077~088 해계 유침과 전침이

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우은석 정
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1 loperamide 77 DOI : /KPI loperamide Received : Accepted : The Effect of Acupuncture and Electro-acupuncture at ST41 on Intestinal Hypomotility Induced with Loperamide in Rats Lee Sang-mi, Lee Hyun Key Words: needle retention, acupuncture, electro-acupuncture, ST41, loperamide Dept. of Acupuncture & Moxibustion, College of Oriental Medicine, Daejeon University ABSTRACT Objectives : The purpose of this study was to compare the effect of acpuncture and electro-acupuncture of low(ea(l)) and high(ea(h)) frequency at Haegye(ST41) on intestinal hypomotility induced with loperamide in rats. Methods : We made suppressed state of intestinal motility with loperamide in rats and carried out needle retention acupuncture, low frequency electro-acupuncture and high frequency electro-acupuncture at ST41 in rats devided into pre-treatment group and post-treatment group. We fed charcoal to them after the treatment and measured the travel rate of charcoal in the gastrointestinal track to analyze which treatment is more effective in state of intestinal hypomotility. Results : None of acupuncture, EA(L) and EA(H) at ST41 had significant influences on intestinal motility of rat in normal state. Needle retention at ST41 did not significantly increase intestinal motility suppressed with loperamide in rats. Pre-treatment of EA(L) and EA(H) at ST41 significantly increased intestinal motility suppressed with loperamide in rats. Post-treatment of EA(L) and EA(H) at ST41 did not have significant influences on intestinal motility of rat in normal state. Conclusions : These results suggest that treatment of EA(L) and EA(H) at ST41 may be effective on gastric disorders such as intestinal hypomotility and its effect had more prevention than cure. Further study is necessary to know more effects of ST41 and electro-acupuncture of low and high frequency. I paracrine Sato Loperamide meperidini Corresponding author : Lee, Hyun. Dept. of Acupuncture & Moxibustion, College of Oriental Medicine, Daejeon University. 621, Dujeong-dong, Seobuk-gu, Cheonan-si, Chungcheongnam-do, South Korea. Tel lh2000@dju.ac.kr

2 (1) Table. 1 (2) Table. 2 loperamide charcoal II Sprague-Dawley rat ~ Table 3 2 normal charcoal holder 15 charcoal needle retention; NR electro-acupuncture; EA loperamide ST41 sham point 15 charcoal L-Control loperamide 15 charcoal pre-treatment groups low frequency electro-acupuncture; EA L high frequency electro-acupuncture; EA H 15 loperamide 15 charcoal Scheme 1 post-treatment groups loperamide 15 charcoal Scheme 2 charcoal 25 charcoal Scheme 1, Scheme Dong Bang Acupuncture Co. Korea 2 ST41

3 loperamide 79 2~3 needle retention LR3 PG-6, Suzuki iryoki, Japan ST41 LR3 3 Loperamide Sigma, USA 0.05 tween 80 Sigma, USA 1 loperamide Charcoal 100 charcoal 5 5 charcoal Charcoal 25 ether total length of intestine charcoal travel length of charcoal III 1. charcoal Table 4, Fig charcoal N-ST41-NR charcoal holder N-Sham-NR Fig. 1 2 charcoal N-ST41-EL L holder N-Sham-EA L charcoal Fig. 2 3 charcoal N-ST41-EL H N- Sham-EA H charcoal Fig. 3 Travel rate( travel length of charcoal 100 total length of intestine 5 SPSS 14.0 Korea one way ANOVA paired t-test 95 p< charcoal N-ST41-NR N-ST41- EL L N-ST41-EL H Fig Loperamide rat normal holder charcoal loperamide L- L-control charcoal normal hold-

