hemorrhagic shock. Chen-Tzu-Yen- Chiu 15: 140-142.
SUMMARY
Assess variations in some indicators of hematology and ECG under the influence of acupuncture Zusanii point
The aim of this study was to compare effects of tonic and dispersal acupuncture stimulated manually by hand with those stimulated automatically electrical impulses on acupuncture points, specifically on Zusanii point (St36). The experiment was done on 20 healthy adult rabbits.
Parameters monitored were numbers of red blood cells (RBC), white blood cells (WBC), and ECG. The results showed that the tonic
stimulation on Zusanii point by hand and by electrical impulses increased mildly the numbers of RBC and WBC, whereas dispersal stimulation on this point by electrical impulses increased more strongly RBC and WBC in peripheral blood (p<0,05) than dispersal stimulation by hand. For ECG waves, tonic stimulation by hand and electrical impulses decreased mildly the magnitude of QRS complex, and dispersal stimulation by hand and electrical impulses caused an increase in the magnitude of QRS complex with equal increased levels (155% - 160%).
Key words: acupuncture, Zusanii
point, ECG
ANH HU-aNG COA DIEN CHAM HUYET TUC TAM LY TQI MOT S 6 CHI S 6 COA HE NOI TI^T VA TIEU HOA
Nguyin Ba Quang
Hpc vien Y Dugc hoc co truyen Viet Nam
Muc tieu nghien ciru cua cdng trinh niy la so sanh tic dung chim bd vi ti bang tay
vi bang cic xung dien len huyet Tuc tam ly. Thi nghiem dwgc tien hinh tren 20 thd dwc
trwdng thanh, khde manh. Cic thdng sd dwgc nghien cwu la ham Iwgng acetylcholin vi
catecholamin trong miu va tin s6 nhu ddng rugt cua thd trwdc va sau cham bd va ta bang
tay va bang xung dien. Acetylcholin dwgc djnh Iwgng theo phwang phap cua Khestrin, cdn
catecholamin dwgc djnh Iwgng theo phwang phip ciia Smaznov. Nhu ddng rugt cua thd
dwgc ghi bang each phau thuat dwa rugt ra ngoai, xic djnh hdi tring roi cd djnh mdt diu
cua doan rugt, diu khic dwgc noi vdi but ghi. But ghi se ghi nhu ddng rugt tren bang giiy
quin tren tru ghi chay vdi tdc do 0,1 mm/giay. Kit qua cho thiy khi kich thich bo bang
xung dien ham Iwgng acetylcholin trong miu thd tang len 123%, so vdi miic acetylcholin
ban diu, cao han so vdi mu'c tang ham Iwgng chit nay khi cham bd va cham ta bang tay
(105% vi 110% so vdi mwc trwdc cham). Trong khi dd dwdi tic dung cham bo va ti bing
may cQng nhw bang tay ham Iwgng catecholamin deu tang len mdt cich twang dong vi
bang 200%, mwc catecholamin trwdc khi chim. Doi vdi he tieu hda thi kich thich bo bang
Vietnam Journal of Physiology 13(3), 12/2009 ISSN: 1 8 5 9 - 2 3 7 6
xung dien tin so nhu ddng rugt cua thd tang len 132%,, cao han so vdi chim ta bang tay (dat 108% so vdi mire trwdc cham).
