Okada Misaki, Itoh Kazunori, Kitakoji Hiroshi, Imai Kenji
Department of Acupuncture and Moxibustion, Meiji University of Integrative Medicine, Kyoto, Japan.
Department of Acupuncture and Moxibustion, Takarazuka University of Medical and Health Care, Hyogo, Japan.
Med Acupunct. 2019 Apr 1;31(2):109-115. doi: 10.1089/acu.2018.1322. Epub 2019 Apr 15.
Acupuncture has been used for treating gastrointestinal (GI) disorders such as postoperative nausea and vomiting. Electroacupuncture (EA) accelerates GI transit following surgery and ameliorates postoperative ileus (POI) to restore colonic transit (CT); however, the mechanisms of this EA-induced restoration remain unclear. The aims of this study were to show CT following surgery and the effects of EA at ST 36 on POI induced by surgical stress (SS) in 45 conscious, male Sprague-Dawley rats. An operation was performed in each rat, setting a cannula into the cecum to connect the proximal colon to inject markers. On the day after surgery, 20 metal radiopaque markers were administered to the proximal colon of each rat. These markers were visible throughout the GI tract on soft X-ray immediately after administration and up to 240 minutes afterward. The rats were divided into 5 groups with 9 rats in each group: (1) SS; (2) 5 days post surgery (POST-5D); (3) SS + phentolamine; (4) EA alone; and (5) EA + atropine. The EA was performed at ST 36 for 20 minutes at a frequency of 10 Hz and agents were administered in the appropriate groups before markers were administered and measurements were taken. Measurements were performed the day after surgery except in the POST 5-D group. CT was calculated by the geometric center on the images showing the CT for each rat. CT after surgery was delayed significantly and phentolamine accelerated CT. EA restored CT following surgery and atropine abolished the effect of EA on CT. The current study demonstrated that surgery induced a delay in CT through the sympathetic pathway via α-adrenoreceptors; CT was restored by EA. These results suggest that EA can be used to treat POI through mediation of the autonomic nervous system.
针灸已被用于治疗胃肠道（GI）疾病，如术后恶心和呕吐。电针（EA）可加速术后胃肠蠕动，并改善术后肠梗阻（POI）以恢复结肠传输（CT）；然而，这种电针诱导恢复的机制仍不清楚。本研究的目的是在45只清醒的雄性Sprague-Dawley大鼠中，观察手术后的结肠传输情况以及电针足三里穴对手术应激（SS）诱导的POI的影响。对每只大鼠进行手术，在盲肠置入插管以连接近端结肠来注射标记物。术后第一天，给每只大鼠的近端结肠注入20个不透X线的金属标记物。给药后及之后长达240分钟内，这些标记物在软X射线下在整个胃肠道均可看见。大鼠被分为5组，每组9只：（1）手术应激组；（2）术后5天组；（3）手术应激+酚妥拉明组；（4）单纯电针组；（5）电针+阿托品组。在足三里穴进行电针，频率为10Hz，持续20分钟，在给药标记物和进行测量前，在相应组给予药物。除术后5天组外，均在术后第一天进行测量。通过显示每只大鼠结肠传输的图像上的几何中心来计算结肠传输时间。手术后结肠传输时间显著延迟，酚妥拉明可加速结肠传输。电针可恢复术后结肠传输时间，阿托品可消除电针对结肠传输时间的影响。本研究表明，手术通过α-肾上腺素能受体经交感神经通路导致结肠传输延迟；电针可恢复结肠传输时间。这些结果提示，电针可通过自主神经系统的介导用于治疗术后肠梗阻。
