目的

研究电针足三里穴对失血性休克延迟补液大鼠肝肠组织血流量、含水率、血浆丙氨酸转移酶（ALT）、肠组织二胺氧化酶（DAO）活性的影响。

方法

取40只3个月龄、体质量为（270±30）g的SD雄性大鼠，按其全血容量的40%放血制成失血性休克模型。将造模后SD雄性大鼠随机分为4组，模型对照组（NT），立即补液组（IFR），电针非经穴延迟补液组（SEA/DFR）和电针足三里穴延迟补液组（EA/DFR），每组各10只。NT组造模后不做任何治疗处理；IFR组于失血后10 min即行补2倍失血量的乳酸林格液；EA/DFR组于失血后10 min电针足三里穴；SEA/DFR组于失血后10 min电针非经穴部位。失血后3 h，EA/DFR组和SEA/DFR组均实施延迟补液。分别测定4组大鼠失血前30 min及失血后3h和12h，肝肠组织血流量、血浆ALT含量、肠组织DAO活性及肝肠组织含水率。采用SPSS 17.0统计学软件进行统计分析。血浆ALT、肠组织DAO、肝组织血流量、肠黏膜血流量、肝肠组织含水率均以表示。上述各组间肝肠组织血流量、含水率、血浆丙氨酸转移酶、肠组织二胺氧化酶活性比较时采用两因素方差分析，两组间比较采用LSD-t检验。

结果

失血后IFR组和EA/DFR组的肝肠组织血流量、肠组织DAO活性显著高于NT组（均P﹤0.05），肝肠组织含水率、血浆ALT显著低于NT组（均P﹤0.05），而SEA/DFR组与NT组比较各指标无显著性差异。失血后3 h，IFR组的肝肠组织血流量、DAO含量显著高于其他各组（均P﹤0.05）、血浆ALT显著低于其他各组（均P﹤0.05），EA/DFR组血浆ALT水平显著低于SEA/DFR组（P﹤0.05），DAO和肠组织血流量显著高于SEA/DFR组（P﹤0.05），肝组织血流量与SEA/DFR组无显著性差别（P﹥0.05）；失血后12 h，EA/DFR组和IFR组血浆ALT水平和肝、肠组织含水率均显著低于SEA/DFR组（P﹤0.05），肝、肠组织血流量和DAO均显著高于SEA/DFR组（P﹤0.05），而IFR组的血浆ALT显著低于EA/DFR组（P﹤0.05），肝组织血流量和DAO显著高于EA/DFR组（P﹤0.05）。

结论

电针足三里穴对失血性休克延迟补液大鼠肝肠组织缺血性损伤具有一定保护作用。

Objective

To investigate the effects of electro-acupuncture of Zusanli points（ST 36）on the hepatic blood flow，intestinal blood flow，rate of liver water content，rate of gut water content，diamine oxidase（DAO）and alanine aminotransferase（ALT）of rats with delayed fluid replacement after hemorrhagic shock.

Methods

Forty SD rats were randomly divided into four groups（n=10），hemorrhage with no treatment（NT），immediate fluid resuscitation（IFR），delayed fluid resuscitation with sham electro-acupuncture（SEA/DFR）and delayed fluid resuscitation with electro-acupuncture Zusanli points（EA/DFR）.No treatment was performed for the rats in NT group after the establishment of the rat model.In IFR group，fluid replacement was performed 10 minutes later after blood loss.No-Acupoints and bilateral Zusanli points（ST 36）were electro-acupunctured with constant voltage 10 minntes after blood loss in SEA/DFR group and EA/DFR group respectively.The rats in both SEA/DFR group and EA/DFR group received delayed fluid resuscitation 3 hours after blood loss.ALT，DAO，the intestinal blood flow and the hepatic blood flow were measured before hemorrhage，3 hours and 12 hours after hemorrhage.The rate of tissue water content for 12 hours after hemorrhage was also determined.SPSS 17.0 software was used.ALT，DAO，hepatic blood flow，intestinal blood flow，rate of liver water content and rate of gut water content were to show with.The comparison between the two factor used analysis of variance，and comparison between the two groups used LSD-t test.SPSS17.0 software was used.ALT，DAO，hepatic blood flow，intestinal blood flow，rate of liver water content and rate of gut water content were expressed with.Two factor analysis of variance was used in multiple comparison and LSD-t test was used for two-group comparison.

Results

After hemorrhage，all parameters of IFR group and EA/DFR group were significantly improved by contrast with NT group.Three hours after blood loss（all P﹤0.05），the hepatic blood flow and DAO of IFR group were significant higher than those of the other groups（all P﹤0.05），while the plasma ALT of IFR group was significant lower than that of the other groups（all P﹤0.05）.The plasma ALT of EA/DFR group was lower than those of SEA/DFR group（P﹤0.05），DAO and the intestinal blood flow of EA/DFR group were higher than those of SEA/DFR group，and the hepatic blood flow of EA/DFR group showed no significant difference compared with that of SEA/DFR group（P﹥0.05）.Twelve hours after blood loss，the plasma ALTs and the rates of tissue water content of EA/DFR group and IFR group were significant lower than those of SEA/DFR group（all P﹤0.05）.The tissue blood flow and DA Os of EA/DFR group and IFR group were significant higher than those of SEA/DFR group（all P﹤0.05）.The plasma ALT of IFR group was significantly lower than that of EA/DFR group（P﹤0.05），while the hepatic blood flow and DAO of IFR were significantly higher than those of EA/DFR group（P﹤0.05）.

Conclusion

The results suggested that electro-acupuncture of Zusanli points（ST 36）alleviate hepatic ischemic injury in rats with delayed fluid resuscitation after hemorrhagic shock.