| Objective:The good clinical effect of acupuncture on postoperative gastrointestinal movement disorder is aboardly proved, but the mechanism of acupuncture is not fully clear。Mir-19a as an oncogene in the tumor, regulates the proliferation apoptosis and metastasis of cell through its transcription, and promotes the occurrence, development and transfer of colorectal cancer. So the miR-19a is closely related with the occurrence, development and prognosis of colorectal cancer. This research used the 3-Leg point in Jin’3-needle technique to prevent abdominal postoperative gastrointestinal dysmotility. By observing the changes of patient’s serum miR-19a relative expression before and after the acupuncture treatment, this search could reveal the mechanism of acupuncture on abdominal postoperative gastrointestinal dysmotility on the gene regulation level. This could offer a scientific theoretical basis to further clinical application of acupuncture treatment on abdominal postoperative gastrointestinal dysmotility.Method:1.32 patients with colorectal cancer was selected out strictly according to the diagnostic criteria and inclusive criteria,6 patients were excleded according to the exclusive criteria, so 26 patients were divided randomly into acupuncture group and blank group by means of random number table. The blank group only adopted normal processing, had no acupuncture treatment, while the acupuncture group used both the 3-Leg point in Jin’3-needle technique(Zusanli, Sanyinjiao, Taichong) and normal processing. Choosing the supine position, made the patients feel relaxed. Inserted the needle perpendicularly into the point, hold the needle waiting for Qi arrived, and did acupuncture manipulation, reinforced deficiency and reduced excess by lifting and thrusting the needle. Manipulation was done 2min per time each point. The total treatment lasted 30minutes. The longest treatment lasted 5days. Stopped treating when 5 day came even thogh the patient still didn’t exhaust. Each group eliminated 1 patient during the treatment, finally 24 patients were adopted in the study.2. Obseved and recorded the first time of exhaust, first defecation after operation, the patients’s condition of abdominal pain, abdominal distension and gastrointestinal reaction, etc.3. Drew the patients’s blood 3ml (before the operation, after the operation of the 1、5 days), centrifuged 2000rpm,20min, installed the supernatant in the free RNA enzyme EP tube with pipettor, stored at -80℃.4. Detected serum RNAs of the blood samples accordance with the the instructions of kit(TRIpure reagent kit), and detected serum miR-19a with quantitative real time polymerase chain reaction (qPCR).Result:There were no statistically significant discrepancy in the general information of the patients, such as the gender, age, course of operation, bleeding during surgery, types of anesthesia and surgery and surgical site(P>0.05), revealing the comparability of the two groups. After the acupuncture treatment, the first anal exhaust time、defecation time and the withdrawal time of nasogastric tube in acupuncture group were significantly shorter than blank group, and there were differences in statistics (p<0.05); the clinical grading of abdominal distension, pain in the acupuncture group were obviously superior than in the blank group(P<0.05), revealing the significant differences. There were statistically significant discrepancy in the relative expression of serum miR-19a in different time (before the operation, after the operation of the 1、5 days). The difference of the serum miR-19a relative expression before and after the acupuncture treatment in the acupuncture group was greater than the difference of the serum miR-19a relative expression after the operation of the 1、5 days in the blank group, which was with statistical significant differerce(p<0.05). The curative effect of grading composition in the acupuncture group was significantly greater than that in the blank group (P<0.01).Conclusions:Acupuncture on 3-Leg point can effectively promote the recovery of gastrointestinal function after colorectal cancer, and in the prevention of bowel expansion, intestinal adhesions, bowel obstruction, dysbacteriosis, lung infection and other postoperative complications. The effects of relieving abdominal distension, pain in the acupuncture group were obviously superior than in the blank group, Acupuncture on 3-Leg point is a simple and effective method for the rapid rehabilitation during the perioperative period, it can further clinical application of acupuncture treatment on abdominal postoperative gastrointestinal dysmotility. The mechanism of acupuncture on postoperative gastrointestinal movement disorder may be related to the relative expression serum miR-19a. |
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