Murakami Haruaki, Li Shiying, Foreman Robert, Yin Jieyun, Hirai Toshihiro, Chen Jiande D Z
Veterans Research and Education Foundation, Oklahoma City VA Medical Center, Oklahoma City, OK, USA.
Department of Physiology, University of Oklahoma, Oklahoma City, OK, USA.
J Neurogastroenterol Motil. 2019 Apr 30;25(2):286-299. doi: 10.5056/jnm18094.
BACKGROUND/AIMS: Postoperative ileus increases healthcare costs and reduces the postoperative quality of life (QOL). The aim of this study is to investigate effects and mechanisms of electroacupuncture (EA) at ST36 and PC6 on gastrointestinal motility in rat model of postoperative ileus.
Laparotomy was performed in 24 rats (control [n = 8], sham-EA [n = 8], and EA [n = 8]) for the implantation of electrodes in the stomach and mid-jejunum for recording of gastric and small intestinal slow waves. Electrodes were placed in the chest skin for electrocardiogram (ECG). Intestinal manipulation (IM) was performed in Sham-EA and EA rats after surgical procedures. Small intestinal transit (SIT), gastric emptying (GE), postoperative pain, and plasma TNF-α were evaluated in all rats.
(1) Compared with sham-EA, EA accelerated both SIT ( < 0.05) and GE ( < 0.05) and improved regularity of small intestinal slow waves. (2) Compared with the control rats (no IM), IM suppressed vagal activity and increased sympathovagal ratio assessed by the spectral analysis of heart rate variability from ECG, which were significantly prevented by EA. (3) EA significantly reduced pain score at 120 minutes ( < 0.05, vs 15 minutes) after the surgery, which was not seen with sham-EA. (4) Plasma TNF-α was increased by IM ( = 0.02) but suppressed by EA ( = 0.04) but not sham-EA.
The postoperative ileus induced by IM, EA at ST36 and PC6 exerts a prokinetic effect on SIT and GE, a regulatory effect on small intestinal slow waves and an analgesic effect on postoperative pain possibly mediated via the autonomic-cytokine mechanisms.
背景/目的:术后肠梗阻增加了医疗成本并降低了术后生活质量(QOL)。本研究旨在探讨针刺足三里(ST36)和内关(PC6)对术后肠梗阻大鼠模型胃肠动力的影响及机制。
对24只大鼠(对照组[n = 8]、假针刺组[n = 8]和针刺组[n = 8])进行剖腹手术,在胃和空肠中部植入电极以记录胃和小肠慢波。将电极置于胸部皮肤用于记录心电图(ECG)。假针刺组和针刺组大鼠在手术后进行肠管操作(IM)。评估所有大鼠的小肠传输(SIT)、胃排空(GE)、术后疼痛和血浆肿瘤坏死因子-α(TNF-α)。
(1)与假针刺组相比,针刺组加速了SIT(<0.05)和GE(<0.05),并改善了小肠慢波的规律性。(2)与对照大鼠(未进行IM)相比,IM抑制了迷走神经活动并增加了通过ECG心率变异性频谱分析评估的交感迷走神经比值,而针刺可显著预防这种情况。(3)针刺组在手术后120分钟时显著降低了疼痛评分(<0.05,与15分钟时相比),假针刺组未见此现象。(4)IM使血浆TNF-α升高(=0.02),但针刺组可抑制(=0.04),假针刺组则无此作用。
IM诱导的术后肠梗阻,针刺ST36和PC6对SIT和GE具有促动力作用,对小肠慢波具有调节作用,对术后疼痛具有镇痛作用,可能通过自主神经-细胞因子机制介导。