TCr khoa: acetylcholin, catecholamin, Tue tam ly
1 . D A T V A N D &
Huyet Tuc tam ly la mdt trong nhung huyet quan trgng dugc cac nha nghien cu'u ca ban v l huyet cQng nhu cac t h i y thulc lam sang thudng xuyen sur dung d l d i l u tri nhQ'ng benh v l tieu hda, t h i n kinh, ndi tilt, suy nhugc ca t h i . Huyet nay dugc coi la huyet ed tae dung lam eudng trang ca the, do dd, dugc ap dung r i t rdng rai trong phdng va dilu tri benh [5]. Nam 1989, Yang J. va cdng sy [10] da t i l n hanh cham huyet Tuc tam ly va nhan t h i y cd tac dung dilu hda chu'c nang tieu hda. Khi dieu tri benh tieu chay d tre em Liu Y. va cdng s u [4]
eho thiy cham huyet Tuc tam ly lam tang nhu ddng rugt non. 6" benh nhan phiu thuat bung, Liu J.X. va edng sy [8] da quan sat thiy cham ciru huyet Tam am giao va Tiic tam ly cd tae dung tang van dgng eua rugt non, lam cho trung tien xay ra nhanh ban. Tae gia cQng nhan t h i y cham huyet Tuc tam ly cd tae dung thiie d i y qua trinh phuc hdi t l bao bj t i n thuang. Day cQng la dilu dang duge cac nha ngoai khoa quan tam, ap dung, vi k i t qua d i l u tri bang cham ciru tot, loai trir dugc mdt sd biin churng do gay me va phiu thuat gay ra.
Mdt so tac gia cung nhan t h i y cham huyet Tiic tam ly lam tang p-endorphin d niem mac da day, mdn vj, ta trang, hong trang, hoi trang cung nhu lam biin ddi chirc nang ngi tilt cua hypothalamus, tuyin
yen, tuyen thugng than. Vdi cudng do xung dien t h i p dien cham lam giai phdng catecholamin tir tuy thugng than, nhung vdi t i n s l va cudng do cao dien eham lai lam tang rd ndng do catecholamin trong mau ngoai vi (theo [3], [6]).
D l lam rd tac dung bd ta trong khi cham ehiing tdi t i l n hanh de tai anh hu'dng cua dien cham huyet Tiic tam ly t d i mot s d c h i s6 cua he noi t i l t va tieu hoa nhim danh gia s y biin doi ham lugng Acetylcholin, Catecholamin trong he ndi tilt va nhu ddng cua rugt d thd thf nghiem khi cham bo va cham ta huyet Tiic tam ly dugc kfch thfch huyet bang tay va b i n g may.
2. D 6 | TU'gNG VA PHLFONG P H A P NGHIEN CU'U
2.1. Ddi tu'O'ng nghien cii'u
- 20 thd due cd t h i trgng 2,2- 2,5 kg/con.
- Ddng vat dugc cham sde, theo ddi tinh trang an uIng va boat ddng trude khi nghien ciru tur 3-5 ngay.
2.2. Phu'ang phap va cac chl tieu nghi§n CU'U
2.2.1. Phirang phap xae dinh vj t r i huyet Tuc tam ly
Huyet Tuc tam ly d thd ndi dung ban la d i i m tuang D'ng vdi huyet Tuc tam ly d ngudi duge xae djnh theo mdc giai p h l u va md ta trong cac atlas huyet d ddng vat eua Plakhotin M.V. [10] (gde dudi ngoai cua
d i u g i i chan sau xuong 1,2 mm each b d trudc cua xuang phfa ngoai d n g ehan 3mm).
2.2.2. Phu'ang p h i p c h i m
C h i m b l : eham xudi theo dudng kinh, kich thieh huyet bang tay thi ve kim xudi theo chilu kim ddng hd 5 phut/lin. Kfch thfch huyet bang may thi ve kim theo kenh b l vdi t i n so 2Hz, cudng do 15 |JA. Thdi gian kieh thfch la 30 phut.
Cham ta: cham ngugc chieu dudng kinh, kfch thfch huyet bang tay: ve di ve lai, 5 phut/lin. Kieh thfch huyet bing may thi theo kenh ta vdi t i n sd 5Hz, cudng do 15 pA. Thdi gian kich thfch la 30 phut.
2.3. Cac phu'ang p h i p nghien cii'u chu'c nang cac he t h i n g c a quan d' dong vat 2.3.1. Ddi v a i he tieu hoa
Hoat ddng nhu ddng cua rugt thd dugc ghi true tilp theo phuang phap khuie rugt tai chd. Cach t i l n hanh nhu sau: mo bung thd, xae djnh hoi trang, co djnh lai, diing but ghi vao bang giiy, tdc do bang giiy chay tren try ghi la 0,10 mm/s (theo [2]). Van ddng eo bdp euia rugt dugc ghi trudc, trong khi cham va sau 30 phut cham.
