电针疗法联合全麻诱导对老年下肢关节置换手术患者血流动力学和术后恢复的影响

摘要 目的：评估电针预处理对行下肢关节置换术的老年患者术中血流动力学、术后心血管不良事件、恢复质量的影响。方法：选择择期行下肢关节置换术（膝关节置换或髋关节置换）的老年患者70例,采用随机数字表法分为试验组和对照组。试验组在全麻诱导前30 min于手术准备间予双侧内关、列缺、足三里电针治疗,对照组单纯行全身麻醉。两组全麻诱导后均采用静吸复合麻醉。记录气管插管时（T1）、手术开始后10 min（T2）、拔管后10 min（T3）时的血流动力学参数（HR、MAP、RPP）,术后24 h的心血管不良事件、VAS评分、恢复质量（QoR40）的情况。结果：与对照组相比,试验组T1、T2、T3三个时间点的HR、MAP、RPP均明显降低（P＜0.05）;试验组术后24 h心血管不良事件发生率高于对照组（P＜0.05）,VAS评分以及术后QoR40比较无差异（P>0.05）。结论：麻醉前电针预处理内关、列缺、足三里可以有效的降低患者心率、血压和心肌氧耗量,降低机体对围术期应激的反应,从而降低围术期不良心血管事件的发生率,提高麻醉的安全和质量。     

Amygdala opioid receptors mediate the electroacupuncture-induced deterioration of sleep disruptions in epilepsy rats

Background

Clinical and experimental evidence demonstrates that sleep and epilepsy reciprocally affect each other. Previous studies indicated that epilepsy alters sleep homeostasis; in contrast, sleep disturbance deteriorates epilepsy. If a therapy possesses both epilepsy suppression and sleep improvement, it would be the priority choice for seizure control. Effects of acupuncture of Feng-Chi (GB20) acupoints on epilepsy suppression and insomnia treatment have been documented in the ancient Chinese literature, Lingshu Jing (Classic of the Miraculous Pivot). Therefore, this study was designed to investigate the effect of electroacupuncture (EA) stimulation of bilateral Feng-Chi acupoints on sleep disruptions in rats with focal epilepsy.

Results

Our result indicates that administration of pilocarpine into the left central nucleus of amygdala (CeA) induced focal epilepsy and decreased both rapid eye movement (REM) sleep and non-REM (NREM) sleep. High-frequency (100 Hz) EA stimulation of bilateral Feng-Chi acupoints, in which a 30-min EA stimulation was performed before the dark period of the light:dark cycle in three consecutive days, further deteriorated pilocarpine-induced sleep disruptions. The EA-induced exacerbation of sleep disruption was blocked by microinjection of naloxone, μ- (naloxonazine), κ- (nor-binaltorphimine) or δ-receptor antagonists (natrindole) into the CeA, suggesting the involvement of amygdaloid opioid receptors.

Conclusion

The present study suggests that high-frequency (100 Hz) EA stimulation of bilateral Feng-Chi acupoints exhibits no benefit in improving pilocarpine-induced sleep disruptions; in contrast, EA further deteriorated sleep disturbances. Opioid receptors in the CeA mediated EA-induced exacerbation of sleep disruptions in epileptic rats.     

Effect of electroacupuncture on mice model of permenopausal depressive disorder

ObjectiveStudy the effect of electroacupuncture on permenopausal depressive disorder (PDD) model through the peri-menopausal depression model mice.MethodsKM female mice were selected. Except for the blank group (BG), the other groups of mice were removed by castration method. The mice of PDD was prepared by combining chronic unpredictable stimulation. Mice in the model group (MG) were not treated and fed normally. The western medicine group (WG) was given the corresponding drug for treatment. The electroacupuncture group (EAG) was given the electroacupuncture for treatment, and consecutive for 28 days. The levels of T, E₂, FSH and LH in serum of mice were measured, and the brain tissue of 5-HT, DA and NE level were measured. Through the HE staining observed the morphological changes of mice hypothalamus.ResultsCompared with MG, EAG could increase the number of spontaneous activities of PDD model mice, the level of T, E₂ in serum and the level of 5-HT, DA, NE in brain tissue was improved, and the level of FSH, LH in serum was reduced, and the hypothalamic lesions was improved.ConclusionElectroacupuncture could improve the activity and memory of PDD mice, adjust the disorder of sex hormone, and increased the levels of monoamine transmitters (5-HT, NE, DA), and it could effectively improve the behavior and related biochemical indexes of PDD, and thus play an important therapeutic role.     

Electroacupuncture Effects in a Rat Model of Complete Freund’s Adjuvant-Induced Inflammatory Pain: Antinociceptive Effects Enhanced and Tolerance Development Accelerated

We have previously shown that electroacupuncture (EA) produced antinociception through the release of endogenous opioid peptides to activate opioid receptors during acute nociception. EA produced tolerance after its prolonged application. It has reported that 100 Hz EA could reduce mechanical hyperalgesia in complete Freund’s adjuvant (CFA)-induced inflammatory nociception rats. The present study aims to investigate the antinociceptive effect of EA and the development of EA tolerance in chronic inflammatory nociception rats with CFA injection into the hind paw plantar. The results showed that the antinociceptive effect of 100 Hz EA was significantly enhanced in CFA-induced inflammatory nociception rats. Naloxone at 20 mg/kg could significantly block this antinociceptive effect. Chronic tolerance to EA was developed faster in CFA-induced inflammatory nociception rats than in normal rats. Therefore, 100 Hz EA could enhance antinociceptive effects and accelerate tolerance development in CFA-induced inflammatory nociception rats. The enhancement of EA antinociceptive effect in CFA-induced inflammatory nociception rats might involve the endogenous opioid peptides such as dynorphin. Special issue article in honor of Dr. Ji-Sheng Han.     

