| BackgroundLower urinary tract is a complete functional unit consisting of bladder and urethra. In a voiding cycle, urination function is mainly controlled by afferent nerve, sacral and efferent nerve.In recent years, the basic research showed that the micturition interval significantly increases in OAB rats when the periosteal of S3 receives acupuncture. And the frequency of micturition reduces when electro-acupuncturing (EA) Zhonglvshu(BL29) or Ciliao(BL32) of OAB rats. However, some studies suggested that bladder contractions and pressure incensement can be observed in normal cats when acupuncturing Ciliao(BL32). Moreover, acupuncturing Ciliao(BL32), Sanyinjiao(SP6), and Shenshu(BL23) will significantly improve the intravesical pressure and reduce the residual urine volume on the urinary retention of rabbit. Other studies indicated that micturition center’s electrical activity increases when acupuncturing Pangguangshu. In conclusion, acupuncture can not only inhibit, but also excite bladder. Thus, we consider that the acupuncture on regulation of bladder is a "dual effect", which is determined by the different state of the body.ObjectThe object of this paper is to evaluate the "dual effect" of acupuncture on bladder, namely acupuncture makes the bladder excite under the inhibited state and makes it inhibit in excited state. This "dual effect" depends on the different state, and the acupuncture regulating mechanism of bladder in afferent nerve is explored directly.Method1. In the normal physiological state of anesthetized rats, stimulate (manual-acupuncture, electro-acupuncture 2Hz, EA-15Hz) Sanyinjiao(SP6), hegu(LI4), Zhongliao(BL33)/ Ciliao(BL32) (random selection of acupuncture sequential) of rats while simultaneously recording urodynamic indices and EMG activity when the bladder detrusor contracts to observe the impacts posed by and the correlation with acupuncture.2. In the AUR state of anesthetized rats, stimulate (manual-acupuncture, electro-acupuncture 2Hz, EA-15Hz) Sanyinjiao(SP6), hegu(LI4), Zhongliao(BL33)/ Ciliao(BL32) (random selection of acupuncture sequential) of rats, while simultaneously recording urodynamic indices and EMG activity when the bladder detrusor contracts to observe the impacts posed by and the correlation with acupuncture..3. In the AUR state of anesthetized rats, stimulate (manual-acupuncture, electro-acupuncture 2Hz, EA-15Hz) Sanyinjiao(SP6), hegu(LI4), Zhongliao(BL33)/ Ciliao(BL32) (random selection of acupuncture sequential) of rats, while simultaneously recording urodynamic indices and EMG activity when the bladder detrusor contracts to observe the impacts posed by and the correlation with acupuncture..Result1. With any stimulation(manual-acupuncture, electro-acupuncture 2Hz, EA-15Hz) on the same nerve segment of bladder in SP6 or BL32/BL33, the voiding intervals of anesthetized rats under normal physiological state delayed, but it didn’t change in LI4 that was in different nerve segments of bladder.2. With any stimulation (manual-acupuncture, electro-acupuncture 2Hz, EA-15Hz) the same nerve segment of bladder in SP6 or BL32/BL33 under AUR state, the contraction time of bladder detrusor and the max detrusor pressure of rats were both increased, and the pressure after voiding and interval and micturition interval were all decreased, whereas the number of discharges of the pelvic nerve and bladder detrusor during the period of bladder contraction was increased, exciting the detrusor and the pelvic nerve afferent fibers to promote bladder contraction. Meanwhile, the dischargeing frequency of the detrusor in the proximal acupoints(BL32/33) (7.19+1.47) was superior to that of the distal acupoints (SP6)(5.84+1.61) (P< 0.05), but it did not change in LI4 which was in different nerve segments of bladder. This indicates that the effects of acupuncture on bladder function is associated with the postion of acupoints, i.e. the acupoint lies in which nerve segment of bladder.3. When any stimulation (manual-acupuncture, electro-acupuncture 2Hz, EA-15Hz)on the same nerve segment of bladder in SP6 or BL32/BL33 under OAB state, the contraction time of bladder detrusor and the max detrusor pressure of rats were increased and the pressure after voiding and interval decrease and micturition interval delayed, while decreasing the number of discharges of the pelvic nerve and bladder detrusor during the process of bladder contraction, and inhibiting the detrusor and the pelvic nerve afferent fibers to inhibit bladder contraction. Meanwhile, the max detrusor pressure (41.14±1.27) and micturition interval (165.22±21.85) in the proximal acupoints(BL32/33) were superior to those of the distal acupoints (SP6) (38.97±1.70) (128.80±22.99) (P＜0.01), but they were not changed in LI4 which was in different nerve segments of bladder. This indicates that the effects of acupuncture on bladder function is associated with the postion of acupoints, i.e. the acupoint lies in which nerve segment of bladder.ConclusionAccording to different body states of rats, acupuncturing acupoints of the same bladder nerve segment has "dual effect" on the bladder, and this effect is determined by the different pathological changes, which has excited effect under inhibited state and inhibited effect under excited state. Meanwhile, the effects of acupuncturing acupoint of proximal bladder nerve segments are superior to that of the distal acupoints, whereas the effects of acupuncturing the acupoints away from bladder nerve segments are not obvious, indicating that the "dual effect" is achieved through dominating the nerve activity of the bladder. Thus, the mechanism of "dual effect" may excite or inhibit afferent nerve activity to excite or inhibit bladder contraction. The effects of micturition period in Physiological state suggests that acupuncturing Sanyinjiao (SP6) delays micturition with inhibiting effect. We speculated that acupuncturing Sanyinjiao (SP6) poses inhibit effects in the normal bladder, but whether there are excited effect remains to be further confirmed... |
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