2.3.2. Nghien ciru ham liFgng Acetylcholin v i Catecholamin trong mau tho t r i r a c va sau c h i m
Ham lugng catecholamin va acetylcholin dugc xae djnh tu" mau tTnh mach cua tai thd trudc khi cham te va sau khi cham 30 phiit. Djnh lugng acetylcholin theo phuang phap Khestrin. Nong do catecholamin trong mau thd duge xae djnh theo phuang phap ciia Smaznov (theo [3]). Ham lugng
acetylcholin va catecholamin dugc xae djnh tai Bd mdn Sinh hda- Hge vien Quan y-
2.4. Phu'ang tien nghien cii'u.
- May dien eham Mg do benh vien Cham CU'U TW san x u i t nam 2000 (1^ may hai t i n so cd tac dung b l , ta).
- Kim cham la kim Viet Nam san x u l t bang inox, kim cd dudng kfnh 0,3 - 0,4 mm, dai 3 cm dung cho ddng vat
- May soi vi t u i n hoan (Lien Xd), try ghi nhu ddng ciia rugt, ban phiu thuat, bdng, kep vd khuan, cdn 70°, khay nhdm dung dung eu.
2.5. Xu> ly s d lieu.
Cac so lieu thu dugc trong nghien cii'u d i u dugc tfnh toan, xii' ly theo phuang phap toan thong ke y sinh hge.
3. K^T QUA NGHIEN CU'U
3.1. B i i n doi mot s6 c h i t trung gian hoa hoc (Acetylcholin, Catecholamin) tru'dc va sau c h i m huyet Tuc tam ly.
K i t qua v l nhQ'ng b i i n d i i trong ning do mdt s l c h i t trung gian hda hge trudc va sau eham bd huyet Tiic tam ly dugc trinh bay tren bang 1.
K i t qua tren bang 1 cho thiy:
- Sau khi cham bo bang tay va b l bing may ham lugng acetylcholin trong mau tho tang len rd so vdi trude dien cham vdi p<0,05. Khi b l bang may ham lugng chit nay tang cao han so vdi b l bang tay.
- Sau khi cham b l bang tay va bo bing may ham lugng catecholamin tang len rd so vdi trudc cham vdi p<0,05. Khi bd
Vietnam Journal of Physiology 13(3), 12/2009 ISSN: 1 8 5 9 - 2 3 7 6
bang tay va bd bang may ham lugng chit nay tang len tuang dong nhau vdi p>0,05.
Bang 1. Biin ddi mgt sd chit trung gian hda hge acetylcholin, catecholamin trudc va sau cham bd huyet Tue tam ly
XThdi d i i m va ky
\ t h u a t cham Chit \ . trung gian hda
hge \ Acetylcholin
(iamol/1)
Catecholamin (mmol/l)
Trude cham (n=5)
(1)
2,87 ±0,27
0,032+0,017
Sau cham (n=10)
Bd bang tay (2)
2,98 ±0,57
0,080 ±0,013
Bo bang may (3)
3,31 ±0,26
0,078 ±0,008
P
Pi.2 <0,05 Pi-3<0,05 P2-3 <0,05 P1-2 <0,05 Pi-3<0,05 P2.3 >0,05
Sy biin ddi nong do acetylcholin va t catecholamin trude va sau eham ta huyet Tiic tam ly dugc trinh bay tren bang 2.
Qua bang 2 thiy rd:
- Sau khi eham ta b i n g tay va ta bang may ham lugng c h i t acetylcholin trong mau ngoai vi eua thd tang len rd so vdi
rude khi cham. Khi cham ta bang tay va ta bing may thi ham lugng chit nay tang len tuang ddng vdi p>0,05.
- Sau khi cham ta b i n g tay va ta bang may thi ham lugng catecholamin trong mau ngoai vi cua thd tang len tuang ddng nhau.
