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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front. Med.    2017, Vol. 11 Issue (1) : 129-136     DOI: 10.1007/s11684-016-0491-6
RESEARCH ARTICLE |
A comparative study of electroacupuncture at Zhongliao (BL33) and other acupoints for overactive bladder symptoms
Likun Yang1,2,Yang Wang1,Qian Mo3,4,Zhishun Liu1()
1. Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
2. Graduate College of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
3. School of Acupuncture-Moxibustion and Tuina, Guiyang College of Traditional Chinese Medicine, Guiyang 550025, China
4. Department of Acupuncture, the Second Affiliated Hospital of Guiyang College of Traditional Chinese Medicine, Guiyang 550003, China
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Abstract  

Electroacupuncture (EA) at Zhongliao (BL33) can improve the symptoms of overactive bladder (OAB), such as urinary frequency, urgency, and incontinence. However, its performance compared with other acupoints remains unclear. This study investigated the effects of EA at BL33 with deep needling on rats with OAB by detecting urodynamics in eight groups: no intervention group, D-BL33 group (deep needling at BL33), S-BL33 group (shallow needling at BL33), non-acupoint group (needling at the non-acupoint next to BL33), Weizhong (BL40) group, Sanyinjiao (SP6) group, Tongtian (BL7) group, and Hegu (LI4) group. Results revealed that EA at BL33 with deep needling, BL40, and SP6 prolonged the intercontraction interval (ICI) of rats with OAB (P=0.001, P=0.005, P=0.046, respectively, post-treatment vs. post-modeling). Furthermore, the change in ICI from post-modeling in the D-BL33 group was significantly greater than those of the no intervention and other EA groups (all P<0.01). Significantly shortened vesical micturition time (VMT) and elevated maximum detrusor pressure (MDP) were also observed in the D-BL33 group (P=0.017 and P=0.024, respectively, post-treatment vs. post-modeling). However, no statistically significant differences in the changes of VMT and MDP from post-modeling were observed between D-BL33 and the other EA groups. In conclusion, EA at BL33 with deep needling may inhibit acetic-acid-induced OAB more effectively.

Keywords overactive bladder      electroacupuncture      acupuncture points     
Corresponding Authors: Zhishun Liu   
Just Accepted Date: 26 December 2016   Online First Date: 15 February 2017    Issue Date: 20 March 2017
URL:  
http://academic.hep.com.cn/fmd/EN/10.1007/s11684-016-0491-6     OR     http://academic.hep.com.cn/fmd/EN/Y2017/V11/I1/129
Group Acupoint Needle depth
(mm)
Location
Rata Humanb
D-BL33 Zhongliao (BL33) c 14.4 A point 5 mm horizontally distant from the midpoint between the spinous process of the second and third sacral vertebra, in the second posterior sacral In the sacral region, in the third posterior sacral foramen
S-BL33 4.2
Non-acupoint Non-acupoint next to BL33 14.4 A point 5 mm horizontally distant from BL33
BL40 Weizhong (BL40) 5 On the medial aspect of knee, at the midpoint of the joint between os femoris and tibia On the posterior aspect of the knee, at the midpoint of the popliteal crease
SP6 Sanyinjiao (SP6) 4–5 On the hind limb, 10 mm superior to the prominence of the malleolus medialis On the tibial aspect of the leg, posterior to the medial border of the tibia, 3 B-cun superior to the prominence of the medial malleolus
BL7 Tongtian (BL7) 3 A point 3 mm horizontally distant from the sagittal midline of parietal bone and 2 mm superior to the coronal midline of parietal bone On the head, 4 B-cun superior to the anterior hairline, 1.5 B-cun lateral to the anterior median line
LI4 Hegu (LI4) 1 On the forefoot, in the depression between the first metacarpal bone and the second metacarpal bone On the dorsum of the hand, radial to the midpoint of the second metacarpal bone
Tab.1  Acupuncture point location and needle depth
Fig.1  Schematic representation of the points stimulated by EA in each intervention group. Anatomical localizations of the acupoints and non-acupoint used in each intervention group are shown on the rat and human bodies. Points indicated by black dots. (A) BL7 group; (B) LI4 group; (C) BL40 group; (D) SP6 group; (E) D-BL33 group and S-BL33 group; (F) Non-acupoint group.
