本文選題：電針 + 足三里穴�。� 參考：《中國人民解放軍醫(yī)學(xué)院》2014年碩士論文

【摘要】：目的：探討電針對失血性休克延遲補(bǔ)液大鼠植物神經(jīng)及心臟功能的影響。 方法：60只SD雄性大鼠（270±20g），隨機(jī)分為5組：手術(shù)對照組（SHAM），失血性休克電針足三里組（EA），失血性休克假針組（SEA），失血性休克電針足三里復(fù)合延遲補(bǔ)液組（EA+DR），失血性休克假針復(fù)合延遲補(bǔ)液組（SEA+DR）,每組12只。SHAM組僅施行麻醉和股動、靜脈置管術(shù)；其余各組按總血容量的45%放血、制作失血性休克模型。EA組在失血后立即針刺大鼠雙側(cè)“后三里”穴，并用電壓強(qiáng)度為4V，電流脈沖為4Hz電針儀連續(xù)刺激40分鐘；SEA組失血后即刻針刺后三里穴皮膚表皮層，只安裝電針儀不進(jìn)行電刺激以避免得氣；EA+DR組大鼠在失血后立刻電針其雙側(cè)三里穴，在失血3h后于股靜脈輸液2倍失血量的乳酸林格氏液40分鐘；SEA+DR組于在失血后即刻假刺后三里穴，失血后3h給予延遲補(bǔ)液治療。各組動物測定失血前和失血后3h、6h的平均動脈壓（MAP）以及其心率變異性（HRV）；同時抽取血樣本檢測腎上腺素（EPI）、乙酰膽堿（ACH）含量和心肌肌酸激酶同工酶（CK-MB）活性；并將處死動物后獲取的心臟組織用于檢測casepase-3蛋白活性及心肌細(xì)胞TUNEL陽性率。 結(jié)果：1、失血后各組大鼠MAP均比失血前顯著降低,休克后3小時EA+DR組MAP顯著高于SEA組和SEA+DR組（P均0.05）；失血6h后EA+DR組MAP顯著高于EA組和SEA組（P0.05）；EA+DR組和SEA+DR兩組大鼠失血6小時后平均動脈壓未見顯著性差異（P0.05）；2、與SHAM組比較失血6h后EA組、SEA組、SEA+DR組大鼠的心肌細(xì)胞casepase-3活性顯著升高（P均0.05）；與SEA組比較EA組、EA+DR組和SEA+DR組casepase-3相對活性降低（P均0.05）；與SEA+DR組比較，EA+DR組大鼠失血6h后心肌組織細(xì)胞capase-3活性降低（0.301±0.022VS0.126±0.019），二者可見顯著性差異（P0.05）。顯微鏡下觀察到熒光標(biāo)記的凋亡心肌細(xì)胞計(jì)數(shù)顯示，失血6h后SHAM組心肌細(xì)胞TUNEL陽性率最低，EA+DR組TUNEL陽性率顯著低于SEA+DR（P0.05）；3、對大鼠失血前、失血3h以及失血6h后心率變異性檢測結(jié)果顯示：與0h比較失血3h后各組LF顯著增高（P0.05）；失血后3h與SEA組比較EA組和EA+DR組LF顯著降低（40.3±2.3n.u VS29.6±2.1n.u,31.3±1.9n.u P0.05）；失血6h后EA+DR組LF低于SEA+DR組（11.4±1.8n.u VS17.8±2n.u），二者比較可見顯著性差異（P0.05）。與失血前比較失血3h后各組HF顯著降低（P0.05）；失血3h后EA組和EA+DR組HF顯著高于SEA組（69.2±2.7n.u，68.7±2.1n.u VS52.1±3.2n.u P0.05）；失血6h后EA+DR組HF高于SEA+DR組（126.3±4.1n.u VS109.7±3.6n.u），二者可見顯著性差異（P0.05）；4、在失血3h和6h后休克各組血漿腎上腺素與休克前相比顯著升高（P0.05）；失血3h后EA組和EA+DR組大鼠血漿腎上腺素水平與SEA組比較顯著降低(198.1±12.3ng/L，213.4±9.8ng/L VS269.5±19.6ng/L P0.05）；失血6h后與SEA+DR組比較EA+DR組腎上腺素含量顯著升高(137.8±6.9ng/L VS98.6±7.4ng/L)，兩組可見顯著差異性（P0.05）；同時發(fā)現(xiàn)，失血3h和6h后各組大鼠血漿中乙酰膽堿含量較0h有顯著變化（P0.05）；失血3h后EA組和EA+DR組ACH含量顯著高于SEA組（P0.05）；失血6h后EA+DR組血漿ACH含量高于SEA+DR組(405±8.6pmol/L VS341±10.1pmol/L P0.05）。 結(jié)論：1、電針足三里穴可以有效地降低休克早期心率變異性HRV中低頻成分LF，升高高頻成分HF，有效地調(diào)節(jié)植物神經(jīng)功能。降低了休克早期血漿中高腎上腺素水平，升高休克大鼠血漿副交感神經(jīng)遞質(zhì)乙酰膽堿的濃度；2、電針足三里升高了休克大鼠的平均動脈壓，降低了心肌細(xì)胞TUNEL陽性率和casepase-3蛋白的相對活性。提示電針足三里能有效地調(diào)節(jié)失血性休克大鼠植物神經(jīng)功能，改善其心臟的泵血功能，降低心臟組織中凋亡細(xì)胞的表達(dá)。
[Abstract]:Objective: To explore the effect of Electroacupuncture on autonomic nerve and cardiac function in rats with delayed fluid resuscitation after hemorrhagic shock.
Methods: 60 SD male rats (270 + 20g) were randomly divided into 5 groups: operation control group (SHAM), hemorrhagic shock electroacupuncture Zusanli group (EA), hemorrhagic shock false needle group (SEA), hemorrhagic shock electroacupuncture Zusanli delayed fluid supplement group (EA+DR), hemorrhagic shock false needle compound delayed fluid supplement group (SEA+DR), each group of 12.SHAM groups only performed anaesthesia and femur. The other groups, according to the total blood volume of 45% of the blood, made the hemorrhagic shock model.EA group immediately after the loss of blood after the loss of the bilateral "Three Li" points, and the voltage intensity was 4V, the current pulse was stimulated by the 4Hz electroacupuncture for 40 minutes, and the SEA group immediately after the blood was needled at the skin layer of the three li point, only the electroacupuncture apparatus was installed. No electrical stimulation was carried out to avoid gas; the rats in group EA+DR were immediately Electroacupuncture with their bilateral three li points after losing blood and 40 minutes of llggr's liquid 2 times the amount of blood loss in the femoral vein after the loss of blood. Group SEA+DR was at the three li point after the loss of blood after the loss of blood, and after the loss of blood, 3h was given a delayed rehydration treatment. Each group of animals measured 3h, 6h after blood loss and after the loss of blood. The mean arterial pressure (MAP) and its heart rate variability (HRV) were used to detect the content of adrenaline (EPI), acetylcholine (ACH) and myocardial creatine kinase isoenzyme (CK-MB) activity, and the cardiac tissue obtained after the death of animals was used to detect the activity of casepase-3 protein and the positive rate of TUNEL in cardiac myocytes.
