目的 探讨针灸对保胆取石（gallbladder-preserving cholecystolithotomy，GPC）术后患者胆囊收缩功能的影响。 方法 本研究共纳入70例保胆取石 GPC患者，分为针灸组（n=41）和非穴位组（假针灸组，n=29）。在针灸组中，对阳陵泉（GB34）、胆囊穴（EX-LE6）、期门（LR14）、足三里（ST36）穴位进行针灸治疗；而在假针灸组中，在相应穴位周围2寸处，细针接触而不插入皮肤。两组均每日进行一次针灸治疗，连续七天。使用彩色多普勒超声扫描仪，在针灸前及针灸后1、3、6月检测胆囊排空指数（gallbladder ejection fraction，GBEF）。在针灸刺激后1月，通过酶联免疫吸附测定法检测血清胆囊收缩素A受体（cholecystokinin A receptor，CCKAR）和胃泌素（gastrin）水平。 结果 与基线相比，针灸组和假针灸组的GBEF明显增加。与假针灸组相比，针灸组在 GPC术后1月和3月时GBEF相对更高，两组之间具有显著性差异（P<0.001）；而在6月时，针灸组的GBEF与假针灸组的GBEF无显著差异。血清CCKAR增加，但不显著（P>0.05），而胃泌素在针灸组中显著减少（P<0.01）。 结论 针灸治疗可有效促进GBEF，其可能通过CCKAR/胃泌素信号进行调控。
Objective To investigate the effect of acupuncture on the gallbladder contraction function in patient after gallbladder-preserving cholecystolithotomy (GPC). Methods Total seventy cases of GPC patients, including acupuncture group (n=41) and non-acupoint (sham-acupuncture) group (n=29) were enrolled in this study. In acupuncture group, acupuncture was applied to Yanglingquan (GB34), Dannangxue (EX-LE6), Qimen (LR14), Zusanli (ST36), while the filiform needle was touched but not inserted skin 2 cun around the corresponding acupoints for the sham-acupuncture group, and the needles were retained for 30 min. Acupuncture was preformed once daily and total for consecutive 7 days in these two groups. A color Doppler ultrasound scanner was used to detect the gallbladder ejection fraction (GBEF) before and 1, 3, 6 months after acupuncture operation. Serum cholecystokinin-A receptor (CCKAR) and gastrin were detected by enzyme-linked immunosorbent assay at 1 months after acupuncture stimulation. Results The GBEF were markedly increased compared to the baseline. Compare to sham-acupuncture group, the GBEF were significantly higher at 1 month and 3 months (P<0.001), while that were similar at 6 months in acupuncture group. Serum CCKAR were increased but not significant (P>0.05), whereas gastrin significantly decreased in the acupuncture group (P<0.01). Conclusions Acupuncture can effectively promote GBEF which might be regulated though CCKAR/gastrin signals.
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