The clinical study of colonic transit time stimulated manual acupuncture and electo-acupuncture(ST25, ST37)

천추(天樞) 및 상거허(上巨虛)의 침자극(針刺棘)이 대장(大腸) 통과시간(通過時間)에 미치는 영향(影響)

  • Kim Dong-Woung (Dept. of Oriental Medicine Graduate School of Woo Suk University) ;
  • Lee Sang-Yung (Dept. of Oriental Medicine Graduate School of Woo Suk University) ;
  • Lee Chang-Hyun (Dept. of Oriental Medicine Graduate School of Woo Suk University)
  • Published : 1998.12.30

Abstract

Amis:ST25(Chonchu) and ST37(Sanggoho) are usually used acupoints to management several disease which induced to abnormal intestinal motility as diarrhea, constipation. Colonic transit time by radio opaque marker is able to study easily and useful method for evaluation of colonic motility. The aim of this study was to assess the effect on colonic transit time by manual acupuncture or electroacupuncture stimulation of ST25, ST37 in normal adult. Method: Colonic transit time, including Rt colon, Lt colon, rectosigmoid colon was measured by radio opaque marker in 11 normal adults. Colon transit time was measured before stimulation and after stimulation on ST25, ST37 by manual acupuncture and electroacupuncture. Each person was treated manual acupuncture or electroacupuncture stimulation for 3 days before colonic transit time measurement with 1 week interval. Result: Colon transit time before stimulation was measured $10.60{\pm}12.11$, $3.92{\pm}7.72$, $3.27{\pm}6.37$, $3.41{\pm}5.57$ hours total colon, Rt colon, Lt colon, rectosigmoid colon, respectively. Colon transit time after manual acupuncture is measured $10.48{\pm}12.35$, $3.72{\pm}7.52$, $3.37{\pm}6.76$, $3.39{\pm}5.84$ hours total colon, Rt colon, Lt colon, rectosigmoid colon, respectively. Colon transit time after electroacupuncture stimulation is measured $10.30{\pm}13.21$, $3.92{\pm}8.02$, $3.07{\pm} $, $3.31{\pm}5.49$ hours total colon, Rt colon, Lt colon, rectosigmoid colon, respectively. Significant change was observed Lt colon transit time after electroacupuncture as compared before acupuncture(P<0.05). Conclusion: Theses results suggest that manual acupuncture and electroacupuncture of ST25, ST37 in normal adults does not change colonic transit time.

목적: 현재 소화기 증상이 없고 정상적인 배변 양상과 습관을 갖고 있으며 과거력상 만성적인 소화기 계통의 질환이 없었던 정상 성인에게 대장운동과 관계있다고 알려진 천추와 상거허에 침자극하고 대장 통과시간의 변화를 관찰하고자 하였다. 방법: 정상 성인 11명의 침자극전 대장 통과시간을 방사선 비투과성 표지자인 Sitzmarks capsule을 사용하여 우측 및 좌측 대장과 직결장, 전대장 통과시간 등으로 나누어 측정한후 대장의 하합혈인 상거허와 복모혈인 천추에 단순유침 15분 및 전침으로 침자극하고 같은 방법으로 대장 통과시간을 측정하여 비교하였다. 결과: 침자극전의 대장 통과시간 측정은 전대장 통과시간이 $10.60{\pm}12.11$시간 이었으며 우측 및 좌측 대장과 직결장의 통과시간이 각각 $3.92{\pm}7.72,\;3.27{\pm}6.37,\;3.41{\pm}5.57$시간 이었다. 단순 15분 유침후 대장 통과시간의 측정은 전대장 통과시간이 $10.48{\pm}12.35$시간, 우측 및 좌측 대장과 직결장의 대장통과 시간이 각각 $3.72{\pm}7.52,\;3.37{\pm}6.76,\;3.39{\pm}5.84$ 시간으로 유의하지 않았다(P>0.05) 전침 자극후 대장 통과시간의 측정은 전대장 통과시간이 $10.30{\pm}13.21$, 우측 및 좌측 대장과 직결장의 통과 시간이 각각 $3.92{\pm}8.02,\;3.07{\pm}5.41,\;3.31{\pm}5.49$ 시간으로 좌측 대장 통과시간이 유의한(P<0.05) 단축 소견을 보였고 우측, 직결장의 통과시간은 유의하지 않았다(P>0.05). 결론: 본 연구의 결과로서 좌측 대장의 통과시간이 천추와 상거허에 전침 자극시 유의하게 단축되는 것을 확인 할 수 있었다. 이것은 전침이 신경계나 체액성 작용에 의해서 신경의 흥분성을 증가시켜 좌측 대장에서 직결장쪽으로 대장 내용물의 이동을 촉진하는 것으로 생각 할 수 있다. 그러나 단순 유침에서는 침자극전 대장 통과시간과 차이를 보이지 않음으로서 모든 침자극이 정상인의 대장운동이 변화를 일으키지는 않는 것으로 생각되었으며 더욱이 전침자극후 좌측 대장외에 우측 대장, 직결장은 단순 유침과 전침자극에 모두 변화가 없었고 전대장 통과 시간의 변화도 유의성이 없어 천추와 상거허의 침자극은 정상인의 대장운동에 영향을 주지는 않을 것으로 사려되었다.

