Effect Of Acupuncture On Irritable Bowel Syndrome And Blood Pressure Regulation

Regulation of acupuncture information on low viscera intestine--The effect of acupuncture against disorders of intestine function in irritable bowel syndrome ratsAcupuncture has been considered as one of the most promising supplementary medical treatments for its effectiveness and minimum side effects in somatic and visceral pain management. Acupuncture has good effect on visceral function like visceral pain, astriction, diarrhea and inflation. Disorders of visceral function contains sense abnormity and motility abnormity. Visceral pain, as one kind of sense abnormity, is a difficult-treated symptom because its upset is usually complicated and the neuromechanism is not clear. Consequently it has been great suffering for patients and high cost of medical care. Visceral pain occurs deeply and has complex clinical characteristics of diffuse and poorly localized, referred pain, autonomous nerve reflex. Thus the understanding of viscera pain is far lagged behind that of somatic pain and less specific therapies of chronic visceral pain are valid. Visceral motility abnormity contains motility deficiency and motility overage. We chose irritable bowel syndrome (IBS) to investigate effect of EA on chronic visceral disorder.Irritable bowel syndrome (IBS) is a clinical common disease that affects up to 15% of the U.S. population and has a significant socioeconomic impact. IBS is presently defined by a bundle of symptoms consisting mainly of recurrent abdominal pain associated with altered bowel movements. Visceral hyperalgesia can be occurred without obvious pathophysiological alteration which is termed as functional gastrointestinal disorders (FGIDs) and irritable bowel syndrome (IBS), featured with a high perception to innoxious and noxious visceral afferent inputs in the spinal cord without identifying structural or biochemical changes in the target organs. IBS is common in youth and adult and the proportion between male and female is 1:2. The study in recent years demonstrated that central sensitization was the key factors of development of visceral pain.The original view of IBS pathology is a disease of disorders of gastrointestinal motility. It was reported that the frequency colon contraction was increased and the swing was augmented in IBS patients with diarrhea compared with normal person. Some researches suggested that visceral hyperalgesia was the pathophysiological feather of IBS. What's the relationship between disorders of gastrointestinal motility and visceral hyperalgesia in IBS patient? Experiment evidence is needed for if EA has effect on both disorders of gastrointestinal motility and visceral hyperalgesia in IBS patient.A new rat model of chronic visceral hyperalgesia was invented by Al-Chaer and his colleague in 2000, which provided a new approach for further exploration of the central mechanism of chronic visceral pain. In our previous study, we repeated the animal model and found that electroacupuncture (EA) was effective on visceral hyperalgesia in IBS rat. Spinal N-methyl-D-aspartic acid (NMDA) receptor was found involving visceral hyperalgesia and EA analgesia. But there were some deficiencies in behavioral test. Our present study was focused on the motility abnormity in the IBS rat, peristaltic wave as the index. There were several shortcomings in behavioral methods. In abdominal withdraw response (AWR), score 1 was given when the rat immobile during the colorectal distention (CRD) and occasionally cliched the head at the onset of the stimulus. But the score was subjective for in some occasion the rat cliched the head for abdominal pain and in others maybe just unconscious behavior with no reasons. And the abdominal electromyogram was an indirect index for it was caused by muscle contraction in case of visceral pain after CRD stimulation. A direct and objective index was in dire needed. Painless method of colon pesistent wave in rat body is a great difficulty of our experiment.Results1 Production and evaluation of IBS rat model of chronic visceral hyperalgesia1.1 Production of IBS rat modelMethod was improved according to the method of Al-Chaer's. Male neonatal SD rats (8 th-21 st postnatal) were given colorectal distention stimulation daily by using self-made balloons. Evaluations were made when they became adults.1.2 Increased abdominal withdrawal reflex (AWR) score in IBS adult ratsSemi-quantitative score was given by observing AWR to graded colorectal distention (CRD) when the rats were awake. The results indicated that AWR of IBS group was significantly increased to graded CRD compared with that of normal rats. IBS rats manifested the sign of visceral hyperalgeisa.1.3 Increased discharge of abdominal electromyograms (AEMGs) in IBS male ratsThe changes of AEMGs in response to graded CRD stimulation was recorded when the rats were under mild and stable anesthesia. The results indicated that AEMGs of IBS rats was abnormal increased in different intensities of CRD stimulation compared with that of normal rats, which reaffirm the occurrence of visceral hyperalgesia in IBS rats.1.4 Increased peristaltic wave (PW) in IBS ratsThe changes of PW in response to CRD stimulation were recorded when the rats were under mild and stable anesthesia. The results indicated that PW of IBS rats was increased in frequency compared with that of normal rats, which reaffirm the occurrence of disorders of gastrointestinal motility caused by visceral hyperalgesia in IBS rats.1.5 Comparison of diarrhea symptom in IBS and normal