4 er Table 3, Fig loperamide Loperamide loperamide charcoal Table 4, Fig loperamide charcoal ST41-NR-L L- L-control Sham-NR-L charcoal Fig. 6 2 Loperamide charcoal L-ST41-NR L- L-control L-Sham-NR charcoal Fig. 7 3 ST41-NR-L L-ST41-NR charcoal L-ST41-NR ST41-NR-L charcoal Fig. 8 4 loperamide charcoal ST41-EA(L)-L L- L-control Sham-EA L -L charcoal Fig. 9 5 Loperamide charcoal L-ST41-EA(L) L- L-control L- Sham-EA(L) charcoal Fig ST41-EA(L)- L L-ST41-EA(L) charcoal L-ST41- EA(L) ST41-EA(L)- L charcoal Fig loperamide charcoal ST41-EA(H)- L L- L-control Sham-EA(H)-L charcoal Fig Loperamide charcoal L-ST41-EA(H) L- L-control L- Sham-EA(H) charcoal Fig ST41-EA(H)- L L-ST41-EA(H) charcoal ST41- EA(H)-L L-ST41- EA(H) charcoal Fig loperamide charcoal

5 loperamide 81 ST41-NR-L ST41-EA(L)-L ST41-EA(H)-L charcoal Fig Loperamide charcoal L-ST41-NR L-ST41-EA(L) L-ST41-EA(H) charcoal Fig. 16 IV Electrical Stimulation Treatment, EST 5-250Hz 50Hz 2Hz, 100Hz 20 charcoal Loperamide pethidine

6 loperamide charcoal charcoal loperamide charcoal charcoal Fig. 3 charcoal Fig. 4 Loperamide L- charcoal loperamide Table 5, Fig. 5 Loperamide Table 6, Fig loperamide charcoal L- charcoal Fig. 6 loperamide charcoal L- charcoal Fig. 7 Fig. 8 loperamide loperamide charcoal L- L-control charcoal Fig. 9 loperamide charcoal L- charcoal Fig. 10 charcoal Fig. 11 loperamide Loperamide charcoal L- charcoal Fig. 12 loperamide charcoal

7 loperamide 83 loperamide charcoal L- charcoal Fig. 13 charcoal Fig. 14 Fig. 15 Fig. 16 V loperamide loperamide 4. VI ; 55, William F. Ganong. Physiology. Seoul : Hanwoori ; Sato A, Sato Y, Suzuki A, Uchida S. Neural mechanisms of the reflex inhibition and excitation of gastric motolity elicited by acupuncture-like stimulation in anesthetized rats. Neurosci Res. 1993, Oct ; 18(1) : ; Theodorou V, Fioramonti J, Hacher T, Bueno L. Absorptive and motor components of the antidiarrhoeal action of loperamide. An invivo study in pigs. Gut ; 32 : ; 58, , ; 14-7, Lee Bangsung, Youn Hyounmin, Jang Kyungjeon, Song Choonho, Ahn Changbeohm. The Effect of ST36 Acupuncture on the Small Intestinal Motility. The Journal of Korea Acupuncture & Moxibustion Society ; 17(2) : Heo Seongwook, Jang Kyungjeon, Song Choonho, Ahn Changbeohm. The Effect of ST36 Acupuncture on the Large Intestinal Motility.

