Inhibiting effect of electroacupuncture at zusanli on early inflammatory factor levels formed by postoperative abdominal adhesions.

Lijian Zhang,Lu Wang,Daniela Litscher,Huizhen Wang,Xian Shi,Gerhard Litscher,Zhenjun Huang,Ingrid Gaischek,Sen Hu

doi:10.1155/2014/950326

Abstract

We observed the inhibitive effect of electroacupuncture (EA) at Zusanli on inflammatory mediators of postoperative intra-abdominal adhesions to find out the relationship between EA and the cholinergic anti-inflammatory pathway. Sixty-four rats were divided into 8 groups (A–H, each = 8): A = sham control; B = abdominal adhesions model; C = abdominal adhesions plus EA; D = sham acupoint control; E = abdominal adhesions plus vagotomy; F = abdominal adhesions plus EA after vagotomy; G = abdominal adhesions plus α-bungarotoxin (BGT); and H = abdominal adhesions plus EA after α-BGT. α-BGT (1 μg/kg) was injected into the abdominal cavity after surgery, and the bilateral celiac vagotomy was done during the surgery. On the third day the levels of inflammatory mediators (TNF-α, nitric oxide (NO), and nitric oxide synthase (NOS)) in tissues were evaluated. The abdominal adhesion groups developed obvious edema. Compared with sham control, the abdominal adhesion resulted in a significant elevation of inflammatory mediators. EA lowered the elevated levels of inflammatory mediators significantly; EA plus α-BGT and vagotomy showed less anti-inflammatory effects. The activation of the cholinergic anti-inflammatory pathway might be one of the mechanisms of EA at Zusanli acupoints to exert the anti-inflammatory effects.

Highlights

Abdominal adhesion is a common complication in pelvic surgery, with an incidence of up to 90%
Sixty-four rats were divided into 8 groups (A–H, each = 8): A = sham control; B = abdominal adhesions model; C = abdominal adhesions plus EA; D = sham acupoint control; E = abdominal adhesions plus vagotomy; F = abdominal adhesions plus EA after vagotomy; G = abdominal adhesions plus α-bungarotoxin (BGT); and H = abdominal adhesions plus EA after α-BGT. α-BGT (1 μg/kg) was injected into the abdominal cavity after surgery, and the bilateral celiac vagotomy was done during the surgery
Compared with group C, groups B, D, E, F, G, and H had a significantly increased Tumor necrosis factor-α (TNF-α) content (P < 0.01 or P < 0.05), which shows that EA was able to significantly reduce early tissue TNF-α levels of abdominal adhesion but not to reach to the level of Group A

Summary

Introduction

Abdominal adhesion is a common complication in pelvic surgery, with an incidence of up to 90%. Severe cases can lead to intestinal obstruction and female infertility, bringing great suffering and a heavy burden to the patient [1]. Injury, and foreign body irritation during surgery, large amounts of proinflammatory cytokines in tissues are produced, which can lead to an increase of vascular permeability and angiogenesis in the adhesion sites, resulting in abdominal adhesions [2]. An early lowering of abnormally elevated proinflammatory cytokine levels is one of the main ways to prevent and treat abdominal adhesions. References show that electroacupuncture at the Zusanli (ST36) acupoint has significant inhibiting effects on sepsis and endotoxemia with proinflammatory cytokine levels, which can effectively protect organ function [3, 4]

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