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[疑核-迷走神经是否介导电针心肌缺血大鼠“内关”(PC 6)-“间使”(PC 7)的抗心肌缺血作用]

[Does the Nucleus Ambiguus-Vague Nerve Mediate Anti-myocardial Ischemic Effect of Electroacupuncture of "Neiguan" (PC 6)-"Jianshi" (PC 7) in Myocardial Ischemia Rats].

作者信息

Chen Wei, Chen Shu-Ping, Li Cheng-Wen, Wang Jun-Ying, Duanmu Cheng-Lin, Chang Xiao-Rong, Liu Jun-Ling

机构信息

College of Acu-moxibustion and Massage, Hunan University of Chinese Medicine, Changsha 410007, China.

Department of Physiology, Institute of Acu-moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700.

出版信息

Zhen Ci Yan Jiu. 2016 Jun 25;41(3):189-96.

Abstract

OBJECTIVE

To observe the effect of electroacupuncture (EA) stimulation of "Neiguan" (PC 6)-"Jianshi" (PC 7) on ischemic myocardial injury in myocardial ischemic (MI) rats, so as to explore its mechanism underlying improvement of MI.

METHODS

A total of 48 male Wistar rats were randomly divided into normal, MI model, PC 6-PC 7, Sanyinjiao-Diji (SP 6-SP 8) groups (=8 in each group for physiological experiments, =4 in each group for immunoflorescence stain). The MI model was established by occlusion of the anterior descending branch of the left coronary artery. Electrocardiogram (ECG) of the neck-thoracic lead was recorded and the heart rate variability (HRV) analyzed by using a physiological signal collecting system (MP 150) and PowerLab software. EA (2 Hz/15 Hz, 0.5 mA) was applied to bilateral PC 6-PC 7 or SP 6-SP 8 for 30 min every time, on the 1,2,3 day after modeling. Serum creatine kinase-MB isoenzyme (CK-MB) and lactate dehydrogenase-1 (LDH 1) and endothelin (ET) contents were assayed by ELISA. The expression of choline acetyltransferase (ChAT) and vesicular acetylcholine transporter (VAChT) and proteins in the nucleus ambiguus (NA) region of the medulla oblongata was detected by immunofluo-rescence stain.

RESULTS

Compared with the normal group, the ECG J-point height (1 h), serum CK-MB, LDH 1 and ET contents (1 d and 3 d), HR (1 h and 1 d) and LF/HF levels of HRV (1 h, 1 d and 3 d) and the number of positive neurons (3 d) in the NA region were significantly increased in the model group (<0.01, <0.05), while HF levels (1 h, 1 d and 3 d) and ECG J-point height (1 d and 3 d) were considerably decreased after MI. After EA intervention, the ECG J-point height 3 d after MI was close to zero in both PC 6-PC 7 and SP 6-SP 8 groups, being better than that (negative value) of the model group, and serum CK-MB, LDH 1 and ET contents (1 d, 3 d) of both EA groups, and HR (1 d) and LF/HF (3 d) of the PC 6-PC 7 group were obviously down-regulated (<0.01, <0.05), and the decreased HF 3 d post-MI and the increased number of positive neurons were significantly up-regulated in the PC 6-PC 7 group (<0.01). No significant differences were found between the two EA groups in raising J-point height and in down-regulating serum CK-MB, LDH 1 and ET contents (>0.05). Compared with the model group, no significant changes were found in HR 1 d post-MI of the SP 6-SP 8 group, 3 d post-MI of both EA groups, in HF 3 d post-MI of the SP 6-SP 8 group, in LF/HF 1 d post-MI of both EA groups and 3 d post-MI of the SP 6-SP 8 group, in the number of positive neurons of the SP 6-SP 8 group, and ChAT and VAChT positive neurons of both EA groups (>0.05).

CONCLUSIONS

EA intervention may improve ischemic myocardial injury in MI rats, probably by activating neurons in the NA region, and enhancing the cardiac parasympathetic tension, and balancing cardiac sympathetic/parasympathetic nerve activities, but the effect of cholinergic neurons of NA needs being studied further.

摘要

目的

观察电针“内关”(PC 6)-“间使”(PC 7)对心肌缺血(MI)大鼠缺血性心肌损伤的影响,以探讨其改善心肌梗死的机制。

方法

将48只雄性Wistar大鼠随机分为正常组、MI模型组、PC 6-PC 7组、三阴交-地机(SP 6-SP 8)组(每组8只用于生理实验,每组4只用于免疫荧光染色)。通过结扎左冠状动脉前降支建立MI模型。使用生理信号采集系统(MP 150)和PowerLab软件记录颈胸导联心电图(ECG)并分析心率变异性(HRV)。建模后第1、2、3天,每次将电针(2 Hz/15 Hz,0.5 mA)施加于双侧PC 6-PC 7或SP 6-SP 8 30分钟。采用ELISA法检测血清肌酸激酶-MB同工酶(CK-MB)、乳酸脱氢酶-1(LDH 1)和内皮素(ET)含量。通过免疫荧光染色检测延髓疑核(NA)区域胆碱乙酰转移酶(ChAT)、囊泡乙酰胆碱转运体(VAChT)及蛋白的表达。

结果

与正常组比较,模型组ECG的J点抬高(1小时)、血清CK-MB、LDH 1及ET含量(1天和3天)、心率(1小时和1天)、HRV的LF/HF水平(1小时、1天和3天)及NA区域阳性神经元数量(3天)均显著增加(P<0.01,P<0.05),而MI后HF水平(1小时、1天和3天)及ECG的J点抬高(1天和3天)明显降低。电针干预后,PC 6-PC 7组和SP 6-SP 8组MI后3天ECG的J点抬高接近零,优于模型组(负值),两组电针组血清CK-MB、LDH 1及ET含量(1天、3天),PC 6-PC 7组心率(1天)及LF/HF(3天)均明显下调(P<0.01,P<0.05),PC 6-PC 7组MI后3天降低的HF及增加的阳性神经元数量明显上调(P<0.01)。两组电针组在抬高J点及下调血清CK-MB、LDH 1及ET含量方面比较,差异无统计学意义(P>0.05)。与模型组比较,SP 6-SP 8组MI后1天心率、两组电针组MI后3天心率、SP 6-SP 8组MI后3天HF、两组电针组MI后1天及SP 6-SP 8组MI后3天LF/HF、SP 6-SP 8组阳性神经元数量、两组电针组ChAT及VAChT阳性神经元数量比较,差异均无统计学意义(P>0.05)。

结论

电针干预可能通过激活NA区域神经元,增强心脏副交感神经张力,平衡心脏交感/副交感神经活动,改善MI大鼠缺血性心肌损伤,但NA胆碱能神经元的作用有待进一步研究。

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