To study the effect of electroacupuncture at Zusanli point combined with delayed venous fluid resuscitation on survival rate, hemodynamics, blood gas index, blood flow and organ function of 60% blood volume hemorrhagic shock (HS) rats.

A total of 144 adult male SPF rats were selected to make a 60% HS model. After anesthesia, the rats were placed into tube, and the abdominal cavity was cut open about 4 cm along the midline of the abdomen, and covered with gauze impregnated with 0.9% sodium chloride solution. After injected 1% heparin saline from the femoral vein for systemic heparin, blood was drawn from the femoral artery. Firstly, 40% of the whole body blood was drawn from the femoral artery within 10 minutes, and then 20% of the whole body blood was slowly drawn from the femoral vein using a suction pump within 170 minutes. The total blood loss was 60% of the whole body blood of the rat. HS model was completed and recorded as shock immediately. (1) In experiment one, seventy-two rat HS models were selected and divided into shock non-hydration group (HS group), shock electroacupuncture group (HS+ EA group), shock delayed fluid replacement group (HS+ DFR group) and electroacupuncture combined delayed fluid replacement group (HS+ EA+ DFR group) according to the random number table method. HS group: only HS model was made, acupuncture and rehydration were not performed. HS+ EA group: acupuncture both sides of Zusanli 30 minutes after the completion of HS model, without rehydration; HS+ DFR group: 3 h after shock, 3 times blood loss of lactated Ringer′s solution for femoral vein infusion for 30 minutes without acupuncture; HS+ EA+ DFR group: 30 minutes after the completion of the HS model, acupuncture both sides of Zusanli point, and 3 hours after shock, the same intravenous delayed rehydration as in the HS+ DFR group was performed. Calculate the immediate, 3, 12, and 24 h aftere shock survival rates of the 4 groups of rats; monitor the mean arterial pressure (MAP) and blood flow in the abdominal organs 30 minutes before the shock, 3, 12 h after shock. (2) Experiment two: 72 rat HS models were selected, grouped and treated in the same way as experiment one, and arterial blood gas and organ function indexes of each group were calculated at 3 h after shock. Data were processed with one-way analysis of variance or Kruskal-Wallis rank sum test, t test, log-rank test.