Bang 2. Biin ddi mdt sd chat trung gian hda hge acetylcholin, catecholamin trude va sau cham ta huyet Tuc tam ly
N i M ' i diem va ky
\ t h u a t eham Chit \ ^ trung gian rroa
hge \ \ Acetylcholin
(iamol/1) Catecholamin
(mmol)
Trude cham (n=5)
(1)
2,676 ±0,412
0,033+0,019
Sau cham (n=10)
Ta bang tay (2)
3,262 ±0,684
0,085 ±0,02
Ta bang may (3)
3.208 ±0,069
0,082 ±0,004
P
P1.2 <0,05 P1-3 <0,05 P2-3 >0,05 Pl-2 <0,05 P1-3 <0,05 P2-3 >0,05
3.2. Biin ddi bien do va tin s6 nhu dong ruot trirdc va sau chim huyet Tuc tam ly Kit qua nghien ciru sy biin ddi nhu ddng rugt cua thd trong nhQ'ng dilu kien
khae nhau dugc trinh bay tren bang 3, 4 va hinhl.
Bang 3. Biin doi bien do va tin so nhu ddng rugt cua thd trudc va sau cham bo huyet Tiic tam ly
"""Tbdi diim va ky
^ h ! j | t cham Chl s l ^ \
T i n sd (m/s)
Bien do (e/s)
Trudc cham (1) 7,0 ±0,6
17,0 ±2,0
Sau cham Bd bang tay
(2) 6,5 ±0,5
17,0 ±1,0
Bo bang may (3) 8,5 ±3,5
16,0 ±1,0
P
Pi-2 <0,05 Pi-3 <0,05 Pi.2 >0,05 Pi-3 <0,05 P2.3 <0,05
Kit qua tren bang 3 cho thay sau khi
eham bd bing tay tin sd nhu ddng rugt ed giam di so vdi trude eham, edn eham bo bing may thi tin s l nhu ddng rugt tang len rd so vdi trudc cham vdi p<0,05. Sau khi
cham bd bang may bien do nhu ddng rugt giam so vdi trudc cham vdi p<0,05, cdn cham bd bing tay khdng cd su khae biet theo bien do nhu dgng rugt so vdi trude cham.
Bang 4. Bien ddi bien do va tin sd nhu ddng rugt euia thd trudc va sau cham ta huyet Tiie tam ly
K^di diim va ky muat eham
Chl sd ^ \ T i n sd (m/s)
Bien do (c/s)
Trudc cham
(1) 6,5 ±0,1
16,5 ±1,5
Sau cham Ta bing tay
(2)
7,05 ±0,45
16,5 ±2,5
Ta bang may (3)
7,9 +0,7
15,0 ±0,1
P
Pi.2<0,05 P2-3 <0,05 Pi.2>0,05 P2-3 <0,05
Qua bang 4 thiy rd sau khi cham ta ddng rugt tang len rd so vdi cham ta bing
bing tay va bing may tin sd nhu ddng rugt tay. Sau khi cham ta bing may bien do nhu
diu tang len so vdi trudc eham vdi ddng rugt giam so vdi trudc dien eham vdi
p <0,05. Cham ta bing may thi tin so nhu p>0,05.
Vietnam Journal of Physiology 13(3), 12/2009 ISSN: 1 8 5 9 - 2 3 7 6
vliv^'.
•-J' j
i
•/V-
/ 4• ^ V ^ ' •' ^'
:^W\J'^\^\
Hinh 1. Nhu ddng euia rugt thd trong nhu'ng d i l u kien khae nhau. 1. Trudc cham; 2. Cham bo bang may; 3. Cham bd bang tay; 4. Cham ta bing may; 5. Cham ta bing tay.
