目的：本研究主要观察隔药灸对慢性炎性内脏痛大鼠下丘脑P 物质、5-羟色胺和c-Fos含量的影响，探讨隔药灸治疗慢性炎性内脏痛的镇痛机制。方法：雄性SD大鼠随机分为正常组、模型组、隔药灸组和假隔药灸组。采用三硝基苯磺酸合50%乙醇灌肠的方法制备慢性炎性内脏痛大鼠模型。隔药灸组选取双侧天枢穴、气海穴进行隔药饼灸治疗；假隔药灸组仅在穴位上放置药饼和艾炷，不点燃艾炷；模型组和正常组均不进行治疗，只做与隔药灸组相同的固定。治疗结束后，采用腹壁撤回反射评分（AWR）、机械性缩足反射阈值（MWT）、热缩足潜伏期（TWL）观察大鼠痛行为的变化，采用ELISA技术检测各组大鼠下丘脑P物质、5-羟色胺、c-Fos的含量。结果：与正常组比较，模型组大鼠AWR评分显著升高（P<0.05），MWT、TWL评分均显著降低（P<0.01）；与模型组、假隔药灸组比较，隔药灸组大鼠AWR评分降低（P<0.05），MWT、TWL 评分均显著升高（P<0.01）；假隔药灸组与模型组比较，AWR、MWT、TWL评分差异均无统计学意义（P>0.05）。与正常组比较，模型组大鼠下丘脑P物质、5-羟色胺、c-Fos含量均显著升高（P<0.01）；与模型组、假隔药灸组比较，隔药灸组大鼠下丘脑P物质、5-羟色胺、c-Fos含量均显著降低（P<0.01）；假隔药灸组与模型组比较，下丘脑P 物质、5-羟色胺、c-Fos含量差异均无统计学意义（P>0.05）。结论：隔药灸能降低慢性炎性内脏痛大鼠下丘脑P物质、5-羟色胺、c-Fos的含量，该作用可能是隔药灸治疗慢性炎性内脏痛发挥镇痛作用的重要中枢机制。

This study aimed to observe the impacts of herb-partitioned moxibustion(HPM)on substance P(SP),5-hydroxy tryptamine(5-HT),and c-fos in the hypothalamus of chronic inflammatory visceral pain(CIVP)rats;and to discuss the analgesic mechanisms of HPM.Thirty-six Sprague-Dawley(SD)rats were randomly divided into the normal group,the model group,the HPM group and the sham herb-partitioned moxibustion(SHPM)group.Rats of model,HPM and SHPM groups were established for CIVP models with enema of trinitrobenzenesulfonic-acid(TNBS)and 50.0% ethanol.The HPM group was treated with moxibustion at CV6-Qihai acupoint and bilateral ST25-Tianshu acupoint,which was practiced by placing a lighted moxa cone with a herbal cake being partitioned under each cone.For the SHPM group,herbal cakes and moxa cones were only placed on the same acupoints without ignition.Rats of the normal group and the model group were given no treatment,but only were fixed in the same way as the HPM group.After the treatment,behavioral indexes of abdominal withdrawal reflex(AWR),mechanical withdrawal threshold(MWT)and thermal withdrawal latency(TWL)were detected for both visceral and physical pain.The contents of SP,5-HT and c-Fos in hypothalamus were quantified by enzyme-linked immunosorbent assay(ELISA).As a result,compared with the normal group,the AWR score increased (P<0.05),while MWT and TWL scores decreased significantly in the model group (P<0.01,P<0.05,respectively).Compared with the model group and the SHPM group,the AWR score decreased (P<0.05),while the MWT and TWL scores increased significantly in the HPM group (P<0.01 or P<0.05).There were no significant differences between the SHPM group and the model group (P>0.05).Hypothalamic SP,5-HT and c-Fos were higher in the model group than those in the normal group (P<0.01).Compared with the model group and SHPM group,hypothalamic SP,5-HT and c-Fos reduced significantly in the HPM group(P<0.01).There were no significant differences between the SHPM group and the model group (P>0.05).It was concluded that HPM down-regulated the contents of SP,5-HT and c-Fos in the hypothalamus of CIVP rats,which may be an important analgesic mechanism of HPM in the tr eatment of CIVP.

国家自然科学基金委面上项目（81273843）：艾灸对内脏痛镇痛作用的MAPKs信号转导机制研究，负责人：马晓芃；国家重点基础研究发展计划项目（2015CB554501）：艾灸效应的启动机制及其内源性调节作用的机理研究，负责人：吴焕淦；上海市卫生和计划生育委员会课题（20144Y0153）：艾灸与针刺治疗炎症性肠病内脏痛的效应及信号转导机制研究，负责人：张丹。