8 The Journal of Korea Acupuncture & Moxibustion Society ; 16(3) : Kim Dongwoung, Lee Sangyung, Lee Changhyun. The Clinical Study of Colonic Transit Time Stimulated Manual Acupuncture and Eletro-acupuncture(ST25, ST37). The Journal of Korea Acupuncture & Moxibustion Society ; 15(2) : Kim Yongjeong, Park Sangmoo, Cha Suk, Yun Jeongahn, Yu Yunjo, Kang Byungki, Kim Kangsan. Effects of Electro-acupuncture`s Stimulated Frequency, Intensity, Duration at ST36 on the Small Intestine Motility in Rats. The Journal of Korea Acupuncture & Moxibustion Society ; 23(4) : Cha Suk, Park Sangmoo, Yun Jeongahn, Yu Yunjo, Kang Byungki, Kim Kangsan. The Effects of Electro-acupuncture at ST36 on the Small Intestine Motility in Rats. The Journal of Korea Acupuncture & Moxibustion Society ; 20(4) : Lee Sunghwan. The Effect of Acupunture and Electroacupunture of Low and High Frequencies at SP6 on Experimentally Induced Intestinal Hypomotility in Rats: Comparison Between Pre-treatment and Post-treatment. The Journal of Korea Acupuncture & Moxibustion Society ; 25(4) : Choi Eunhee. The Effect of Needle Retention and Electro-acupuncture of Low and High Frequencies at SP6 on Experimentally Induced Intestinal Hypermotility in Rats. The Journal of Korea Acupuncture & Moxibustion Society ; 25(5) : Lim Sungchul. Effect of Acupuncture and Electro-acupuncture at LR3 on Intestinal Motility in Rats. The Journal of Korea Acupuncture & Moxibustion Society ; 25(4) : ; 11-3, 88, ; ; 48-52, 94-7, Kim Jongin, Kim Yongsuk, Kim Changhwan. Difference in NOS between 2Hz and 100Hz EA in Cerebral Cortex, Brain Stem and Cerebellum of Spontaneously Hypertensive Rat. The Journal of Korea Acupuncture & Moxibustion Society ; 18(4) : ; ; E. Braunwald, Fauci, Kasper, Hauser, Longo, Jameson. Harrison s Internal Medicine. Seoul : MIP ; ; ; ; ; ; 363. Table 1. The List of Reagents Table 2. The List of Devices that Used in This Study Reagent Manufacturer Nation Device Manufacturer Nation Ethyl ether Chacoal Loperamide Carbachol Saline Tween 80 Samchun Chemical Sigma Korea USA Scale Stainless still Electric stimulator(pg-6) Munhaw Dong Bang Acupuncture Co Ito Co Korea Japan

9 loperamide 85 Table 3. Classification of Experimental Groups Group Treatment ( : immediate, : 15 min, : 25 min) 1 Normal charcoal intestinal extirpate 2 Holder Holder restriction charcoal intestinal extirpate 3 N-Sham-NR NR at sham point charcoal intestinal extirpate 4 N-Sham-EA(L) EA(L) at sham point charcoal intestinal extirpate 5 N-Sham-EA(H) EA(H) at sham point charcoal intestinal extirpate 6 N-ST41-NR NR at ST41 charcoal intestinal extirpate 7 N-ST41-EA(L) EA(L) at ST41 charcoal intestinal extirpate 8 N-ST41-EA(H) EA(H) at ST41 charcoal intestinal extirpate 9 L-Control loperamide charcoal intestinal extirpate 10 L-Sham-NR loperamide NR at sham point charcoal intestinal extirpate 11 L-Sham-EA(L) loperamide EA(L) at sham point charcoal intestinal extirpate 12 L-Sham-EA(H) loperamide EA(H) at sham point charcoal intestinal extirpate 13 L-ST41-NR loperamide NR at ST41 charcoal intestinal extirpate 14 L-ST41-EA(L) loperamide EA(L) at ST41 charcoal intestinal extirpat 15 L-ST41-EA(H) loperamide EA(H) at ST41 charcoal intestinal extirpat 16 Sham-NR-L NR at sham point loperamide charcoal intestinal extirpate 17 Sham-EA(L)-L EA(L) at sham point loperamide charcoal intestinal extirpate 18 Sham-EA(H)-L EA(H) at sham point loperamide charcoal intestinal extirpate 19 ST41-NR-L NR at ST41 loperamide charcoal intestinal extirpate 20 ST41-EA(L)-L EA(L) at ST41 loperamide charcoal intestinal extirpate 21 ST41-EA(H)-L EA(H) at ST41 loperamide charcoal intestinal extirpate Scheme 1. Pre-treatment of NR or EA at sham or ST41. Scheme 2. Post-treatment of NR or EA at sham or ST41.

86 12 4 2009 12 Table 4. Effects of NR (needle retention), Low Frequency Electro-Acupunctur EA(L) and High Frequency Electro-Acupuncture EA(H) at ST41 on Intestinal Motility of Rat in Normal State.

05 by one-way ANOVA N-Sham-EA(L) 46.268 3.163 N-ST41-EA(L) 56.219 5.164 N-Sham-EA(H) 39.904 5.683 N-ST41-EA(H) 51.668 5.806 Figure 4.

