电针调控自主神经电活动抑制膀胱过度活动症的机制  

Mechanism of regulating autonomic nerve electrical activity by electroacupuncture to inhibit over active bladder

作　　者：李林俊 杨硕 莫倩 LI Linjun;YANG Shuo;MO Qian(Guizhou University of Traditional Chinese Medicine,Guiyang 550025,China;The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang 550001,China)

机构地区：[1]贵州中医药大学,贵阳550025 [2]贵州中医药大学第二附属医院,贵阳550001

出　　处：《中华中医药杂志》2024年第5期2411-2416,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金地区科学基金项目(No.82260972,No.81660822)。

摘　　要：目的:探讨电针调控自主神经电活动抑制膀胱过度活动症的机制。方法:将40只SD雄性大鼠随机分为正常组、OAB模型组、OAB+盆神经离断组、OAB+腹下神经离断组、OAB+盆神经+腹下神经离断组,每组8只。造模成功后,实验分3部分进行:实验一(正常组和OAB模型组)不予电针干预;实验二(OAB模型组)分别予电针中髎(次髎)、三阴交、合谷、中极;实验三(OAB+盆神经离断组、OAB+腹下神经离断组、OAB+盆神经和腹下神经离断组)予电针中髎(次髎),电针强度1 mA,频率2 Hz,连续波,持续刺激5 min。记录膀胱排尿周期,观察大鼠基础膀胱内压等尿动力学指标、逼尿肌肌电及盆神经放电信号。结果:(1)与正常组比较,OAB大鼠膀胱收缩时间缩短,最大逼尿肌收缩压显著下降(P<0.01),排尿间隔缩短,基础膀胱内压,收缩后膀胱内压增高(P<0.01),提示OAB造模成功;且OAB逼尿肌肌电和盆神经信号增加(P<0.01)。(2)电针中髎/次髎后,较针刺前,OAB大鼠尿动力学参数明显改善;电针中髎(次髎)或三阴交后,大鼠逼尿肌膀胱收缩时放电次数减少(P<0.05),盆神经膀胱收缩时放电次数显著减少(P<0.05)。(3)电针前,与离断神经前OAB模型组比较,OAB+盆神经离断组及OAB+盆神经+腹下神经离断组的膀胱收缩时间及排尿间隔时间变长、最大逼尿肌收缩压增加、排尿阈值压降低、收缩后膀胱内压降低(P<0.05);电针干预后,与离断神经OAB组比较,OAB+腹下神经离断组的膀胱收缩时间变长、最大逼尿肌收缩压增加、排尿间隔时间延长、排尿阈值压降低、收缩后膀胱内压降低(P<0.05)。电针干预前,OAB+盆神经离断组、OAB+离断盆神经+腹下神经组的逼尿肌膀胱收缩时放电降低、膀胱收缩时放电降低(P<0.05);电针干预后,与离断神经OAB组比较,OAB+腹下神经离断组的逼尿肌膀胱收缩时放电降低、盆神经膀胱收缩时放电降低(P<0.05)。结论:针刺抑制OAB主要是通�Objective:To explore the mechanism of regulating autonomic nerve activity by electroacupuncture to inhibit over active bladder.Methods:Forty SD male rats were randomly divided into normal group,OAB+pelvic nerve dissociation group,OAB+hypogastric nerve dissociation group,OAB+pelvic nerve and hypogastric nerve dissociation group,with 8 rats in each group.After successful modeling,the experiment is conducted in three parts.No electroacupuncture intervention was given in experiment 1(normal group and OAB model group).In experiment 2(OAB model group),Zhongliao(BL33)Ciliao(BL32),Sanyinjiao(SP6),Hegu and Zhongji Point selection were respectively electrocuted.In experiment 3(OAB+pelvic nerve dissociation group,OAB+hypogastric nerve dissociation group,OAB+pelvic nerve and hypogastric nerve dissociation group)electricacupuncture Zhongliao(Ciliao),electric acupuncture intensity 1 mA,frequency 2 Hz,continuous wave,continuous stimulation for 5 min.The urinary cycle of the bladder was recorded,the basic bladder pressure,and other urodynamic indexes,the discharge signals of the detrusor muscle and the pelvic nerve.Results:(1)Compared with the normal group,the bladder contraction time of OAB rats was shortened,and the maximum detrusor systolic blood pressure was significantly decreased(P<0.01),the urination interval was shortened,the basal bladder pressure was increased after contraction(P<0.01),indicating that OAB molding success.OAB detrusor muscle and pelvic nerve signals increased(P<0.01).(2)Urinary dynamics parameters of OAB rats were significantly improved after electricacupuncture Zhongliao(Ciliao)compared with before acupuncture,the discharge times of the detrusor muscle during bladder contraction decreased after Zhongliao(Ciliao)or Sanyinjiao(P<0.05),the discharge times of pelvic nerve during bladder contraction were significantly decreased(P<0.05),but the Zhongliao(Ciliao)of electroacupuncture was significantly less than that of Sanyinjiao.(3)Before electroacupuncture intervention,compared with the OAB model group befo

关 键 词：电针 膀胱过度活动症 自主神经 抑制 盆神经 尿动力学 逼尿肌肌电 盆神经放电信号 

分 类 号：R245.97[医药卫生—针灸推拿学]