4. BAN LUAN
4.1. Anh hirdng cua t i c dung chim huyet Tuc tam ly theo phirang phap bo va ta ddi vdi mot sd chit trung gian hda hoc trong m i u ngoai vi thd
4.1.1. Khi eham bo huyet Tue tam ly bang tay, bing may ta t h i y ham lugng acetylcholin va catecholamin tang len rd so
vdi trudc cham. Cham b l b i n g may lam cho ham lugng catecholamin tang len rd ban so vdi b l b i n g tay. C h i t nay cd tac dung lam tang kha nang hoat hda cua he giao cam, r i t ed the lam tang kha nang co bdp cua tim, lam tang huylt ap cung nhu t i n s l eua tim [2], [4]. Do dd, ngudi ta thudng cham bo huyet Tuc tam ly d l dilu
tri cae chu'ng choang, ngat. Nhan xet nay phu hgp vdi nhan xet cua cac tac phim kinh d i l n cho ring "hQ'u vj khi t i e sinh, vd vi khf t i e tur" [5]. Chfnh vi vay trong thyc t l lam sang r i t it khi ngudi ta cham ta huyet Tue tam ly ma thudng eham binh bd binh ta.
4.1.2. Khi cham ta huyet Tiie tam ly ham lugng acetylcholin va catecholamin d i u tang len rd so vdi trudc khi cham va eao han so vdi trudng hgp cham bo. Dieu nay eho thiy khi cham ta huyet Tuc tam ly cd kha nang kfch hoat manh he t h i n kinh giao cam va phd giao cam; giiip cho ca t h i vugt qua duge nhQ'ng can dau [1], [7]. Chinh vi vay ngudi ta cham huyet Tue tam ly d l dilu tri chirng dau d vung bung tren khdng phai do nguyen nhan ngoai khoa. Mat khae ngudi ta cham huyet Tue tam ly d l phlu thuat da day, rugt nhd phuang phap vd cam bang cham te.
4.2. Anh hu'dng cua t i e dung cham huyet Tuc tam ly theo phirang phap b l ta d i n bien do va t i n sd nhu dong cua ruot non
4.2.1. Khi cham bd bing may t i n s l nhu dgng rugt tang len rd so vdi b l bing tay, cdn bien do lai giam xudng. D i l u nay churng td ring khi eham bd lam tang kha nang co bdp cua rugt, ddng nghTa vdi tang sy h i p thu cac chit dinh dudng qua rugt [2]. Do dd, ngudi ta thudng diing ky thuat eham b l huyet Tue tam ly d l dilu trj eac chu'ng Ty hu, Ty vi hu ban, Tam ty hu t i n . Than ty hu trong eac chu'ng suy nhugc ca
t h i , chung hu lao, ngudi ldn g i y yeu, kem an hoac tre em suy dinh dudng.
4.2.2. Khi cham ta bang cae xung dien t i n sd va bien do nhu dgng rugt d i u tang len rd so vdi cham ta b i n g tay. D i l u nay chu-ng minh kha nang co bdp cua rugt tang len cd tac dung d i y cac c h i t la hoac cac ddc t l ra ngoai ca t h i [10]. Do dd, ngudi ta thudng cham ta huyet Tuc tam ly d l d i l u tri eae chu'ng ngd ddc thu'c an, nang cao chfnh khf cua ca t h i giiip cho benh nhan chdng hoi phue. Mat khae, khi cham ta huyet Tue tam ly ed tae dung giam dau vung bung nhu da trinh bay d tren.
5. KET LUAN
Qua nghien curu kfch thfch bo bing tay, bang may va ta bang tay, bang may huyet Tuc tam ly tren 20 thd thye nghiem eho thiy:
- Kfch thfch bd bang may ham lugng acetylcholin tang len 123%, cao han so vdi kfch thfch ta b i n g tay (ehi tang 110%), ddng thdi cQng cao ban so vdi bd bing tay (chl tang 105% so vdi mii'c ban diu). Ham lugng c h i t catecholamin khi b l , ta bing tay va bang may tang len mdt each tuang ddng va eao ban so vdi trude cham la 200%.
- Khi kfch thfch b l bang may thi t i n s l nhu dgng rugt non cua thd tang len 132% cao han ta bang may (122%) va eao ban ta bang tay (108%) so vdi mure trude cham, cdn bien do nhu ddng rugt lai giam (10%
b i n g may, 6% b i n g tay) so vdi trudc khi cham.
