电针足三里和长强穴对神经源性大便失禁大鼠肛门括约肌生理功能的影响  

Effects of electroacupuncture at Zusanli and Changqiang points on physiological function of anal sphincter in neurogenic fecal incontinence rats

作　　者：秦钦 王迪 董青军[2] 王琛[2] 曹永清[2] 陆金根[2] QIN Qin;WANG Di;DONG Qingjun;WANG Chen;CAO Yongqing;LU Jingen(Surgery of Traditional Chinese Medicine Research Institute,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Anorectal Department,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)

机构地区：[1]上海中医药大学附属龙华医院中医外科研究所,上海200032 [2]上海中医药大学附属龙华医院肛肠科,上海200032

出　　处：《上海中医药杂志》2020年第6期93-96,共4页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81503577);上海市科委科研计划项目(19401933000);国家中医药管理局全国名老中医药专家传承工作室建设项目[国中医药人教教育便函(2016)167];上海市名中医曹永清专家工作室建设项目。

摘　　要：目的观察电针足三里和长强穴对神经源性大便失禁大鼠肛门括约肌生理功能的影响,并探讨其作用机制。方法选取90只健康雄性SD大鼠,随机分为模型组、电刺激组、电针组,每组30只,另取6只健康雄性SD大鼠设为空白组。除空白组外,其余3组大鼠采用切断双侧阴部神经的方法建立大便失禁模型。造模成功后电针组、电刺激组予以相应的措施连续干预14 d,模型组、空白组不干预。观察大鼠的粪便情况,检测肛门括约肌生理功能相关指标(肛门直肠压力、肛门外括约肌电活动),HE染色观察各组大鼠肛门括约肌组织病理变化情况。结果①空白组大鼠垫料干燥,粪便呈颗粒状;模型组大鼠垫料箱内潮湿,粪便稀薄呈糊状;电刺激组和电针组大鼠粪便由糊状逐渐成形,最后成柔软的圆球状,电针组粪便的性状改善更显著,粪便质地更硬。②与空白组相比,模型组大鼠肛门直肠压力降低(P<0.05),肛门外括约肌电活动减弱(P<0.05)。③与模型组相比,电刺激组大鼠各观察时间点肛门直肠压力、肛门外括约肌电活动差异无统计学意义(P>0.05);电针组大鼠治疗3 d、7 d、14 d肛门直肠压力升高(P<0.05),治疗7 d、14 d肛门外括约肌电活动增强(P<0.05)。④与电刺激组相比,电针组大鼠治疗3 d、14 d肛门直肠压力高于电刺激组(P<0.05),治疗7 d、14 d肛门外括约肌电活动强于电刺激组(P<0.05)。⑤空白组大鼠肛门外括约肌肌纤维排列致密有序;模型组大鼠肌纤维结构紊乱,肌纤维间隙增宽,肛门外括约肌出现不同程度的萎缩;电刺激组与电针组大鼠肌纤维结构和排列有明显改善,且电针组改善更为显著。结论电针足三里和长强穴可有效改善神经源性大便失禁大鼠的大便失禁状态,其机制可能与增大肛门直肠压力及增强肛门外括约肌电活动有关。Objective To observe the effect of electroacupuncture at Zusanli and Changqiang points on the physiological function of anal sphincter in rats with neurogenic fecal incontinence and to explore its mechanism.Methods Ninety healthy male SD rats were selected and randomly divided into the model group,electrical stimulation group and electroacupuncture group,with 30 rats in each group,and another 6 healthy male SD rats were set as blank group.Except the blank group,the fecal incontinence models were established in other three groups of rats by cutting off bilateral pudendal nerves.After successful modeling,the electroacupuncture group and the electrical stimulation group were continuously intervened for 14 days,while the modelgroup and the blank group were not intervened.The stool condition of rats was observed,and related indexes of the physiological function of anal sphincter(anorectal manometry and myoelectric activity of external anal sphincter)were detected.HE staining was used to observe the pathological changes of anal sphincter tissue of rats in each group.Results(1)In the blank group,the padding in the box was dry and the feces were granular.In the model group,the padding was wet and the feces were thin and mushy.The feces of rats in the electrical stimulation group and the electroacupuncturegroup gradually formed from mush to soft spherical shape.The feces in the electroacupuncture group improved more significantly and their texture was harder.(2)Compared with the blank group,the anorectal manometry in the model group decreased(P<0.05),and the myoelectric activity of the external anal sphincter decreased(P<0.05).(3)Compared with the model group,there was no significant difference in anorectal manometry and myoelectric activity of external anal sphincter in the electrical stimulation group at each observation time point(P>0.05).In the electroacupuncture group,the anorectal manometry increased on day 3,day 7 and day 14 after treatment(P<0.05),and the myoelectric activity of the external anal sphincter increas

关 键 词：大便失禁 神经源性 电针 肛门直肠压力 肛门外括约肌 电活动 大鼠 

分 类 号：R245.97[医药卫生—针灸推拿学]