Group Phase Intercontraction interval
(s)
Vesical micturition time
(s)
Basal pressure
(mmHg)
Maximum detrusor pressure (mmHg)
No intervention n = 6 Before-modeling 398.44±10.34 2.69±0.32 3.26±1.43 28.24±3.05
Post-modeling 172.91±14.72†† 3.46±0.61 4.39±1.62†† 23.05±0.99
No intervention 188.75±10.73 3.00±0.71 4.51±0.87 23.38±1.10
Change from post-modeling 15.84±8.64** -0.47±0.43 0.12±0.53 0.34±1.66
D-BL33
n = 6
Before-modeling 453.30±67.89 2.69±0.32 3.32±1.44 31.14±1.93
Post-modeling 184.03±14.70 3.46±0.61 4.80±1.37 21.58±1.21††
Post-treatment 394.00±39.56## 2.34±0.83# 4.89±0.83 27.45±1.93#
Change from post-modeling 209.97±26.94 -1.12±0.32 0.09±0.58 5.87±1.84
S-BL33
n = 6
Before-modeling 491.82±85.16 1.96±1.03 3.05±1.49 29.33±1.65
Post-modeling 178.34±45.53†† 2.67±1.48 4.90±0.48 19.99±1.21††
Post-treatment 210.84±35.20 2.14±0.73 5.16±0.53 20.05±1.32
Change from post-modeling 32.5±18.69** -0.53±0.42 0.26±0.15 0.06±1.38
Non-acupoint
n = 6
Before-modeling 487.16±58.20 2.57±0.71 3.52±1.17 35.81±2.12
Post-modeling 171.22±17.54†† 3.00±0.71 4.71±1.19 21.40±2.25††
Post-treatment 191.50±65.83 2.52±0.66 4.88±0.99 18.46±1.72
Change from post-modeling 20.28±36.97** -0.48±0.76 0.17±0.50 -2.94±2.84
BL40
n = 6
Before-modeling 450.61±35.45 2.59±0.56 3.42±1.14 32.36±2.87
Post-modeling 158.35±19.41†† 3.14±0.54 4.15±0.59 25.26±0.92
Post-treatment 205.98±25.42## 3.56±0.99 4.57±1.33 21.41±1.26
Change from post-modeling 47.63±9.88** 0.42±0.57 0.42±0.64 -3.85±1.59
SP6
n = 6
Before-modeling 397.50±38.11 2.34±0.20 3.39±1.03 34.89±1.68
Post-modeling 147.17±12.71†† 2.89±0.95 4.70±1.25 24.37±2.01††
Post-treatment 181.50±19.11# 3.20±0.76 4.87±1.88 22.26±1.17
Change from post-modeling 34.33±13.04** 0.31±0.91 0.17±0.31 -2.11±2.00
BL7
n = 6
Before-modeling 368.15±28.46 2.61±0.68 3.15±1.43 27.53±2.59
Post-modeling 160.04±18.09†† 3.45±1.82 4.56±0.85 23.29±1.25
Post-treatment 175.47±12.47 3.19±0.37 5.06±0.86 21.02±1.24
Change from post-modeling 15.42±25.67** -0.26±0.69 0.50±0.62 -2.27±2.04
LI4
n = 6
Before-modeling 403.61±34.75 2.62±0.70 3.65±0.73 32.33±2.40
Post-modeling 159.07±15.40†† 3.12±0.73 4.24±1.24 21.27±1.55
Post-treatment 171.59±14.57 3.30±0.34 4.49±0.81 4.49±0.81
Change from post-modeling 12.53±62.27** 0.18±0.39 0.25±0.39 1.66±2.19
Tab.2  Cystometric variables
Fig.2  (A) Typical cystometric findings from an OAB rat without EA stimulation. (B) An OAB rat treated with EA stimulation at Zhongliao (BL33) with deep needling.
Fig.3  Change in ICI from post-modeling after intervention in each group. Animals were divided into eight groups: (1) no intervention: rats with acetic acid-induced bladder overactivity and without EA stimulation; (2) D-BL33: EA at BL33 with deep needling; (3) S-BL33: EA at BL33 with shallow needling; (4) non-acupoint: EA at non-acupoint next to BL33 with deep needling; (5) BL40: EA at BL40; (6) SP6: EA at SP6; (7) BL7: EA at BL7; (8) LI4: EA at LI4. The bars denote change from post-modeling in ICI after intervention in each group and represent the mean±95% confidence interval (**P<0.01, compared with the D-BL33 group).
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