艾灸調(diào)節(jié)消化性潰瘍大鼠腸道菌群失衡的作用機制研究摘要：本實驗通過體外和體內(nèi)的方法探究艾灸對消化性潰瘍大鼠腸道菌群失衡的作用機制。實驗結(jié)果表明，在消化性潰瘍大鼠體內(nèi)應(yīng)用艾灸能夠顯著改善腸道菌群的種類組成和相對豐度，增加有益菌群的數(shù)量，降低有害菌群的數(shù)量，使腸道菌群失衡狀態(tài)得以糾正。同時，艾灸可通過調(diào)節(jié)小腸黏膜-腸道菌群軸（Gut-BrainAxis）的信號傳遞通路，調(diào)控胃腸激素、神經(jīng)肽、神經(jīng)遞質(zhì)等物質(zhì)的釋放，從而調(diào)節(jié)腸道菌群失衡狀態(tài)，發(fā)揮治療作用。本實驗為深入探究艾灸治療消化性潰瘍的作用機制提供了新思路和實驗依據(jù)。

關(guān)鍵詞：艾灸；消化性潰瘍；腸道菌群；失衡；Gut-BrainAxis

Abstract:Thisstudyexploredthemechanismofmoxibustiononregulatingtheimbalanceofintestinalflorainratswithpepticulcerthroughinvitroandinvivoexperiments.Theresultsshowedthattheapplicationofmoxibustioninratswithpepticulcercansignificantlyimprovethespeciescompositionandrelativeabundanceofintestinalflora,increasethenumberofbeneficialflora,reducethenumberofharmfulflora,andcorrecttheimbalanceofintestinalflora.Atthesametime,moxibustioncanregulatethereleaseofgastrointestinalhormones,neuropeptides,neurotransmitters,andothersubstancesbymodulatingthesignaltransductionpathwayofthesmallintestinemucosa-gut-brainaxis,therebyregulatingtheimbalanceofintestinalfloraandexertingtherapeuticeffects.Thisstudyprovidesnewideasandexperimentalevidenceforfurtherexploringthemechanismofmoxibustioninthetreatmentofpepticulcers.

Keywords:moxibustion;pepticulcer;intestinalflora;imbalance;Gut-BrainAxiPepticulcersareacommongastrointestinaldisorderthataffectsmillionsofpeopleworldwide.Thepathogenesisofpepticulcersinvolvesmultiplefactors,includingH.pyloriinfection,NSDsuse,stress,andgeneticsusceptibility.However,accumulatingevidencehassuggestedthatalterationsintheintestinalmicrobiotamayalsoplayapivotalroleinthedevelopmentandprogressionofpepticulcers.

Theintestinalmicrobiotaisacomplexecosystemconsistingoftrillionsofmicroorganisms,includingbacteria,archaea,fungi,andviruses.Itformsacrucialinterfacebetweenthehostandtheenvironment,andplayskeyrolesinnutrientmetabolism,immunemodulation,andbarrierfunctionmaintenance.However,disturbancesinthecompositionanddiversityoftheintestinalmicrobiota,alsoknownasdysbiosis,havebeenlinkedtoawiderangeofdiseases,includinginflammatoryboweldisease,obesity,diabetes,andcancer.

Inrecentyears,moxibustionhasemergedasapromisingcomplementarytherapyforgastrointestinaldisorders,includingpepticulcers.Moxibustioninvolvestheburningofdriedmugwortonornearspecificacupuncturepointsonthebody.Ithasbeenshowntostimulatethesecretionofvariousgastrointestinalhormones,neuropeptides,andneurotransmitters,whichcanmodulatethesignaltransductionpathwaysofthesmallintestinemucosa-gut-brainaxis.Moreover,moxibustionhasbeenreportedtoregulatethebalanceofintestinalfloraandimprovegastrointestinalsymptoms,suchasbloating,constipation,anddiarrhea.

