摘要
目的:探讨芒针透刺秩边-水道穴治疗脊髓损伤后尿潴留的机制。方法:选择健康日本大耳兔35只,体质量(2.50±0.25)kg,3月龄,雌雄不拘。随机将其分为空白组、模型组、针灸对照组、芒针透刺组4组(空白组5只,其他每组10只)。以改良式Allen's脊髓损伤造模法对模型组、针灸对照组、芒针透刺组动物进行造模(空白组只行假手术,不造模)。模型建立后芒针组立即给予芒针双侧穴位透刺,并进行电针刺激,电刺激15min,刺激频率20～40次/min,强度1.5～3V;针灸对照组立即给予普通电针针刺,其他处置同芒针组;模型组不予电针,静待15min,开始与芒针组同样的方法检测和记录各项观察指标;空白组只做假手术,其他不予处理。以Tarlov评分、排尿点膀胱内压、排尿阈值、排尿量为观察指标,探讨芒针透刺秩边-水道穴对膀胱尿动力学的影响。结果:造模的3组动物脊髓损伤后均出现尿潴留,术后5d芒针组、针灸对照组、模型组Tarlov评分较术后1d明显改善(P<0.05),而术后5d芒针组与针灸对照组比较差异无统计学意义(P>0.05)。芒针组、针灸对照组较模型组在术后5d排尿点膀胱内压值有不同程度下降,相对于针灸对照组,芒针组排尿点膀胱内压下降更为明显(P<0.05);术后5d芒针组和针灸对照组较模型组排尿阈值有明显改善(P<0.05),相对于针灸对照组,芒针组改善更为明显(P<0.05);术后5d芒针组和针灸对照组较模型组排尿量有明显增加(P<0.05),相对于针灸对照组,芒针组尿量增加更为明显(P<0.05)。结论:芒针透刺秩边-水道穴治疗脊髓损伤后尿潴留治疗效果优于一般针灸方法,其治疗机制与刺激膀胱周围神经,纠正逼尿肌-括约肌紊乱有关。
Objective ：To investigate the therapeutic mechanism of point BL54-through-point ST28 acupuncture with elongate needles in treating urinary retention after spinal cord injury. Methods： Thirty-five healthy Japanese rabbits （weight 2.5 ±0.25 kg, 3 months old, male or female）, used as experimental subjects, were divided into 4 groups involving blank group, model group,acupuncture group,elongate needles group （5 rabbits in blank group, 10 rabbits in each of the other group 10）. Modified Allen＇s method was used to cause spinal cord injury model for the model group, the acupuncture group and the elon- gate needles group ,the blank group was only sham surgery. Immediately after spinal cord injury model ,the elongated needle group was given the bilateral acupoints of the elongated needle penetration needling and electric stimulation, electrical stimulation 15 rain stimulation frequency of 20 to 40 times/min,intensity 1.5 to 3 V;the acupuncture group immediately was given ordinary electric needle acupuncture, given other disposals as the elongated needle group;model group was not given electric needle acupuncture, waiting 15 minutes, started to detect and record the observed indicator as the elongated needle group; the blank group was only sham surgery. The following indicators including the Tarlov score,urinary bladder pressure point,the threshold urination, voided volume, were observed in the first day and the fifth day after surgery. Results：Three groups of animals which modeled were urinary retention after operation. Compared to 1 d,Tarlov score of model group, acupuncture group and elongate needles group significantly improved at postoperative 5 d （P〈0.05）. Compared with acupuncture group,the Tarlov score of elongate needles group had no significant difference at postoperative 5 d （P〉0.05）. Compared with model group, values of urinary bladder pressure point decreased with varying degrees in the acupuncture group and elongate needles group at postoperative 5 d （P〈0.05） ; relative to the acupuncture group, the point of the bladder voiding pressure in the elongate needles group decreased more significantly at postoperative 5 d （P〈0.05）; compared with model group,micturition threshold of acupuncture group and elongate needles group had been significantly improved at the fifth day after surgery （P〈0.05） ;relative to the acupuncture group, the improvement is more obvious in the elongate needles group. Compared with model group, voided volume of acupuncture group and elongate needles group had increased significantly at the fifth day after surgery （P〈0.05） ;relative to the acupuncture group,the increment is more evident in the elongate needles group （P〈0.05）. Conclusion：To treat urinary retention after spinal cord injury, the method, which was point-through-point acupuncture with elongate needles in the ＂Zhibian＂ and ＂Shuidao＂, was better than general acupuncture method. The therapeutic mechanism may be related to stimulate peripheral nerve of bladder, and to rectify the dysfunction between detrusor and sphincter.
出处
《中国骨伤》
CAS
2013年第1期54-58,共5页
China Journal of Orthopaedics and Traumatology
基金
浙江省中医药科研基金项目(编号:2008CB067)~~
关键词
芒针
穴
秩边
穴
水道
脊髓损伤
尿潴留
Awn needles
Point BL54 （Zhibian）
Point ST28 （Shuidao）
Spinal cord injuries
Urinary retention
