壮医针挑挑出物形态学、细胞学及其相关基因转录水平影响研究

Needle-pricking is one of the unique external treatments of the Zhuang Medicine. It uses needles to prick white fibrous material on each abnormal point of the patients' skin. The material is dubious and obscure which only exists in patients. Patients respond with disappearing symptoms when the material that blocks the meridian is removed. Many physicians have confirmed that this therapy is effective and safe through clinical study. Although they have initially investigated its therapeutic mechanism from different points of view in Zhuang Medicine, Traditional Chinese Medicine and modern medicine, the mechanism still remains unclear; especially since no relevant report about the pricked material exists. Finding out the therapeutic mechanism of needle-pricking is the only way toward modernization. But the mechanism is a bottleneck for the development of needle-pricking method due to many difficulties of various reasons. In such situations, we propose a hypothesis that "pricked material by needle-pricking method in Zhuang Medicine is strongly relevant to the occurrence, development and treatment of the disease". We also selected "the needle-pricking therapy in Zhuang Medicine" and its dominant disease "hemorrhoids" as a case study. We then used this study to research the material morphology, cytology and the level of gene transcription of pricked material by means of immunohistochemistry and molecular biology to find out its material basis. The results of this study are of critical scientific significance in clarifying the mechanism of needle-pricking for treating disease.

针挑疗法是壮医特色外治疗法之一，其治疗方式是用挑针挑出皮肤异点内白色纤维状物质。此物成分可疑、来历不明，针挑患者特有。因其堵塞经络，导致气血不通，故此物挑净后疾病症状消失，患者如释重负。许多医家通过临床观察研究证实本疗法有效、安全，虽从壮医、中医及现代医学等不同角度对其治疗机理做了粗略探讨，但目前仍未明确，特别是对其异点内挑出物的研究未见相关报道。而针挑治疗疾病的机理研究是其走向现代化必经之路，但由于多方面原因，对其研究存在诸多困难，这是目前针挑医学发展的瓶颈之一。针对此种现状，我们提出了"壮医针挑挑出物与疾病的发生、发展、治疗密切相关"的假说，并选用"壮医针挑疗法"及其优势病种"痔疮"为研究载体，借助免疫组织化学及分子生物学方法从微观角度对针挑挑出物的形态学、细胞学及相关基因转录水平影响进行研究，探讨针挑疗法治疗疾病的物质基础。研究结果对阐明壮医针挑疗法治疗疾病的机理具有重要的科学意义。

壮医针挑疗法是用挑针挑出皮肤异点内白色纤维状物质而达到治疗疾病的目的，但其异点内挑出物是否与其治疗疾病的机理密切相关未见相关研究，故本课题拟壮医针挑挑出物与疾病的发生、发展、治疗密切相关，并选用"壮医针挑疗法"及其优势病种"痔疮"为研究载体，借助免疫组织化学及分子生物学方法从微观角度对针挑挑出物的形态学、细胞学及相关基因转录水平影响进行研究，探讨针挑疗法治疗疾病的物质基础。首先通过开展II期II度的30例内痔患者皮肤异地点内挑出物和10例健康志愿者的大肠俞穴位皮下内容物的形态学、细胞学特点的研究：痔疮患者的皮肤异点挑出物、健康志愿者大肠俞穴位挑出物在显微镜下所见并无明显差异，均是成熟的纤维结缔组织，纤维细胞都是条形的、条索状的。接着运用荧光定量PCR 方法，选择了2个在一般组织细胞中表达量比较高的看家基因——甘油醛-3-磷酸脱氢酶（GAPDH）和细胞骨架蛋白β-肌动蛋白（ACTB）基因，对40例针挑挑出物进行扩增分析，约有6例样本得到一定程度的扩增，ACTB的扩增效率更高一些，为下一步检测更多相关基因提供了参考的内参。综合上述结果，本研究为探讨针挑疗法治疗疾病的物质基础奠定了坚实的工作基础，但研究结果对阐明壮医针挑疗法治疗疾病的机理有待进一步研究。项目资助发表论文3篇，待发表2篇。协助培养硕士生2名，均已取得硕士学位。培养了3名学科骨干，其中窦锡彬和李克明均晋升了副主任医师。项目投入经费45万，支出37.0081万，各项支出基本与预算相符。剩余经费7.9919万元，剩余经费计划用于本项目研究后续支出。