Electroacupuncture in the Treatment of Obesity

Obesity is becoming one of the most common health problems in the world. Many other disorders, such as hypertension and diabetes are considered as the consequences of obesity. Since effective remedies are rare (only two drugs, Orlistat and Sibutramine, were officially approved by the US Food and Drug Administration for long-term obesity treatment so far), researchers are trying to discover new therapies for obesity, and acupuncture is among the most popular alternative approaches. To facilitate weight reduction, one can use manual acupuncture, electroacupuncture (EA) or transcutaneous electrical acupoint stimulation (TEAS). As the parameters of the EA or TEAS can be precisely characterized and the results are more or less reproducible, this review will focus on EA as a treatment modality for obesity. Results obtained in this laboratory in recent five years will be summarized in some detail. Special issue article in honor of Dr. Ji-Sheng Han.     

Electroacupuncture Reduces Voluntary Alcohol Intake in Alcohol-preferring Rats via an Opiate-sensitive Mechanism

Electroacupuncture (EA) has been shown to modify the effects of various drugs of abuse, including alcohol. Inbred P rats were trained to drink alcohol voluntarily and then subjected to two periods of alcohol deprivation lasting 3 days. During the second deprivation, the rats received either EA or sham EA. The rats were pretreated with naltrexone (5 mg/kg) or saline 30 min before each of the EA or sham EA sessions. Approximately 6 h after the last naltrexone or saline treatment, the alcohol tubes were returned and alcohol and water intakes were recorded later at 2, 4, 6, and 24 h. Only EA led to a decrease in alcohol intake, which was most prominent at 6 and 24 h, and this inhibitory effect of EA was blocked by naltrexone, suggesting that activation of the endogenous opiate system may be responsible for EA’s effects on alcohol intake in the alcohol-dependent iP rats. Special issue article in honor of Ji-Sheng Han.     

不同时辰电针对大鼠杏仁核一氧化氮合酶表达的影响

目的观察不同时辰电针对大鼠杏仁核一氧化氮合酶(NOS)表达的影响.方法采用还原型尼克酰胺腺嘌呤二核苷酸脱氢酶(NADPH-d)法,观察不同时辰电针大鼠一侧"足三里"穴对杏仁核NOS表达的影响.结果电针对大鼠杏仁皮质内侧核群、基底外侧核群NOS的表达有上调作用,并存在时辰差异(P<0.05);电针对大鼠杏仁中央核NOS表达无明显作用(P>0.05).结论电针对大鼠杏仁核NOS表达的影响有时辰差异.     

电针对大鼠足底疼痛病灶所属脊髓节段一氧化氮合酶阳性反应的影响

采用NADPH-d组织化学方法,观察电针对大鼠一侧足底注射5%福尔马林50μl后病灶所属脊髓节段（L4-L6）一氧化氮合酶（NOS）阳性反应的影响。结果表明,福尔马林组大鼠L4-L6节段脊髓胶状质NOS阳性反应较生理盐水组显著增强,电针治疗组大鼠L4-L6节段脊髓胶状质NOS阳性反应与生理盐水组无显著差异。但明显弱于福尔马林组,提示电针治疗能抑制大鼠足底疼痛病灶所属脊髓节段NO合成,减弱脊髓神经元的敏感化,从而发挥镇痛作用。     

Enhanced insulin sensitivity using electroacupuncture on bilateral Zusanli acupoints (ST 36) in rats

In this study, intravenous glucose tolerance test (ivGTT) and insulin challenge test (ICT) were applied to evaluate the influence of electroacupuncture (EA) on insulin sensitivity in rats. Firstly, hypoglycemic activity was confirmed on normal Wistar rats (36+/-12%) and streptozotocin (STZ)-induced diabetic rats (13+/-8%) after 60 min of 15 Hz EA on bilateral Zusanli acupoints. The rats were divided into the experiment group (EG) and control group (CG) randomly. After fasting, plasma glucose and insulin levels were assayed in the normal Wistar rats undergoing ivGTT. Plasma glucose levels and hypoglycemic activity were also evaluated in the normal Wistar rats and STZ diabetic rats during ICT. As the data showed, EA improved the glucose tolerance from 15 to 90 min (p<0.005 compared with the plasma glucose levels of the CG) during ivGTT. In addition, significant improvement in the Homeostasis Model Assessment (HOMA) index was found in the EG from 15 to 90 min (p<0.005 compared with the CG). More hypoglycemic activity was achieved in normal Wistar and STZ diabetic rats in the EG than in the CG (from 30 to 60 min) during ICT. In conclusion, the results suggest that 15 Hz EA at bilateral Zusanli acupoints improved glucose tolerance. Thus, EA should be considered as an alternative method for improving insulin sensitivity and/or increase insulin-hypoglycemic activity in rats.