Li Shiying, Lei Yong, Chen Jiande D Z
Veterans Research and Education Foundation, VA Medical Center, Oklahoma City, OK, USA.
Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, USA.
Neuromodulation. 2018 Apr;21(3):254-260. doi: 10.1111/ner.12712. Epub 2017 Nov 1.
Acupuncture or electroacupuncture (EA) has been applied for treating chemotherapy-induced emesis with limited success. The aims of this study were to investigate the anti-emetic effect of EA and to explore underlying anti-emetic mechanisms.
Rats were chronically implanted with a pair of stainless steel leads at acupoint pericardium 6 (PC6). Effects of EA with different parameters on cisplatin-induced nausea were assessed by pica (intake of kaolin, a surrogate of nausea in species without vomiting reflex). C-fos expressions in the area postrema (AP) and nucleus tractus solitarii (NTS) were analyzed. Subdiaphragmatic vagotomy was used to study involvement of the vagal pathway.
EA at PC6 with appropriate parameters has an inhibitory effect on cisplatin-induced nausea. The anti-emetic effect of the EA is centrally medicated involving the AP via the vagal pathway as well as the potential effect on AP by reducing the release of hormones.
针刺或电针(EA)已被用于治疗化疗引起的呕吐,但效果有限。本研究旨在探讨电针的止吐作用,并探索其潜在的止吐机制。
将大鼠长期植入一对位于心包经6穴(PC6)的不锈钢电极。通过异食癖(摄入高岭土,这是一种在没有呕吐反射的物种中作为恶心替代指标)评估不同参数的电针对顺铂诱导的恶心的影响。分析最后区(AP)和孤束核(NTS)中C-fos的表达。采用膈下迷走神经切断术研究迷走神经通路的参与情况。
1)与假电针组相比,20Hz/0.6ms的电针在顺铂注射后的第一天和第二天减少了高岭土摄入量(第一天:1.0±0.2 vs. 1.9±0.3g,p = 0.017;第二天:0.4±0.2 vs.1.1±0.3g,p = 0.010)。然而,10Hz/1.2ms的电针在这两天均无效。2)膈下迷走神经切断术显著降低了顺铂诱导的高岭土摄入量(1.1±0.3 vs. 2.2±0.3g,p = 0.014),并且在第一天也阻断了电针对高岭土摄入量的抑制作用。3)顺铂显著增加了NTS和AP中C-fos的表达。迷走神经切断术大大降低了NTS和AP中C-fos的表达。电针降低了顺铂诱导的AP中C-fos的表达,但对NTS没有影响。
PC6穴处采用适当参数的电针可对顺铂诱导的恶心产生抑制作用。电针的止吐作用是通过迷走神经通路在中枢介导的,涉及AP,以及通过减少激素释放对AP产生的潜在作用。