目的: 探讨针刺、艾灸对于腹泻型肠易激综合征（irritable bowel syndrome with predominant diarrhea,IBS-D）大鼠肠道组织中胞质紧密连接蛋白1（zonula occludens-1,ZO-1）、及血清白细胞介素-18（interleukin-18,IL-18）表达的影响。方法: 从58只雄性SD大鼠随机抽取10只作为对照组。剩余48只采用乙酸灌肠联合束缚夹尾应激方法制备IBS-D模型。造模成功的40只随机分为模型组、针刺组、艾灸组、西药组,每组各10只。针刺组于“足三里”行针刺干预,每次15 min,每5 min平补平泻捻转行针20 s;艾灸组于“足三里”行悬灸干预,每次施灸15 min;西药组予以匹维溴铵片灌胃,连续干预14 d。于造模及干预结束后对大鼠粪便性状评分、腹泻指数进行观察,于干预结束后对大鼠血清IL-18水平、结肠组织中ZO-1表达进行分析统计。结果: 造模后,与对照组相比,其他4组大鼠粪便性状评分、腹泻指数均有升高。经干预后,与对照组相比模型组大鼠粪便性状评分、腹泻指数均升高;与模型组相比,针刺组、艾灸组、西药组粪便性状评分、腹泻指数均降低,艾灸组粪便性状评分低于西药组;与模型组相比,对照组、针刺组、艾灸组、西药组（匹维溴铵）大鼠结肠组织中ZO-1表达均有不同程度升高;与模型组相比,针刺组、对照组血清IL-18浓度值均低于模型组,艾灸组、西药组IL-18浓度水平均明显低于模型组。结论: 针刺、艾灸均可改善IBS-D模型大鼠腹泻症状,其机制可能是通过调节IL-18水平,提高ZO-1蛋白表达,重塑紧密连接结构,降低其组织细胞间渗透性,修复受损的肠道屏障来实现的。

Objective To explore the effect of acupuncture and moxibustion on the expression of zonula occludens-1(ZO-1), and blood interleukin-18(IL-18) and other related inflammatory factors in the intestinal tissues of rats with irritable bowel syndrome with predominant diarrhea(IBS-D). Methods Ten rats were randomly selected from 58 male SD rats as a control group. The remaining 48 were used to prepare the IBS-D model by acetic acid enema combined with restraint tail-clamping stress method. The remaining 48 rats were prepared by using acetic acid enema combined with the restraint tail-clamping stress method.40 rats that were successfully modeled were randomly divided into the model group, acupuncture group, moxibustion group, and western medicine group, with 10 rats in each group. In the acupuncture group, acupuncture was performed at the “foot-sanli” for 15 min each time, and the needle was twisted every 5 min for 20 s. In the moxibustion group, moxibustion was performed at the “foot-sanli” for 15 min each time, and in the western medicine group, pivoxyl bromide was administered by gastric lavage for 14 d. In the modeling group, the IBS-D models were randomly divided into the model group, moxibustion group and western medicine group, each of which had 10 animals. In the western medicine group, the rats were gavaged with pivacurium bromide tablets (Deshotep) for 14 d. Observations were made on the fecal character score and diarrhea index of the rats at the end of the modeling and the intervention, and the serum IL-18 level and the expression of ZO-1 in the colon tissues of the rats were analyzed and statistically analyzed at the end of the intervention. Results After modeling, the fecal character score and diarrhea index of rats in the other four groups were elevated compared with the control group. After intervention, fecal character score and diarrhea index of rats in the model group were elevated compared with those in the control group; fecal character score and diarrhea index of rats in the acupuncture, moxibustion, and western medicine groups were reduced compared with those in the model group, and fecal character score of rats in the acupuncture group was lower than that of rats in the western medicine group; ZO-1 expression in the colonic tissues of rats in the control group, acupuncture, moxibustion, and Western medicine (Pivacidium bromide ) ZO-1 expression was elevated to different degrees in rat colon tissues; compared with the model group, the serum IL-18 concentration values in the acupuncture group and control group were lower than those in the model group, and the IL-18 concentration levels in the moxibustion group and western medicine group were significantly lower than that in the model group. Conclusion Both acupuncture and moxibustion improved diarrhea symptoms in IBS-D model rats, and the mechanism may be achieved by regulating IL-18 levels, increasing ZO-1 protein expression, remodeling the tight junction structure, decreasing its tissue intercellular permeability, and repairing the damaged intestinal barrier.