| Background :Stellate ganglion block is a practical and widely used clinical technology in the field of pain in recent years.It can be used in the treatment of cardiovascular disease,chronic pain,insomnia and other diseases.However,the stellate ganglion is adjacent to the large blood vessels,pleura and spinal canal in the neck.During the block,there may be serious complications such as vascular injury,pleura injury,local anesthetic drugs mistakenly entering the spinal canal or local anesthetic poisoning.Whether an alternative method can be used to achieve the same effect as stellate ganglion block has always been the focus of pain medicine.Based on the similar clinical effects of acupuncture at Neiguan point and stellate ganglion block,the anatomical connection between Neiguan point and stellate ganglion,this study speculates that Neiguan point and stellate ganglion may be closely related.It is to be confirmed that electroacupuncture at Neiguan acupoint can inhibit the discharge effect of stellate ganglion,and achieve the same inhibition effect as stellate ganglion block,so as to find a more safe and convenient alternative therapy for stellate ganglion block.Part 1 The establishment of a monitoring model of stellate ganglion discharge in ratsMethods :30 healthy SD rats which aged 6-7 weeks and weighed from 230 g to 270 g were chosen of either sex.The left stellate ganglion was isolated and hung on the platinum electrode head to observe its electrical signal continuously after anesthesia.The heart rate and respiratory frequency of rats were recorded immediately after anesthesia(T0),immediately after the stellate ganglion was suspended on the electrode head(T1)and 10 minutes(T2),20 minutes(T3),30 minutes later(T4).The discharge frequency and amplitude of the stellate ganglion were recorded from T1 to T4.After recording the nerve electrical signal at T4,0.2% lidocaine 0.2 ml was locally infiltrated the stellate ganglion and then the discharge frequency and amplitude,as well as the heart rate and respiratory frequency were recorded 5 minutes later(T5).The occurrence of Horner’s syndrome(left blepharoptosis and little fission)is a sign of successful block,and the number of successful cases of block was recorded.Results :Two rats died and 28 rats were included in the experiment.There was no significant difference in heart rate and respiratory frequency between T1-T5(P >0.05).We got paroxysmal clustered,rhythmically regular neuroelectrical activity of stellate ganglion at T1-T5,there was no significant difference in the frequency and amplitude of nerve discharge at T1-T4(P > 0.05).The discharge frequency and amplitude of stellate ganglion decreased at T5,which compared with T1-4(P < 0.01).The left Horner sign appeared in all 28 rats,and the success rate of block was 100%.Conclusion:The discharge monitoring model of stellate ganglion was established successfully in rats,and the stable nerve electrical signal was obtained.Part 2 The effect of electroacupuncture at Neiguan on electrical signal of stellate ganglionMethods :90 healthy SD rats which aged 6-7 weeks and weighed from 230 g to 270 g were chosen of either sex.They were randomly divided into 9 groups: Group L10,group L20 and group L30 in the low frequency(2Hz)electroacupuncture,group M10,group M20 and group M30 in the medium frequency(50Hz)electroacupuncture,group H10,group H20 and group H30 in the high frequency(100Hz)electroacupuncture,10 rats in each group.The left stellate ganglion was isolated and hung on the platinum electrode head after anesthesia.According to the groups,different frequency and time of electroacupuncture were selected,recording the heart rate 、 respiratory frequency、discharge frequency and amplitude of stellate ganglion before(T0)and after electroacupuncture(T1).Results :1.90 rats were included in the experiment,there was no significant difference in heart rate and respiratory frequency between T0 and T1 in each group(P > 0.05).Nither of difference in discharge frequency and amplitude of stellate ganglion at T0(P > 0.05).Compared with T0,there was no statistical difference in L10,L20 and L30 groups(P > 0.05),while statistical difference in the other groups(P < 0.01).2.Comparison with the same electroacupuncture time but different frequency:(1)After 10 min electroacupuncture,the discharge frequency and amplitude of group H10 were lower than that of group M10 and L10(P < 0.001);the discharge frequency and amplitude of group M10 were lower than that of group L10(P < 0.001).(2)After 20 min electroacupuncture,the discharge frequency and amplitude of group H20 were lower than that of group M20 and L20(P < 0.001);the discharge frequency and amplitude of group M20 were lower than that of group L20(P < 0.001).(3)After 30 min electroacupuncture,the discharge frequency and amplitude of group H30 were lower than that of group M30 and L30(P < 0.001);the discharge frequency and amplitude of group M30 were lower than that of group L30(P < 0.001).3.Comparison with the same electroacupuncture frequency but different time:(1)With 2Hz electroacupuncture,the discharge frequency and amplitude of group L30 are lower than that of group L20 and L10,but there is no statistical difference(P > 0.05);the discharge frequency and amplitude of group L20 are lower than that of group L10,but neither of difference(P > 0.05).(2)With 50 Hz electroacupuncture,the discharge frequency and amplitude of M30 group were lower than that of group M20 and M10(P < 0.001);the discharge frequency and amplitude of group M20 were lower than that of group M10(P < 0.01).(3)With 100 Hz electroacupuncture,the discharge frequency and amplitude of group H30 were lower than that of group H20 and H10(P < 0.001);the discharge frequency and amplitude of group H20 were lower than that of group H10(P < 0.001).4.Comparison with the different electroacupuncture time and frequency:The discharge frequency and amplitude of group H10 were lower than that of group M20,but there was no statistical difference(P > 0.05),the other groups had statistical difference(P < 0.05).5.Correlation analysis of the electroacupuncture time and frequency: the time of electroacupuncture,the frequency of electroacupuncture and their interaction were all significant factors(P < 0.001).The correlation coefficient of the inhibition rate of the effect of acupuncture time and frequency on the electrical signal of stellate ganglion(rs > 0.5,P < 0.001).There was no significant difference in the inhibitory rate of electrical signal of stellate ganglion between group H10 and group M20(P > 0.05).Conclusion:Electroacupuncture at Neiguan point can inhibit the electrical signal of stellate ganglion.The time of electroacupuncture,the frequency of electroacupuncture and their interaction were all significant factors affecting the electrical signal of stellate ganglion.There was a positive correlation between the inhibition of stellate ganglion electrical signal and the time and frequency of electroacupuncture,and it may be related to the total amount of electrical stimulation. |
PDF Full Text Request