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中华损伤与修复杂志(电子版) ›› 2020, Vol. 15 ›› Issue (01) : 45 -50. doi: 10.3877/cma.j.issn.1673-9450.2020.01.007

所属专题： 文献；

论著

电针足三里穴对Ⅲ度烫伤大鼠口服补液后胃排空率和胃黏膜血流的影响
张慧苹1, 赵增凯2, 吕艺1, 马丽千1, 王海滨3, 张立俭4, 周方强5, 蔡红娟6, 胡森1,†()   
  1. 1. 100853　北京，解放军总医院医学创新研究部创伤修复与组织再生研究中心
    2. 100700　北京中医药大学东直门医院针灸科
    3. 100037　北京，解放军总医院第四医学中心检验科
    4. 100094　北京，解放军总医院第八医学中心康复医学科
    5. 200020　上海三代医药科技有限公司
    6. 100730　北京协和医院内科重症监护病房
  • 收稿日期:2019-12-16 出版日期:2020-02-01
  • 通信作者: 胡森
  • 基金资助:
    国家自然科学基金项目(81774422); 军委后勤保障重大项目(ALB19J001)

Effect of electroacupuncture at Zusanli point on gastric emptying rate and gastric mucosal blood flow after oral resuscitation of full thickness scalded rats

Huiping Zhang1, Zengkai Zhao2, Yi Lyu1, Liqian Ma1, Haibin Wang3, Lijian Zhang4, Fangqiang Zhou5, Hongjuan Cai6, Sen Hu1,†()   

  1. 1. Research Center of Trauma Repair and Tissue Regeneration, Medical Innovation Research Department, Chinese PLA General Hospital, Beijing 100853, China
    2. Department of Acupuncture, Dong Zhi Men Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
    3. Department of Laboratory Medicine, Fourth Medical Center of Chinese PLA General Hospital, Beijing 100037, China
    4. Department of Realbilitation, Eighth Medical Center of Chinese PLA General Hospital, Beijing 100094, China
    5. Three Generations Pharmaceutical Technology Co., Ltd, Shanghai 200020, China
    6. Medical Intensive Care Unit, Peking Union Medical College Hospital, Beijing 100730, China
  • Received:2019-12-16 Published:2020-02-01
  • Corresponding author: Sen Hu
  • About author:
    Corresponding author: Hu Sen, Email:
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引用本文：

张慧苹, 赵增凯, 吕艺, 马丽千, 王海滨, 张立俭, 周方强, 蔡红娟, 胡森. 电针足三里穴对Ⅲ度烫伤大鼠口服补液后胃排空率和胃黏膜血流的影响[J]. 中华损伤与修复杂志(电子版), 2020, 15(01): 45-50.

Huiping Zhang, Zengkai Zhao, Yi Lyu, Liqian Ma, Haibin Wang, Lijian Zhang, Fangqiang Zhou, Hongjuan Cai, Sen Hu. Effect of electroacupuncture at Zusanli point on gastric emptying rate and gastric mucosal blood flow after oral resuscitation of full thickness scalded rats[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2020, 15(01): 45-50.

目的

研究电针足三里穴对Ⅲ度烫伤大鼠口服补液时胃排空率和胃黏膜血流的影响。

方法

采用随机数字表法将120只SPF级成年大鼠分为5组：假伤后胃内补液组(GR组)、烫伤后胃内补液组(SGR组)、烫伤后电针＋胃内补液组(SGR＋EA组)、双侧迷走神经切断＋烫伤后胃内补液(VGX＋SGR组)、双侧迷走神经切断＋烫伤后电针＋胃内补液组(VGX＋SGR＋EA组)，每组24只。在1 000 mL无菌蒸馏水中，加入3.5 g丙酮酸钠、3.5 g氯化钠，1.5 g氯化钾和20.0 g葡萄糖，配置丙酮酸钠口服补液盐(Pyr-ORS)，调节pH值至7.35。将大鼠麻醉后分别行颈动脉、股静脉和股动脉分离术并置管。烫伤大鼠采用沸水(100 ℃，15 s)造成背部约35%总体表面积(TBSA)的Ⅲ度烫伤，假烫伤大鼠采用温水浸泡(37 ℃，15 s)。烫伤后即刻，每只大鼠给予皮下注射0.5 mL 0.9%氯化钠溶液和500 mL丁丙诺啡用于止痛。采用输液泵立即经胃管输注Pyr-ORS，持续1 h。VGX＋SGR组和VGX＋SGR＋EA组大鼠烫伤前进行双侧迷走神经切断术。SGR＋EA组和VGX＋SGR＋EA组，选择足三里穴进行针刺，连接电针仪，强度为2 mA，2～100 Hz，针刺深度7 mm，在给予烫伤大鼠Pyr-ORS的胃内补液后，持续电针刺激0.5 h。分别于烫伤后2、4 h检测各组大鼠胃排空率、胃黏膜血流量。数据比较采用单因素方差分析和LSD－t检验。