Vietnam Journal of Physiology 13(3), 12/2009 ISSN: 1 8 5 9 - 2 3 7 6
TAI LIEU THAIVl KHAO
1. Tru'ang Viet Binh (1993), Gdp phin nghien eiru eham te thye nghiem va tae dung ciia cham te p h i i hgp vdi thulc hd trg trong phlu thuat san phu khoa, Tdm t i t luan an PTS khoa hge Y Dugc, Ha Ngi, Thu vien Y hge Trung uang.
2. Vu V i n Lap (1996), Nghien ciru dac diim huyet Tuc tam ly va anh hudng ciia dien cham huyet nay len chu'c nangmgt s l a quan trong ea t h i , Tdm t i t Luan an PTS khoa hge y dugc, Thu vien Y hge trung uang.
3. N g u y i n Ba Quang (2000), Nghien ciru tac dung ciia cham te trong phlu thuat Budu tuyin giap. Luan van T i l n sT, tr 49-50.
4. N g u y i n Van T I P (1998), Nghien cu'u dac d i i m huyet Tam am giao va tac dung ciia dien cham huyet nay len mdt so chl sd sinh ly, Luan an T i l n sT tr 4 4 - 45.
5. Y hoc c l t r u y i n (2008), Bd Mdn Y hge cd truyin - Trudng Dai hge Y Ha Ndi, Nha x u l t ban Y hge.
6. Bao H., Zhou Z., Yu Y., Han J . (1991), C-fiber is not neccesary in Electroacupuncture analgesia, but necessary in diffuse noxious inhibitory control (DNIC), Chen-Tzu-Yen-Chiu, 16: 120-124.
7. Daivis R., Koelle G.B. (1976), Electron microscopic localization of acetylcholinesterase anh non - specific cholinesterase at the neuromuscular
junction by the goldthiocholine anh goldthioaecetic methods, J Cell Biol.
8. Liu X. (1993), Effect d acupuncture and point-injection treatment on immunologic function in rheumatoid arthriitis. J Tradit Chin Med, 13: 174- 178.
9. Tang Z., Song X. (1990), The effect d acupuncture on the changes of ANP and All in plasma of rabits with the hemorrhagic shock, Chen-Tzu-Yen- Chiu 15: 140-142.
10. Yang J., Liu W.Y., Song C. Y. (1989), Effect of acupuncture of zusanii (St- 36) on the content of beta- endorphin of the gastrointestinal tract in rats, Chung - Hsi -1 - Chieh- Ho - Tsa- Chih.
SUMMARY
Effects of electrical acupuncture on Zusanly point to some indicators of the
endocrine and digestive systems The aim of this study was comparing effects of tonic and dispersal stimulation manually by hand and by stimulated automatically electrical impulses on Zusanii point (St36). The experiment was conducted using 20 healthy adult rabbits.
Parameters investigated were blood concentrations of acetylcholine and catecholamine and frequency of intestinal peristalsis before and after tonic and dispersal stimulations by hand and by electrical impulses. Acetylcholine and catecholamine concentrations were quantified by Khestrin's method and Smaznov's method, respectively. Intestinal
peristalsis was recorded by a surgery taking intestines out, determining ileum and then fixed a head of an intestine piece while the other head was connected to a recording pen. The recording pen recorded peristalsis activity on a paper rolling over a rotating pillar running by electrical pulses at the speed of 0.1 mm/sec. The results showed that tonic stimulation by electrical impulses increased rabbit blood acetylcholine to 123%, compared with its initial level, more than the increase of this substance when applying tonic and dispersal stimulations by hand (increased 105%, and 110% compared with those
before acupuncturing, respectively).
However, under the effects of tonic and dispersal stimulations by electrical impulses as well as by hand the catecholamine level were equally increased by 200%, compared with that of before acupuncturing. For intestinal system, tonic stimulation by electrical impulses increased rabbit intestinal peristalsis about 132%,, more than that of dispersal stimulation by hand (upped 108% compared with that of before acupuncturing).
Key words: acetylcholine,
