针刺不同腧穴对急性尿潴留大鼠膀胱功能的影响

目的：探讨针刺不同腧穴对急性尿潴留大鼠膀胱功能的影响。方法：40只SD大鼠随机分为模型组、三阴交组、合谷组、中髎（次髎）组，每组10只。均先采用0.9%生理盐水进行膀胱灌注60 min，测定正常状态下膀胱的尿动力学指标，继予0.9%生理盐水进行膀胱灌注造模。造模成功后，模型组不予针刺治疗，三阴交组、合谷组、中髎（次髎）组进行针刺。观察灌注期间大鼠基础膀胱内压、排尿时膀胱收缩时间、最大逼尿肌收缩压、排尿间隔时间、排尿阈值压、收缩后膀胱内压的改变。结果：与正常基线相比，模型组大鼠基础膀胱内压、收缩后膀胱内压明显升高（P < 0.01），排尿阈值压亦上升（P < 0.05），排尿时膀胱最大压力下降（P < 0.01），排尿间隔时间延长（P < 0.05），但其膀胱收缩时间未见显著差异（P > 0.05）；针刺干预后，三阴交组、中髎（次髎）组与针刺前相比，最大逼尿肌收缩压升高（P < 0.01），收缩后膀胱内压减少（P < 0.01），排尿阈值压未见显著差异（P >0.05），排尿时膀胱收缩时间增加（P < 0.05），排尿间隔时间缩短（P < 0.01）；两组组间比较，最大逼尿肌收缩压、排尿阈值压、收缩后膀胱内压、排尿时膀胱收缩时间、排尿间隔时间未见显著差异（P > 0.05）；合谷组最大逼尿肌收缩压、排尿阈值压、收缩后膀胱内压、排尿时膀胱收缩时间、排尿间隔时间均未见显著差异（P > 0.05）。结论：针刺治疗AUR大鼠主要是通过刺激相关神经节段腧穴中髎（次髎）、三阴交从而使AUR大鼠最大逼尿肌收缩压升高、收缩后膀胱内压减少、排尿时膀胱收缩时间增加、排尿间隔时间缩短，效应具有穴位特异性。

Effect of Acupuncture at Different Acupoints on Bladder Function of Acute Urinary Retention Rats

Objective: To explore the effect of acupuncture at different acupoints on bladder function of acute urinary retention (AUR) rats. Methods: A total of 40 SD rats were randomly divided into model group, SP6 group, LI4 group, andBL33(BL32) group, with 10 rats in each group. All the rats underwent intravesical instillation of 0.9% normal saline for60 min to determine the urodynamic indexes of bladder under normal state, and 0.9% normal saline was givensuccessively for intravesical instillation modeling. After the model was established successfully, the rats in model groupwere not given acupuncture treatment, and the rats in SP6 group, LI4 group, BL33(BL32) group were acupunctured atcorresponding acupoints. The changes of basal intravesical pressure, bladder contraction time during micturition,maximum detrusor systolic pressure, micturition interval, micturition threshold pressure, intravesical pressure aftercontraction of rats during instillation were observed. Results: Compared with normal baseline, the basal intravesicalpressure and the intravesical pressure after contraction of rats in the model group were significantly increased (P < 0.01)and the micturition threshold pressure was increased as well (P < 0.05). The maximum bladder pressure duringmicturition was decreased (P < 0.01) and the micturition interval was prolonged (P < 0.05). However, no statisticallysignificant difference was found in bladder contraction time (P > 0.05); after intervention with acupuncture, comparedwith before acupuncture, in rats of SP6 group and BL33(BL32) group, the maximum detrusor systolic pressure wasincreased (P < 0.01), the intravesical pressure after contraction was decreased (P < 0.01), the difference in micturitionthreshold pressure was not statistically significant (P > 0.05), the bladder contraction time during micturition wasincreased (P < 0.05), and the micturition interval was shortened (P < 0.01); there were no statistically significantdifferences in maximum detrusor systolic pressure, micturition threshold pressure, intravesical pressure after contraction,bladder contraction time during micturition and micturition interval in rats of LI4 group before and after acupuncture (P >0.05). And there were no statistically significant differences in maximum detrusor systolic pressure, micturition threshold pressure, intravesical pressure after contraction, bladder contraction time during micturition and micturition interval inrats of LI4 group between before and after acupuncture (P > 0.05) in LI4 group. Conclusion: Acupuncture treats ARU ratsmainly by stimulating the BL33(BL32) acupoint and SP6 acupoint of the related nerve segments, thereby increasing themaximum detrusor systolic pressure, decreasing the intravesical pressure after contraction, increasing the bladdercontraction time during micturition as well as shortening the micturition interval of ARU rats, and the efficacy ofacupuncture has acupoint specificity.