结果

烫伤后2、4 h，SGR组、SGR＋EA组、VGX＋EA组和VGX＋SGR＋EA组大鼠的胃排空率[2 h：(16.5±3.2)%、(22.6 ± 3.7)%、(13.6±3.0)%、(14.2±3.2)%；4 h：(12.9± 2.4 )%、(17.1±2.3)%、(10.8±2.7)%、(12.7±2.5)%]均分别低于GR组[2 h：(45.9±4.6)%；4 h：(42.4±5.7)%]，差异均有统计学意义[2 h：(t＝18.18、13.67、20.37、19.60，P值均小于0.05)；4 h：(t＝28.29、24.71、28.67、27.96，P值均小于0.05)。SGR＋EA组的胃排空率高于SGR组、VGX＋SGR组和VGX＋SGR＋EA组，差异均有统计学意义[2 h：t＝4.32、6.54、5.94，P值均小于0.05)；4 h：(t＝4.38、6.15、4.49，P值均小于0.05)]。烫伤后2、4 h，SGR组、SGR＋EA组、VGX＋EA组和VGX＋SGR＋EA组大鼠胃黏膜血流量[2 h：(54.0±7.3)、(74.6±8.7)、(42.0±5.5)、(45.2±6.2) BPU；4 h：(46.0±6.8)、(65.6±10.1)、(37.8±5.6)、(42.7±6.4) BPU]均分别明显低于GR组[2 h：(142.0±18.1) BPU；4 h：(127.4±16.5) BPU]，差异均有统计学意义[2 h：(t＝15.67、11.67、18.35、17.56，P值均小于0.05)；4 h：(t＝15.80、11.07、17.81、16.58，P值均小于0.05)]；SGR＋EA组与SGR组、VGX＋SGR组和VGX＋SGR＋EA组比较，差异均有统计学意义[2 h：(t＝6.28、10.97、9.53，P值均小于0.05)；4 h：(t＝5.58、8.33、6.63，P值均小于0.05)]。

结论

电针足三里穴能促进Ⅲ度烫伤大鼠口服补液后的胃排空率，增加胃黏膜血流，提高口服补液的疗效，其作用机制可能与兴奋迷走神经有关。

关键词: 电针, 大鼠, 补液疗法, 迷走神经, 烫伤, 足三里穴, 胃排空
Objective

To study the effect of electroacupuncture at Zusanli point on gastric emptying rate and mucosal blood flow after oral rehydration of full thickness scalded rats.

Methods

Using random number table method, 120 rats were divided into 5 groups: sham+ intragastric rehydration group(GR group), scald+ intragastric rehydration group(SGR group), scald+ electro-acupuncture+ intragastric rehydration group(SGR+ EA group), vagotomy+ scald+ intragastric rehydration group(VGX+ SGR group) and vagotomy+ scald+ electro-acupuncture+ intragastric rehydration group (VGX+ SGR+ EA group), with 24 rats in each group. In 1 000 mL of sterile distilled water, 3.5 g of sodium pyruvate, 3.5 g of sodium chloride, 1.5 g of potassium chloride, and 20.0 g of glucose were added, sodium pyruvate oral rehydration salt (Pyr-ORS) was configured, and the pH was adjusted to 7.35. After the rats were anesthetized, the carotid artery, femoral vein, and femoral artery were separated and the catheterization was did. The scalded rats were scalded with boiling water (100 ℃, 15 s) for about 35% total body surface area (TBSA) of the back, and the scalded rats were immersed in warm water (37 ℃, 15 s). Immediately after the scald, each rat was given a subcutaneous injection of 0.5 mL of 0.9% sodium chloride solution and 500 mL of buprenorphine for pain relief. Pyr-ORS was immediately infused via a gastric tube using an infusion pump for 1 h. Rats in the VGX+ SGR group and the VGX+ SGR+ EA group underwent bilateral vagus nerve resection before burns. In the SGR+ EA and VGX+ SGR+ EA groups, Zusanli point was selected for acupuncture and connected to an electroacupuncture instrument. The intensity was 2 mA, 2 to 100 Hz, and the acupuncture depth was 7 mm. After rehydration, the electroacupuncture was continued for 0.5 h. The gastric emptying rate and gastric mucosal blood flow of each group were measured at 2 and 4 h after scald. Data were compared using one-way analysis of variance and t test.

