芒针疗法对脊髓损伤后尿潴留的影响
[Awn needle therapy on the impact of urinary retention after spinal cord injury].
作者信息
Quan Ren-Fu, Chen Rong-Liang, Xu Shi-Chao, Qu Fei, Gong An, Yang Zong-Bao
机构信息
Xiaoshan TCM Hospital, Xiaoshan 311201, Zhejiang, China.
出版信息
Zhongguo Gu Shang. 2013 Jan;26(1):54-8.
OBJECTIVE
To investigate the therapeutic mechanism of point 8L54-through-point ST2S acupuncture with elongate needles in treating urinary retention after spinal cord injury.
METHODS
Thirty-five healthy Japanese rabbits (weight 2.5 +/- 0.25 kg, 3 months old, male or female), used as experimental subjects, were divided into 4 groups involving blank group, model group, acupuncture group, elongate needles group (5 rabbits in blank group, 10 rabbits in each of the other group 10). Modified Allen's method was used to cause spinal cord injury model for the model group, the acupuncture group and the elongate needles group, the blank group was only sham surgery. Immediately after spinal cord injury model,the elongated needle group was given the bilateral acupoints of the elongated needle penetration needling and electric stimulation, electrical stimulation 15 mm stimulation frequency of 20 to 40 times/mm, intensity 1.5 to 3 V the acupuncture group immediately was given ordinary electric needle acupuncture, given other disposals as the elongated needle group; model group was not given electric needle acupuncture, waiting 15 minutes, started to detect and record the observed indicator as the elongated needle group; the blank group was only sham surgery. The following indicators including the Tarlov score ,urinary bladder pressure point, the threshold urination, voided volume, were observed in the first day and the fifth day after surgery.
RESULTS
Three groups of animals which modeled were urinary retention after operation. Compared to 1 d, Tarlov score of model group, acupuncture group and elongate needles group significantly improved at postoperative 5 d (P < 0.05). Compared with acupuncture group, the Tarlov score of elongate needles group had no significant difference at postoperative 5 d (P > 0.05). Compared with model group, values of urinary bladder pressure point decreased with varying degrees in the acupuncture group and elongate needles group at postoperative 5 d (P < 0.05); relative to the acupuncture group, the point of the bladder voiding pressure in the elongate needles group decreased more significantly at postoperative 5 d (P < 0.05); compared with model group, micturition threshold of acupuncture group and elongate needles group had been significantly improved at the fifth day after surgery (P < 0.05); relative to the acupuncture group, the improvement is more obvious in the elongate needles group. Compared with model group, voided volume of acupuncture group and elongate needles group had increased significantly at the fifth day after surgery (P < 0.05); relative to the acupuncture group, the increment is more evident in the elongate needles group (P < 0.05).
CONCLUSION
To treat urinary retention after spinal cord injury, the method, which was point-through-point acupuncture with elongate needles in the "Zhibian" and "Shuidao", was better than general acupuncture method. The therapeutic mechanism may be related to stimulate peripheral nerve of bladder, and to rectify the dysfunction between detrusor and sphincter.
目的
探讨长针透刺8L54经ST2S穴治疗脊髓损伤后尿潴留的作用机制。
方法
选取35只健康日本大耳白兔(体重2.5±0.25kg,3月龄,雌雄不限)作为实验对象,分为空白组、模型组、针刺组、长针组(空白组5只,其他每组10只)。模型组、针刺组和长针组采用改良Allen法制备脊髓损伤模型,空白组仅行假手术。脊髓损伤模型建立后,长针组立即给予双侧穴位长针透刺并电刺激,电刺激15mm,刺激频率20~40次/mm,强度1.5~3V;针刺组立即给予普通电针针刺,其余处置同长针组;模型组不给予电针针刺,等待15分钟后,开始检测并记录观察指标,同长针组;空白组仅行假手术。术后第1天和第5天观察Tarlov评分、膀胱压力点、排尿阈值、排尿量等指标。
结果
造模的3组动物术后均出现尿潴留。与术后1天比较,模型组、针刺组和长针组术后5天Tarlov评分均显著提高(P<0.05)。与针刺组比较,长针组术后5天Tarlov评分差异无统计学意义(P>0.05)。与模型组比较,针刺组和长针组术后5天膀胱压力点值均有不同程度下降(P<0.05);与针刺组比较,长针组术后5天膀胱排尿压力点下降更显著(P<0.05);与模型组比较,针刺组和长针组术后第5天排尿阈值均显著改善(P<0.05);与针刺组比较,长针组改善更明显。与模型组比较,针刺组和长针组术后第5天排尿量均显著增加(P<0.05);与针刺组比较,长针组增加更明显(P<0.05)。
结论
长针透刺“秩边”“水道”穴治疗脊髓损伤后尿潴留效果优于普通针刺法,其作用机制可能与刺激膀胱周围神经、纠正逼尿肌与括约肌功能失调有关。