adult ratsThe diarrhea symptom was observed in adult IBS and normal rats. In IBS group, the stool was unshaped and the anus was full of stool trace. In normal group, the stool was shaped and the anus was clean.1.6 The comparison of body weight in adult IBS and normal ratsThe body weight of adult IBS and normal rat (9 d,14 d,19 d,24 d,29 d) was compared. The results indicated that no significant difference between body weight in adult IBS and normal rats, which implied that model fabrication itself had no influence on body weight.1.7 Histological examination of colorectal tissue in IBS ratsLocal histological changes were observed in adults IBS and normal rats. The results indicated that no abnormal infiltrations of neutrophil and interstitial edema were observed by naked eye and microscope in adult IBS and normal rat.Summary Animal model was improved according to method of Al-Chaer's and was proved to be a successful model of IBS. Obvious signs of visceral hyperalgesia were observed at peripheral and central levels by different methods in well-made adult IBS rats. The symptom of diarrhea was evident in IBS rat and the animal model belonged to functional chronic visceral hyperalgesia model. The behavior of IBS rats was stable and could last for long time.2 Electro-acupuncture (EA) relieved visceral hyperalgesia in IBS rats2.1 EA treatment decreased AWR score in IBS ratsThe instant effect (20-90 min after EA treatment stopped) of single EA on AWR score in IBS rats was observed. The rats were divided into four groups, normal group (normal), model group (model), model plus EA treatment group (model+EA) and model plus sham EA treatment group (model+sham EA). The results indicated that AWR in response to graded CRD stimulation (20,40,60,80 mmHg) of model+EA was significantly decreased compared with that in model group, while no change in group of model+sham EA. It suggested that EA treatment could remarkably relieve visceral hyperalgesia in short time after EA stopped.2.2 EA treatment inhibited AEMGs discharge in IBS ratsThe instant effect (20-90 min after EA treatment stopped) of single EA on AEMGs discharge in IBS rats was observed. The rats were divided into four groups, normal group (normal), model group (model), model plus EA treatment group (model+EA) and model plus sham EA treatment group (model+sham EA). The results indicated that discharge of AEMGs in response to graded CRD stimulation (20,40,60,80 mmHg) of model+EA was significantly inhibited compared with that in model group, while no change in group of model+sham EA. It again suggested that EA treatment could remarkably suppress visceral hyperalgesia in short time after EA stopped.3 The effect of EA treatments on disorders of gastrointestinal motility in IBS ratsThe effect of EA treatments on PW in IBS rats was observed. The rats were divided into four groups:normal group (normal), model group (model), model plus EA treatment group (model+EA) and model plus sham EA treatment group (model+sham EA). The results indicated that PW in response to CRD stimulation was significantly inhibited in EA treated group compared with that in model group, while no change in group of model +sham EA. It again suggested that EA treatment could remarkably suppress disorders of gastrointestinal motility caused by visceral hyperalgesia in short time after EA stopped.Conclusion1. The well-made IBS model prettily mimiced the symptoms of clinical disease of IBS mainly including evident and stable visceral hyperalgesia, so it was an ideal functional chronic visceral pain model.2. EA treatment could significantly relieve chronic visceral hyperalgesia in short time by behavioral and electro-physiological test.3. EA treatment could significantly relieve gastrointestinal motility abnormity. A direct and objective index--peristaltic wave was developed and applied to investigate the intestine motility function in IBS rat. Regulation of acupuncture information on high viscera cardiovascular--Inhibitory regulation of blood pressure of manual acupuncture at Nei-guan (PL-6) and Zu-san-li (ST-36) with different types in the anesthetized ratEffect of manual acupuncture (twisting; lifting and thrusting; combination of the above) at acupoints Nei-guan (PL-6) in the fore limb and Zu-san-li (ST-36) in the hind limb on mean arterial blood pressure was investigated in anesthetized rats with i.p. pentobarbital (50 mg/Kg) injection, followed by continuous infusion of 1% pentobarbital-PBS-solution (0.75-1 ml/h) intravenously. Ventilation of the animal was artificially applied and body temperature was kept between 37-38℃. Manual acupuncture was applied for 30 s with a frequency of 1 Hz by inserting a needle into the left side of PL-6 and ST-36 in the fore and hind limb, respectively. Mean arterial blood pressure was used as an indicator to judge the effect of manual acupuncture. Results showed that mean arterial blood pressure was decreased, but fluctuated in intact rats, and intensively decreased in all cases after vagotomy during manual acupuncture at PL-6, ST-36, respectively. The depressor response is significantly higher with combination treatment than others at PL-6 rather than ST-36. Meanwhile, the reductions of mean arterial blood pressure were completely abolished during manual acupuncture at either PL-6 or ST-36 after spinalization. These results suggest that manual acupuncture stimulation of either PL-6 or ST-36 is a supraspinal reflex response and leads to a reduction of the mean arterial blood pressure, particularly in the combination treatment at PL-6 rather than at ST-36.