has been showed that the recurrence rate of AR was significantly lower in treatment group than in the control one. But the mechanism is unclear.We propose the 'Race to Regulate and Restraint' hypothesis which is based on the axon reflex of Yingxiang(LI10).In the hypothesis, we assume that the stimuli of Catgut Implantation at Yingxiang would pass along the pathway which is composed of trigeminal nerve, sphenopalatine nerve ganglion and the nerve fibers in nasal mucosa.Then the exciting stimuli of the fibers before the sphenopalatine nerve ganglion would race to restraint the axon reflex of C type sensory neural fibers. At last,Yin/Yang balbace of the parasympathetic/sympathetic nerve would be promoted and the neurogenic inflammation would be mitigated.We will verify our hypothesis through animal tests. Firstly,the reflex arc is to be investigated by tracing technique.The rats with or without catgut implantation at acupoint would be injected with Dil（1,1'-dioctadecyl-3,3,3',3'-tetram-ethylindocarbocyanine perchlorate） at Yingxiang and QD (quantum dot) under nasal mucosa simultaneously to show the distribution of the sensory nerve fibers bidirectionally.Secondly,the rats of allergic rhinitis(AR) would be founded with Ovalbumin.Then the animals in the study group would be treated with capsaicin for 15 days.Behaviors of the rats would be recorded according to rating scale.And the changes of neuropeptide(Substace P ,SP), AchE(Acetylcholine esterase), sympathomimetic/parasympathomimetic neuropeptides (neuropeptide Y ,NPY/ Vasoactive intestinal peptide ,VIP) would be studied.Thirdly,the rat models of AR are to be divided into the study group and control group.The study group would be treated with catgut implantation at Yingxiang.Similarly,the behavior scores would be recorded.The neuropeptides(SP,CGRP,NKA,NPY,VIP),NO and AchE would be studied by immunohistochemical and specific radioimmunoassy methods.At the same time,the SP-IR (substance P-immunoreactive) fibers would be observed with ElectroMicroscopy.We hope we could clarify the preliminary machanism of how Catgut Impalatation at Acupoint regulate the neurogenic inflammation of AR and elucidate the significance of this therapy for AR.

在穴位埋线治疗变应性鼻炎（AR）的临床研究中我们发现穴位埋线能有效延长AR缓解期，降低复发率，但机制不清。我们提出基于迎香穴初级感觉神经纤维轴索反射的抢先抑制调平假说：迎香穴埋线产生的刺激经三叉神经-蝶腭神经节-鼻黏膜神经径路，抢先抑制鼻黏膜C类感觉神经纤维的轴索反射，并恢复交感/副交感神经阴阳平衡，改善AR神经源性炎症反应。首先对动物分别于迎香穴与鼻黏膜内注射Dil与QD神经示踪剂，双向检测其传入感觉神经纤维分布及相互关系。其次，对动物行辣椒素干预，观察各组动物行为学特征，检测蝶腭神经节、鼻黏膜及血液中感觉神经肽SP、副交感神经介质Ach、拟副交感/交感神经肽VIP及NPY。最后，对AR模型行迎香穴埋线，观察各组行为学特征，检测穴位组织、三叉神经节、蝶腭神经节、鼻黏膜及血液中的感觉神经肽（SP、CGRP、NKA）、NO、Ach、VIP及NPY等，并行电镜观察，阐明穴位埋线治疗AR的机制。

2012年自然基金面上项目——穴位埋线经轴索反射对变应性鼻炎神经源性炎症的调控机制（编号81273985）。该项目于2013年1月启动，于2016年12月截止，按时标书设计共分为三个研究阶段：第一阶段，大鼠迎香穴解剖结构及感觉信号的初级神经传入研究；第二阶段，变应性鼻炎模型大鼠神经源性炎症表达的相关研究；第三阶段，穴位埋线对变应性鼻炎模型大鼠神经源性炎症调控的相关研究。在该项目执行过程中，我们严格遵循标书设计要求，保质保量的完成阶段研究，客观分析各项研究结果，并针对课题设计环节中的不足进行及时校正。目前，该课题各项主要研究目标，已顺利完成。依托该课题，发表SCI 5篇，中文核心期刊论文15篇，进行全国性会议交流3次，建立科普微信平台1座，培养硕博士研究生共24人。并以本次课题为基础，成功申请2014年、2016年国家自然科学基金项目2项，进行该课题的深化研究。综上，本次课题完成情况已达到标书预期，进行结题，并将结果向国家呈报。