手塚 清恵

Kiyoe TETSUKA

明治鍼灸大学大学院, 泌尿器科学教室

Department of Clinical Medicine of Acupuncture and Moxibusion, Graduate School of Acupuncture and Moxibustion, Meiji University of Oriental Medicine

キーワード : acupuncture, color flow imaging, Doppler method, ultrasonography, urine jet phenomenon

ヒトにおいて鍼刺激が尿噴流に及ぼす影響を調べるため, 超音波カラードプラ法を用いて検討した. 対象は18歳から26歳 (平均年齢23歳)の健康なボランティア20名 (男性10名, 女性10名)で, 実験3時間前に350 mlの飲水負荷を行い, 以後絶飲食とするように各対象者に指導した. 膀胱超音波断層像は横断像を描出後, 尿噴流の観察を行った. 尿噴流の測定項目は5分間における尿噴流の出現頻度, 最高流速, 持続時間とした. さらに腎臓の血流動態を検索するために腎葉間動脈のResistance Index (RI)を測定し検討した. 鍼刺激は中極穴 (CV3)を選択し, 鍼通電刺激を行った. 鍼徒手的刺激は同じ部位に行った. 無刺激をコントロールとした. 尿噴流の出現頻度, 最高流速は鍼通電刺激群と鍼徒手的刺激群で増大したが, コントロール群では変化がなかった. 持続時間は鍼通電刺激群と鍼徒手的刺激群で短縮がみられた. さらにコントロール群では刺激前値に比べて, 持続時間の延長が観察された. RIについては全群で変化がみられなかった. 中極穴への鍼刺激は尿管機能に作用し, 蠕動運動を促進させると考えられた.

We evaluated the effect of acupuncture stimulation on the urine jet phenomenon in humans by color Doppler ultrasonography. Twenty healthy volunteer subjects (10 men and 10 women) aged 18 to 26 (mean, 23) years drank 350 ml of water 3 hours before the experiment started and were then directed to restrict eating and drinking. Ultrasonographic images showing the bladder in transverse section enabled us to observe the urine jet phenomenon. The frequency of the appearance of the jet phenomenon was counted for a period of 5-minutes, and the maximum velocity and duration of the phenomenon were measured. Blood flow in the renal interlobar arteries was also studied to measure the resistance index in order to assess renal blood flow. Acupuncture needles were inserted at the Chung-Chi (CV3) acupoint, where electroacupuncture and manual stimulation were performed. No stimulation was used on the control group. Frequency of appearance and maximum velocity of the urine jet increased in both the electroacupuncture and manual stimulation groups, but not in the control group. Duration of the phenomenon was shorter with both types of stimulation, but was longer in the control group than the baseline duration time. Resistance index did not change significantly in any group. We conclude that acupuncture stimulation affects ureter function and promotes its peristalsis.