Results

The gastric emptying rates of rats in the SGR group, SGR + EA group, VGX + EA group, and VGX + SGR + EA group [2 h: (16.5±3.2)%, (22.6±3.7)%, (13.6±3.0)%, (14.2±3.2)%; 4 h: (12.9±2.4)%, (17.1±2.3)%, (10.8±2.7)%, (12.7±2.5)% were lower than those of rats in the GR group [2 h: (45.9±4.6)%; 4 h: (42.4±5.7)%], the differences were statistically significant [2 h: (t=18.18, 13.67, 20.37, 19.60; with P values below 0.05); 4 h: (t=28.29, 24.71, 28.67, 27.96; with P values below 0.05). The gastric emptying rates of rats in the SGR+ EA group was higher than those of rats in the SGR group, VGX+ SGR group and VGX+ SGR+ EA group, and the differences were statistically significant [2 h: (t=4.32, 6.54, 5.94; with P values below 0.05); 4 h: (t=4.38, 6.15, 4.49; with P values below 0.05)]. Gastric mucosal blood flow of rats in the SGR group, SGR+ EA group, VGX+ EA group, and VGX+ SGR+ EA group at 2 and 4 h after scald [2 h: (54.0±7.3), (74.6±8.7), (42.0±5.5), (45.2±6.2) BPU, 4 h: (46.0±6.8), (65.6±10.1), (37.8±5.6), (42.7±6.4) BPU] were significantly lower than the GR group [2 h: (142.0±18.1) BPU; 4 h: (127.4±16.5) BPU], the differences were statistically significant [2 h: (t=15.67, 11.67, 18.35, 17.56; with P values below 0.05); 4 h: (t=15.80, 11.07, 17.81, 16.58; with P values below 0.05)]; the gastric mucosal blood flow of rats in the SGR+ EA group compared with SGR group, VGX+ SGR group and VGX+ SGR+ EA group, the difference were statistically significant[2 h: (t=6.28, 10.97, 9.53; with P values below0.05); 4 h: (t= 5.58, 8.33, 6.63; with P values below 0.05)].

Conclusions

Electro acupuncture at Zusanli point can promote the rate of gastric emptying, increase gastric mucosal blood flow, and improve the efficacy of oral rehydration in full thickness scalded rats. The mechanism may be related to the stimulation of the vagus nerve.

Key words: Electroacupuncture, Rats, Fluid therapy, Vagus nerve, Scald, Zusanli, Gastric emptying
表1 烫伤后2、4 h各组大鼠胃排空率比较(%, ±s)
组别 鼠数(只) 烫伤后2 h 烫伤后4 h
GR组 12 45.9±4.6 42.4±5.7
SGR组 12 16.5±3.2ab 12.9±2.4ab
SGR＋EA组 12 22.0±3.7a 17.1±2.3a
VGX＋SGR组 12 13.6±3.0ab 10.8±2.7ab
VGX＋SGR＋EA组 12 14.2±3.2ab 12.7±2.5ab
F值 ? 170.6 182.7
P值 ? <0.05 <0.05
表2 烫伤后2、4 h各组大鼠胃黏膜血流量比较(BPU, ±s)
组别 鼠数(只) 烫伤后2 h 烫伤后4 h
GR组 12 142.2±18.1 127.4±16.5
SGR组 12 54.0±7.3ab 46.0±6.8ab
SGR＋EA组 12 74.6±8.7a 65.6±10.1a
VGX＋SGR组 12 42.0±5.5ab 37.8±5.6ab
VGX＋SGR＋EA组 12 45.2±6.2ab 42.7±6.4ab
F值 ? 196.4 167.0
P值 ? <0.05 <0.05
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