Results: 1, the MAP in each group was significantly lower than that before blood loss, and the MAP in group EA+DR was significantly higher than that in group SEA and SEA+DR (P 0.05) after 3 hours of shock, and MAP in EA+DR group after 6h was significantly higher than that in EA group and SEA group (P0.05), and the average arterial pressure was not significantly different after 6 hours of blood loss in the two groups and 2. Compared with group SEA, group SEA and group SEA+DR, the casepase-3 activity of myocardial cells in group SEA and SEA+DR was significantly higher (P 0.05). Compared with group SEA, casepase-3 relative activity in group EA+DR and SEA+DR groups decreased (P was 0.05). There was a significant difference (P0.05). Under the microscope, the apoptotic cardiomyocyte count showed that the TUNEL positive rate in SHAM group was the lowest, and the positive rate of TUNEL in EA+DR group was lower than that of SEA+DR (P0.05) in EA+DR group. 3, the results showed that before the loss of blood, the blood loss 3H and the heart rate variability after the loss of blood 6h showed that the blood loss 3H was compared with 0h. After blood loss, the LF of 3H and EA+DR in group EA and EA+DR group decreased significantly (40.3 + 2.3n.u VS29.6 + 2.1n.u, 31.3 + 1.9n.u P0.05), and the two groups were significantly lower than those in the EA group and EA+DR group. 5) after 3h, the HF in group EA and EA+DR group was significantly higher than that in group SEA (69.2 + 2.7n.u, 68.7 + 2.1n.u VS52.1 + 3.2n.u P0.05), and the EA+DR group was higher than that of the group (126.3 + 2.1n.u), and the two showed significant difference. 4, the plasma adrenaline was significantly higher than before the shock. The plasma adrenalin level in group EA and EA+DR group was significantly lower than that in group SEA after 3H loss (198.1 + 12.3ng/L, 213.4 + 9.8ng/L VS269.5 + 19.6ng/L P0.05), and the adrenaline content in the EA+DR group was significantly higher than that in the SEA+DR group (137.8 + 9.8ng/L). The content of acetylcholine in plasma of each group was significantly higher than that of 0h after 3H and 6h (P0.05), and the content of ACH in EA group and EA+DR group after 3H was significantly higher than that in group SEA (P0.05), and the plasma content of EA+DR group was higher than that of the group (405 +).
Conclusion: 1, electroacupuncture at Zusanli can effectively reduce the low frequency component LF in the early heart rate variability HRV, increase the high frequency component HF, effectively regulate the function of the plant nerve, reduce the level of high epinephrine in the plasma and increase the concentration of parasympathetic acetylcholine in plasma of shock rats, and 2, the increase of electroacupuncture at Zusanli. The mean arterial pressure of the shock rats decreased the positive rate of TUNEL and the relative activity of casepase-3 protein, suggesting that Zusanli can effectively regulate the function of the autonomic nervous system in the rats with hemorrhagic shock, improve the blood pump function of the heart and reduce the expression of apoptotic cells in the cardiac tissue.

【學(xué)位授予單位】：中國人民解放軍醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R245

【參考文獻(xiàn)】

相關(guān)期刊論文 前5條

1 石現(xiàn),杜懷東,花麗艷;針刺對家犬實(shí)驗(yàn)性心率變異性改變的影響[J];大連醫(yī)科大學(xué)學(xué)報;1999年01期

2 朱漢華;李浪;汪熠;李佳荃;文偉明;陸永光;趙獻(xiàn)明;;TUNEL檢測心肌細(xì)胞凋亡的影響因素探討[J];廣西醫(yī)科大學(xué)學(xué)報;2009年01期

3 尹文;;創(chuàng)傷失血性休克早期復(fù)蘇的幾個關(guān)鍵問題[J];創(chuàng)傷外科雜志;2013年06期

4 趙玉雪;何偉;榮培晶;朱兵;;膽堿能抗炎通路的研究進(jìn)展[J];中華中醫(yī)藥雜志;2013年11期

5 胡森;周國勇;李琳;侯經(jīng)元;盛志勇;;莫沙比利對40%血容量丟失大鼠口服補(bǔ)液時胃排空率和血漿胃動素水平的影響[J];中國全科醫(yī)學(xué);2009年10期

，

本文編號：1798903