10 Table 4. Effects of NR (needle retention), Low Frequency Electro-Acupunctur EA(L) and High Frequency Electro-Acupuncture EA(H) at ST41 on Intestinal Motility of Rat in Normal State. Group Travel rate (%) Normal Holder N-Sham-NR N-ST41-NR Figure 3. Effect of EA(H) at ST41 on intestinal motility of rat in normal state. *: P 0.05 by one-way ANOVA N-Sham-EA(L) N-ST41-EA(L) N-Sham-EA(H) N-ST41-EA(H) Figure 4. Effect of NR, EA(L) and EA(H) at ST41 on intestinal motility of rat in normal state. Table 5. Effect of loperamide on intestinal motility of rat. Figure 1. Effect of NR at ST41 on intestinal motility of rat in normal state. Group Travel rate (%) Normal Holder L-Control Figure 2. Effect of EA(L) at ST41 on intestinal motility of rat in normal state. Figure 5. Effect of loperamide on intestinal motility of rat *: P 0.01 by one-way ANOVA

with Loperamide in Rat Group Travel rate (%) Normal 49.480 5.513 Holder 50.934 8.084 L-control 33.845 4.457 Figure 8.

151 9.992 Sham-EA(L)-L 21.07 3.085 ST41-EA(L)-L 51.4 10.176 L-Sham-EA(L) 24.979 7.695 L-ST41-EA(L) 31.03 7.266 Sham-EA(H)-L 23.541 8.653 ST41-EA(H)-L 53.172 10.652 L-Sham-EA(H) 18.692.617 Figure 9.

11 loperamide 87 Table 6. Effects of Pre-treatment or Post-treatment of NR (needle retention), Low Frequency Electro- Acupuncture EA(L) and High Frequency Electro-Acupunctur EA(H) at ST41 on Intestinal Motility Suppressed with Loperamide in Rat Group Travel rate (%) Normal Holder L-control Figure 8. Effect of pre-treatment and post-treatment of NR at ST41 on intestinal motility suppressed with loperamide in rat Sham-NR-L ST41-NR-L L-Sham-NR L-ST41-NR Sham-EA(L)-L ST41-EA(L)-L L-Sham-EA(L) L-ST41-EA(L) Sham-EA(H)-L ST41-EA(H)-L L-Sham-EA(H) Figure 9. Effect of pre-treatment of EA(L) at ST41 on intestinal motility suppressed with loperamide in rat *: P 0.05, ***: P by one-way ANOVA L-ST41-EA(H) Figure 6. Effect of pre-treatment of NR at ST41 on intestinal motility suppressed with loperamide in rat Figure 10. Effect of post-treatment of EA(L) at ST41 on intestinal motility suppressed with loperamide in rat Figure 7. Effect of post-treatment of NR at ST41 on intestinal motility suppressed with loperamide in rat Figure 11. Effect of pre-treatment and post-treatment of EA(L) at ST41 on intestinal motility suppressed with loperamide in rat

01, ***: P 0.001 by one-way ANOVA Figure 15.

12 Figure 12. Effect of pre-treatment of EA(H) at ST41 on intestinal motility suppressed with loperamide in rat **: P 0.01, ***: P by one-way ANOVA Figure 15. Effect of pre-treatment of NR, EA(L) and EA(H) at ST41 on intestinal motility suppressed with loperamide in rat Figure 13. Effect of post-treatment of EA(H) at ST41 on intestinal motility suppressed with loperamide in rat Figure 16. Effect of post-treatment of NR, EA(L) and EA(H) at ST41 on intestinal motility suppressed with loperamide in rat Figure 14. Effect of pre-treatment and post-treatment of EA(H) at ST41 on intestinal motility suppressed with loperamide in rat

012임수진

012임수진 Received : 2012. 11. 27 Reviewed : 2012. 12. 10 Accepted : 2012. 12. 12 A Clinical Study on Effect of Electro-acupuncture Treatment for Low Back Pain and Radicular Pain in Patients Diagnosed with Lumbar