(1) Immediate shock, the survival rate of each group was 100.0%, and 3 h after shock, the survival rates of rats in the HS group, HS+ EA group, HS+ DFR group, and HS+ EA+ DFR group were 61.1%, 77.8%, 77.8% and 88.9%, there was no statistically significant difference between the 4 groups (P>0.05). At 12 h after shock, the survival rates of the rats in the HS+ EA group, HS+ DFR group, and HS+ EA+ DFR group were 55.6%, 55.6%, and 61.1%, which were significantly higher than that (0) of the HS group, the differences were statistically significant (t= 6.51, 6.73, 6.84; with P values below 0.05). At 24 h after shock, the survival rate of the rats in the HS+ EA+ DFR group was 50.0%, significantly higher than those in the HS+ DFR group (16.7%) and the HS+ EA group(11.1%) (t= 2.51, 2.17; with P values below 0.05). (2) Immediately after shock, the MAP, liver tissue blood flow (HBF), renal tissue blood flow (RBF), and small intestinal mucosal blood flow (IMBF) in the 4 groups were significantly reduced compared with 30 minutes before modeling, and the differences were statistically significant (with P values below 0.05). At 3 and 12 h after shock, the MAP of the HS group, HS+ EA group, HS+ DFR group, and HS+ EA+ DFR group were (43.32±5.94), (64.09±9.64), (52.85±10.12), (62.04±7.12) mmHg (1 mmHg=0.133 kPa) and 0, (55.52±11.32), (67.39±12.03), (94.78±9.54) mmHg, the differences between the HS group and the HS+ EA group at the two time points were statistically significant (t= 3.61, 37.00; with P values below 0.05); the differences between the HS+ EA+ DFR group and the HS+ DFR group were statistically significant (t= 2.01, 6.54; with P values below 0.05); at 3 h after shock, there was no statistically significant difference between the HS+ EA+ DFR group and the HS+ EA group (t=1.04, P>0.05), at 12 h after shock, the difference between the 2 groups was statistically significant (t=3.68, P<0.05). At 3 and 12 h after shock, the HBF in the HS group, HS + EA group, HS + DFR group, and HS+ EA+ DFR group were (41.31±4.13), (47.55±3.21), (42.54±4.19), (49.86±4.68) U and 0, (52.14±5.53), (66.24±4.04), (79.41±7.51) U, there were statistically significant differences between HS group and HS+ EA group at two time points (t=4.16, 45.00; with P values below 0.05); the differences between the HS+ EA+ DFR group and the HS+ DFR group were statistically significant (t=3.41, 3.12; with P values below 0.05); at 3 h after shock, there was no statistically significant difference between HS+ EA+ DFR group and HS+ EA group (t=1.58, P>0.05), at 12 h after shock, the difference between the two groups was statistically significant (t=3.98, P<0.05). At 3, 12 h after shock, the RBF in the HS, HS+ EA, HS+ DFR and HS+ EA+ DFR groups were (81.29±8.49), (106.48±9.74), (77.59±8.32), (100.18±10.48) U and 0, (86.81±4.58), (113.38±10.03), (158.01±11.63) U, there were statistically significant differences between HS group and HS+ EA group at two time points (t= 3.21, 24.00; with P values below 0.05); the difference between the HS+ EA+ DFR group and the HS+ DFR group was statistically significant (t=2.67, 3.49; with P values below 0.05); at 3 h after shock, there was no statistically significant difference between the HS+ EA+ DFR group and HS+ EA group (t=1.55, P> 0.05), and at 12 h after shock, the difference between the two groups was statistically significant (t=3.71, P<0.05). At 3, 12 h after shock, the IMBF of HS group, HS+ EA group, HS+ DFR group and HS+ EA+ DFR group were (43.98±4.75), (89.92±4.72), (51.03±6.90), (94.50±7.61) U and 0, (76.65±11.32), (104.42±12.03), (143.26±9.54) U, the differences between the HS group and the HS+ EA group at two time points were statistically significant (t=3.71, 30.00; with P values below 0.05); the differences between the HS+ EA+ DFR group and the HS+ DFR group were statistically significant (t=2.37, 4.38; with P values below 0.05); at 3 h after shock, there was no statistically significant difference between the HS+ EA+ DFR group and the HS+ EA group (t=1.08, P>0.05), and at 12 h after shock, the difference between the two groups was statistically significant (t=4.74, P<0.05). (3) At 3 h after shock, the pH, lactic acid, partial pressure of arterial carbon dioxide, alanine aminotransferase, creatinine, and diamine oxidase in the HS group were 7.04±0.07, (9.11±1.28) mmol/L, (50.08±3.07) mmHg, (153.15±16.56) U/L, (82.70±7.26) mmol/L, (19.06 ± 2.50) U/L, and HA+ EA group [7.19±0.03, (7.16±1.18) mmol/L, (42.53±4.40) mmHg, (98.26±11.45) U/L, (74.4±6.56) mmol/L, (29.35±2.06) U/L], by comparison, the differences were statistically significant (t=8.36, 4.75, 5.97, 11.57, 3.60, 13.48; with P values below 0.05); at 3 h after shock, each index of the HS+ DFR group was 7.04±0.04, (9.06±1.15) mmol/L, (48.14±3.10) mmHg, (136.46±14.24) U/L, (86.5±7.38) mmol/L, (20.56±2.64) U/L, and HS+ EA+ DFR group [7.17±0.14, (7.22±1.07) mmol/L, (40.52±3.09) mmHg, (99.01±10.14) U/L, (72.5±6.41) mmol/L, (25.74±3.20) U/L], the differences were statistically significant (t=3.79, 4.97, 7.39, 9.09 , 6.08, 5.30; with P values below 0.05); there were no statistically significant differences between HS+ EA group and HS+ EA+ DFR group (t= 0.31, 0.28, 0.33, 0.36, 0.29, 0.35; with P values above 0.05).

Electroacupuncture at Zusanli point can significantly improve tissue perfusion of fatal hemorrhagic shock model and protect organ function, and improve the 24-hour survival rate of rats with delayed fluid replacement.