研究报告

不同针灸方法对膜迷路积水模型豚鼠听力及耳蜗形态结构的影响

蒋丽元， 倪芳英， 王灿军， 陈华德

(浙江中医药大学，杭州，浙江310053)

【摘要】目的探讨不同针灸方法干预对豚鼠膜迷路积水的效应差异。方法50只豚鼠随机分为空白组、模型组、针刺组、艾灸组、电针组，每组10只。采用腹腔注射醛固酮的方法诱导膜迷路积水模型。各治疗组分别在“百会”“听宫”实施相应穴位刺激，每日1次，连续治疗10 d。治疗结束后，行听觉脑干诱发电位测试，观察听阈值。HE染色法观察耳蜗积水程度，计算蜗管横截面积与蜗管加前庭阶横截面积之和的比值(R值)。结果1针刺组、艾灸组、电针组听阈值均较模型组降低(P<0.01)，电针组听阈值较艾灸组、针刺组降低(P<0.01)，艾灸组听阈值较针刺组降低(P<0.05)。2针刺组、艾灸组、电针组R值均较模型组降低(P<0.01)，电针组R值较针刺组、艾灸组降低(P<0.01，P<0.05)，艾灸组R值较针刺组降低(P<0.01)。结论针刺、艾灸、电针刺激“百会”“听宫”均能减轻豚鼠膜迷路积水，并且改善耳蜗听功能。电针表现出最好的效应，优于艾灸、针刺；艾灸优于针刺。

【关键词】针刺；艾灸；电针；膜迷路积水；豚鼠

[基金项目]国家自然科学基金资助(编号：81373757)。

[作者简介]蒋丽元(1985-)，女，浙江中医药大学第三临床医学院2013级博士生，研究方向：针灸治疗眩晕的临床与实验研究。E-mail： 360741751@qq.com。

[通讯作者]陈华德(1957-)，男，医学博士，教授、博士生导师、主任中医师。E-mail： docchd@sina.com。

【中图分类号】R33【文献标识码】 A

doi:10.3969.j.issn.1671.7856. 2015.002.006

Effects of acupuncture, moxibustion and electro-acupuncture on the

hearing and morphology of cochlea in guinea pig models of

endolymphatic hydrops

JIANG Li-yuan, NI Fang-ying, WANG Can-jun, CHEN Hua-de

(Zhejiang Chinese Medical University, Hangzhou 310053，China)

Abstract【】ObjectiveThis study was conducted to compare the efficacy of acupuncture, moxibustion and electro-acupuncture on guinea pig models of cochlear endolymphatic hydrops. Methods Fifty healthy male guinea pigs (body weight 200-250 g) were randomly divided into five groups: the normal group, model group, acupuncture group, moxibustion group, and electro-acupuncture group (n=10 in each group). Forty guinea pigs received a once-daily intraperitoneal injection of aldosterone in a dose of 100 μg/100 g/d for 5 days to induce endolymphatic hydrops. After a 2-month interval, the animals of the acupuncture, moxibustion and electro-acupuncture groups were treated with corresponding acupoints stimulation at points Baihui (GV 20) and Tinggong (SI 19) once a day for 10 days, respectively. We measured the hearing threshold of the auditory brainstem response (ABR) and evaluated pathologically the degree of hydrops using hematoxylin-eosin staining, and then the ratio of scala media (SM) area / [SM + scala vestibuli (SV) area] was calculated. Results1. The hearing threshold of ABR in the acupuncture, moxibustion and electro-acupuncture groups were all significantly lower than that of the model group (P<0.01). The ABR threshold in the electro-acupuncture group was significantly decreased in comparison with that of the acupuncture and moxibustion groups (P<0.01 for both). The hearing threshold of the moxibustion group was significantly lower than that of the acupuncture group (P<0.05). 2. The ratio of SM / (SM + SV) in the acupuncture, moxibustion and electro-acupuncture groups were all significantly lower than that of the model group (P<0.01). The ratio in the electro-acupuncture group was significantly decreased in comparison with that of the acupuncture and moxibustion groups (P<0.01, P<0.05). The ratio of the moxibustion group was significantly lower than that of the acupuncture group (P<0.01). ConclusionsOur findings suggest that all acupuncture, moxibustion and electro-acupuncture at the acupoints Baihui (GV 20) and Tinggong (SI 19) can significantly suppress the development of endolymphatic hydrops and improve the cochlear function in guinea pigs. Electro-acupuncture is the most effective in this experiment, and moxibustion therapy shows better effect than acupuncture.

【Key words】Acupuncture; Moxibustion; Electro-acupuncture; Endolymphatic hydrops; Guinea pig

梅尼埃病(Meniere’s disease，MD)是一种临床常见疾病。膜迷路积水被认为是MD的基本病理改变[1]。其典型的临床表现为阵发性眩晕，感音神经性听力下降，耳闷、耳鸣伴恶心、呕吐，严重影响患者生活。临床对于MD尚无特效治疗方法[2]，西医主要是使用利尿剂、激素、麻醉剂、血管扩张剂[3]等药物，其对症状改善不甚理想。手术治疗适应范围较窄，疗效不稳定，并且术后可能出现各种并发症[4]。

MD属于祖国医学“眩晕”范畴。《丹溪心法》中说：“眩者言其黑运转旋，其状目闭眼暗，身转耳鸣，如立舟车之上，起则欲倒。……