Severalstudieshaveinvestigatedtheeffectsofmoxibustiononintestinalflorainanimalmodelsofpepticulcers.Forinstance,Wuetal.(2018)foundthatmoxibustiontreatmentcouldrestorethediversityandrichnessofintestinalmicrobiotainratswithindomethacin-inducedgastriculcers.Thiseffectwasattributedtothedownregulationofpro-inflammatorycytokines,suchasTNF-αandIL-6,andtheupregulationofanti-inflammatorycytokines,suchasIL-10andTGF-β.Similarly,Chenetal.(2020)reportedthatmoxibustionattheZhongwan(CV12)andTianshu(ST25)acupointscouldalleviateH.pylori-inducedgastricinflammationanddysbiosisinmice,byreducingtheabundanceofpathogenicbacteria,suchasHelicobacterandClostridium,andincreasingtheabundanceofbeneficialbacteria,suchasBifidobacteriumandLactobacillus.

Overall,thesefindingssuggestthatmoxibustionmayexertitstherapeuticeffectsonpepticulcersbyregulatingthegut-brainaxisandrestoringthebalanceofintestinalflora.However,furtherstudiesareneededtoelucidatetheprecisemechanismsunderlyingtheseeffects,andtooptimizethemoxibustionprotocolsfordifferentsubtypesofpepticulcersandpatientpopulationsInadditiontopepticulcers,moxibustionhasbeenstudiedforitspotentialtherapeuticeffectsinvariousothergastrointestinaldisorders,suchasirritablebowelsyndrome(IBS),inflammatoryboweldisease(IBD),andgastroesophagealrefluxdisease(GERD).

ForIBS,moxibustionhasbeenshowntoalleviatesymptomssuchasabdominalpain,bloating,andconstipation,andimprovequalityoflife.OnestudyfoundthatmoxibustioncombinedwithacupuncturewasmoreeffectivethaneithertreatmentaloneinreducingsymptomsandimprovingoverallIBSseverity.AnotherstudysuggestedthatthemechanismunderlyingthetherapeuticeffectsofmoxibustiononIBSmayinvolvemodulationofthegutmicrobiotaandimmunesystem.

Similarly,forIBD,moxibustionhasbeenshowntoreduceinflammationandimprovesymptomssuchasdiarrheaandrectalbleeding.Onestudyfoundthatmoxibustioncombinedwithconventionalmedicationwasmoreeffectivethanmedicationaloneinreducingdiseaseactivityandimprovingqualityoflifeinpatientswithulcerativecolitis.AnotherstudysuggestedthatthetherapeuticeffectsofmoxibustiononIBDmayinvolvemodulationofthegut-brainaxisandimmunesystem.

ForGERD,moxibustionhasbeenshowntoreducesymptomssuchasheartburn,acidregurgitation,andchestdiscomfort,andimproveesophagealfunction.OnestudyfoundthatmoxibustioncombinedwithprotonpumpinhibitorswasmoreeffectivethanmedicationaloneinreducingsymptomsandimprovingesophagealfunctioninpatientswithGERD.AnotherstudysuggestedthatthetherapeuticeffectsofmoxibustiononGERDmayinvolvemodulationofthegastricmotilityandacidsecretion,aswellasthegut-brainaxis.

Overall,thesestudiessuggestthatmoxibustionmaybeasafeandeffectivecomplementarytherapyforvariousgastrointestinaldisorders,andmayworkthroughmodulatingthegut-brainaxisandregulatingthegutmicrobiotaandimmunesystem.However,furtherstudiesareneededtoconfirmthesefindingsanddeterminetheoptimalmoxibustionprotocolsfordifferentgastrointestinaldisordersandpatientpopulationsInadditiontothegastrointestinaldisordersdiscussedabove,severalotherconditionsmaypotentiallybenefitfrommoxibustiontherapy.

Oneareaofresearchistheuseofmoxibustionforpainmanagement.Ithasbeensuggestedthatmoxibustionmayworkbyincreasingbloodflowandreducinginflammationintheaffectedarea,aswellasbystimulatingthereleaseofendorphins,whicharenaturalpain-relievingcompounds.Studieshavefoundmoxibustiontobeeffectiveinalleviatingpainfromconditionssuchasosteoarthritis,lowbackpain,andmenstrualcramps.

Moxibustionmayalsobeusefulinmanagingcertainrespiratoryconditions,suchaschronicobstructivepulmonarydisease(COPD).Inonestudy,moxibustionwasfoundtoimprovepulmonaryfunctionandreducesymptomsinpatientswithmoderatetosevereCOPD.

Thereisalsosomeevidencetosuggestthatmoxibustionmayhavearoleinmanagingmentalhealthconditions.Forexample,asystematicreviewofseventrialsfoundthatmoxibustionwaseffectiveinred