1. 上海中医药大学附属龙华医院中医外科研究所,上海,200032
2. 上海中医药大学附属龙华医院肛肠科,上海,200032
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秦钦, 王迪, 董青军, 等. 电针足三里和长强穴对神经源性大便失禁大鼠肛门括约肌生理功能的影响[J]. 上海中医药杂志, 2020,54(6):93-96.
QIN Qin, WANG Di, DONG Qingjun, et al. Effects of electroacupuncture at Zusanli and Changqiang points on physiological function of anal sphincter in neurogenic fecal incontinence rats[J]. Shanghai Journal of Traditional Chinese Medicine, 2020,54(6):93-96.
秦钦, 王迪, 董青军, 等. 电针足三里和长强穴对神经源性大便失禁大鼠肛门括约肌生理功能的影响[J]. 上海中医药杂志, 2020,54(6):93-96. DOI: 10.16305/j.1007-1334.2020.06.010.
QIN Qin, WANG Di, DONG Qingjun, et al. Effects of electroacupuncture at Zusanli and Changqiang points on physiological function of anal sphincter in neurogenic fecal incontinence rats[J]. Shanghai Journal of Traditional Chinese Medicine, 2020,54(6):93-96. DOI: 10.16305/j.1007-1334.2020.06.010.
目的:观察电针足三里和长强穴对神经源性大便失禁大鼠肛门括约肌生理功能的影响,并探讨其作用机制。 方法:选取90只健康雄性SD大鼠,随机分为模型组、电刺激组、电针组,每组30只,另取6只健康雄性SD大鼠设为空白组。除空白组外,其余3组大鼠采用切断双侧阴部神经的方法建立大便失禁模型。造模成功后电针组、电刺激组予以相应的措施连续干预14 d,模型组、空白组不干预。观察大鼠的粪便情况,检测肛门括约肌生理功能相关指标(肛门直肠压力、肛门外括约肌电活动),HE染色观察各组大鼠肛门括约肌组织病理变化情况。 结果:①=1\*GB3空白组大鼠垫料干燥,粪便呈颗粒状;模型组大鼠垫料箱内潮湿,粪便稀薄呈糊状;电刺激组和电针组大鼠粪便由糊状逐渐成形,最后成柔软的圆球状,电针组粪便的性状改善更显著,粪便质地更硬。②=2\*GB3与空白组相比,模型组大鼠肛门直肠压力降低(P<0.05),肛门外括约肌电活动减弱(P<0.05)。③=3\*GB3与模型组相比,电刺激组大鼠各观察时间点肛门直肠压力、肛门外括约肌电活动差异无统计学意义(P>0.05);电针组大鼠治疗3 d、7 d、14 d肛门直肠压力升高(P<0.05),治疗7 d、14 d肛门外括约肌电活动增强(P<0.05)。④=4\*GB3与电刺激组相比,电针组大鼠治疗3 d、14 d肛门直肠压力高于电刺激组(P<0.05),治疗7 d、14 d肛门外括约肌电活动强于电刺激组(P<0.05)。⑤=5\*GB3空白组大鼠肛门外括约肌肌纤维排列致密有序;模型组大鼠肌纤维结构紊乱,肌纤维间隙增宽,肛门外括约肌出现不同程度的萎缩;电刺激组与电针组大鼠肌纤维结构和排列有明显改善,且电针组改善更为显著。 结论:电针足三里和长强穴可有效改善神经源性大便失禁大鼠的大便失禁状态,其机制可能与增大肛门直肠压力及增强肛门外括约肌电活动有关。
Objective:To observe the effect of electroacupuncture at Zusanli and Changqiang points on the physiological function of anal sphincter in rats with neurogenic fecal incontinence and to explore its mechanism. MethodsNinety healthy male SD rats were selected and randomly divided into the model group, electrical stimulation group and electroacupuncture group, with 30 rats in each group, and another 6 healthy male SD rats were set as blank group. Except the blank group, the fecal incontinence models were established in other three groups of rats by cutting off bilateral pudendal nerves. After successful modeling, the electroacupuncture group and the electrical stimulation group were continuously intervened for 14 days, while the model group and the blank group were not intervened. The stool condition of rats was observed, and related indexes of the physiological function of anal sphincter (anorectal manometry and myoelectric activity of external anal sphincter) were detected. HE staining was used to observe the pathological changes of anal sphincter tissue of rats in each group. Results:①=1\*GB3In the blank group, the padding in the box was dry and the feces were granular. In the model group, the padding was wet and the feces were thin and mushy. The feces of rats in the electrical stimulation group and the electroacupuncture group gradually formed from mush to soft spherical shape. The feces in the electroacupuncture group improved more significantly and their texture was harder. ②=2\*GB3Compared with the blank group, the anorectal manometry in the model group decreased (P<0.05), and the myoelectric activity of the external anal sphincter decreased (P<0.05). ③=3\*GB3Compared with the model group, there was no significant difference in anorectal manometry and myoelectric activity of external anal sphincter in the electrical stimulation group at each observation time point (P>0.05). In the electroacupuncture group, the anorectal manometry increased on day 3, day 7 and day 14 after treatment (P<0.05), and the myoelectric activity of the external anal sphincter increased on day 7 and day 14 after treatment (P<0.05). ④Compared with the electrical stimulation group, the anorectal manometry in the electroacupuncture group was higher than that in the electrical stimulation group on day 3 and day 14 (P<0.05), and the myoelectric activity of the external anal sphincter was stronger than that in the electrical stimulation group on day 7 and day 14 (P<0.05). ⑤The muscle fibers of the external anal sphincter of rats in the blank group were arranged densely and orderly. In the model group, the muscle fiber structure was disordered, the muscle fiber space was widened, and the external anal sphincter atrophy occurred to varying degrees. The structure and arrangement of muscle fibers in electrical stimulation group and electroacupuncture group were significantly improved, and the improvement in electroacupuncture group was more significant. Conclusion:Electroacupuncture at Zusanli and Changqiang points can effectively improve the fecal incontinence of neurogenic fecal incontinence rats, and its mechanism may be related to increasing anorectal manometry and enhancing myoelectrical activity of external anal sphincter.
大便失禁神经源性电针肛门直肠压力肛门外括约肌电活动大鼠
fecal incontinenceneurogenicelectroacupunctureanorectal manometryexternal anal sphincterelectric activityrats
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