Keywords

References

  1. Physiology of the Gastrointestinal Tract(2nd edi.) Leonard, R.J.;James Christensen
  2. 黃帝內經素問靈樞合編 馬元臺;張隱庵
  3. Cecil textbook of medicine Bennett and Plum
  4. Am. J Physiol. v.6 The movements of the intestines studied by means of roentgen rays Cannon, W.B.
  5. Gastroenterology v.92 Simplified assessment of segmental colonic transit Metcalf, A.M.;Philps, S.F.;Zinsmeister, A.R.;MacCarthy, R.L.;Beart, R.W.;Wolff, B.G.
  6. Am. J. Physiol. v.247 Enteric Neurophysiology Wood, J.D.
  7. 針灸學 全國 韓醫科大學 鍼灸經穴學敎室(編著)
  8. Disease Colon Rectum v.24 Segmental colonic transsit time Arhan, P.;Devroede, G.;Jehannin, B.;Lania, M.;Faverdin, C.;Dornic, C.;Person, B.
  9. J. Physiol. v.31 Antiperistalsis and other muscular activities of the colon Elliott, T.;Barclay-Smith
  10. Proc. R. Soc. Med. v.57 The distribution of faecal x-ray shadows in subjects without gastrointestinal disease Connell, A.M.;Lennard-Jones, J.E.
  11. Chen Tzu Yen Chiu v.19 no.2 Infiluence of stress on gastroenteric electric activity and modulated effect of acupuncture on it in rat Xu, G.
  12. Chung Hsi I Chih Tsa Chih v.11 no.3 Effect of acupuncture on intestinal motion and sero-enzyme acitivity in perioperation Liu, J.X.;Zhao, Q.
  13. Chen Tzu Yen Chiu v.19 no.2 Regulative effects of electroacupuncture on gastric hyperfunction induced by electrostimulation of the lateral hypothalamus area of rabbits Ma, C.;Liu, Z.
  14. Chung Kuo Chung Hsi I Chieh Ho Tsa Chih Jun v.13 no.6 Effect of electroacupuncture at ST36 point in regulating the pylorus peristaltic function Qian, L.W.;Lin, Y.P.
  15. 全國中醫經絡針灸學術座談會資料選編 X線觀察針刺對胃動力的改變 上海市 楊浦區 中心醫院 等
  16. 難經本義 v.下 滑壽
  17. 針灸學 楊甲三(主編)
  18. 大韓 消化器病學會雜誌 v.22 no.3 건강한 한국인에서 대장통과 시간 유석근;나용호
  19. Gastroenterology Clin Biol v.10 Measurement of colonic transit time:Description and validation of a new method Chaussade, S.;Roche, H.;Khyari, A.;Couturier, D.;Guerre, J.
  20. Z Gastroenterol v.28 no.8 Measurement of colon transit time time Schindlbeck, N.E.;Klauser, A.G.;Muller-Lissner, S.A.
  21. Correlative Neuroanatomy Degroot, J.;Chusid, J.G.
  22. Principles of Neural Science Small Molecules and Peptide Schwartz, J.H.
  23. Gastroenterology v.85 Arrangement of the myenteric plexus throughout the gastrointestinal tract of the opossum Christensen, J.;Rick, G.A.
  24. Exp. Brain Res. v.16 Les afferences splanchniques provenant des mecanorecepteurs gastrointestinaux et peritoneaux Ranieri, F.;Mei, N.;Crousillat, J.
  25. Research Int. J v.14 Connection found between each meridian and organ representation area of corresponding internal organs inside of the cerebral cortex. Acupuncture and Electrotherapeutics Omura, Y.
  26. Am J Gastroenterol v.92 no.9 Electrical stimulation of acupuncture points enhances gastric myoelectrical activity in humans Lin, X.;Liang, J.;Ren, J.;Mu, F.
  27. Exp Neurol v.94 no.1 Sympathetic effects of manual and electrical acupuncture of the Tsusanli knee point:comparison with the Hoku point sympathetic effect Ernst, M.;Lee, M.H.
  28. Gut v.35 no.8 Acupuncture inhibits vagal gastric acid secretion stimulated by sham feeding in healthy subjects Lux, G.;Hagel, J.;Backer, P.;Vogel, R.
  29. Anesteziol Reanimatol Mar-Apr no.2 Electroacupuncture stimulation in the treatment of postoperative disorders of the motor-evacuatory function of the stomach and intestines Ponpmarenko, T.P.;Khakimov, S.A.;Derzhavina, I.N.;Belitskaia, R.A.
  30. Effects of acupuncture and moxibusion on intestinal motility in mice v.22 no.2 Iwa, M.;Sakita, M.
  31. Chen Tzu Yen Chiu v.15 no.3 An approach to mechanism of function of auricular point Liu, W.;Xu, G.
  32. American J. of Chinese Medicine v.XIX Acupuncture to the skin induces release of substance P and calcitonin gene-related peptide from peripheral terminal of primary sensory neurons in the rat Kashiba, H.;Ueda, Y.
  33. Am J. v.8 no.4 Central neurotransmitters and acupuncture analgesia Han, J.S.;Tang, J.;Ren, M.F.
  34. Am J Gastroenterology. Oct. v.87 no.10 The effect of acupuncture on gastrointesinal function and disorders Li, Y.;Tougas, G.;Chiverton, S.G.;Hunt, R.H.