Du Ting, Ren Yulan, He Yonggang, Chen Zhihan, Liang Fanrong
College of Acupuncture-Moxibustion and Tuina, Chengdu University of TCM, Chengdu 610000, Sichuan Province, China.
Zhongguo Zhen Jiu. 2017 Nov 12;37(11):1197-203. doi: 10.13703/j.0255-2930.2017.11.016.
To explore the protective effect of acupuncture along meridians on rats with myocardial ischemia and its effect and action mechanism on cardiomyocyte energy metabolism.
A total of 104 healthy 12-week-old SD rats were fed adaptively for 1 week and included into study with no disease symptoms observed. Of them, 24 SD rats were selected regardless of gender, and were randomly divided into a blank group and a sham operation group, 12 rats in each one. The remaining 80 SD rats were treated with ligation of left anterior descending coronary artery to establish the model of myocardial ischemia. The successful rate of model establishment was 60%, and 48 rats survived. They were randomly divided into a model group, an acupuncture along meridian group, an acupuncture along another-meridian group and a non-acupoint group, 12 rats in each one. The blank group was not treated with operation, but only bundle fixation. The sham operation group was treated with sham operation (coronary artery was not ligatured). The model group bundle fixation. The acupuncture along meridian group were treated with electroacupuncture (EA) at "Neiguan" (PC 6), the acupuncture along another-meridian group were treated with EA at "Hegu" (LI 4), and the non-acupoints group were treated at a non-acupoint which located in the hollow of the 3rd and 4th metatarsal bones of the dorsal foot of fore rate limb. Each bundle fixation or EA was given for 30 min, once a day for consecutive 5 days. The electrocardiogram was tested in all groups; the apoptosis rate of cardiomyocytes was detected by Tunel; the contents of ATP, ADP and AMP in myocardium were detected by high performance liquid chromatography.
The ST segment voltage after model establishment was higher than that before modeling (all <0.05). Compared with the model group after intervention, the ST segment was elevated in the acupuncture along meridian group, acupuncture along another-meridian group and non-acupoint group (<0.01, <0.05), but the apoptosis rate of cardiomyocytes was significantly reduced (all <0.01). Compared with the acupuncture along another-meridian group and non-acupoint group, the apoptosis rate of cardiomyocytes in the acupuncture along meridian group was significantly decreased (both <0.01). Compared with the model group after intervention, the content of ATP was increased in acupuncture along meridian group (<0.05); compared with the non-acupoint group, the content of ATP was increased in the acupuncture along meridian group (<0.05); compared with the model group, the contents of ADP and AMP were reduced in the acupuncture along meridian group, acupuncture along another-meridian group and non-acupoint group (all <0.05); the energy charge EC in the acupuncture along meridian group was higher than that in the model group (<0.05).
Acupuncture along meridians can effectively relieve the damage of cardiac muscle tissue; the possible mechanism is to increase ATP and reduce ADP, AMP of cardiomyocytes, so EC level is elevated and myocardial cell apoptosis is inhibited, leading to protective effect on cardiac muscle tissue and cells.
探讨循经针刺对心肌缺血大鼠的保护作用及其对心肌细胞能量代谢的影响和作用机制。
选取104只12周龄健康SD大鼠,适应性喂养1周,无疾病症状者纳入研究。其中,随机选取24只SD大鼠,不分性别,随机分为空白组和假手术组,每组12只。其余80只SD大鼠采用冠状动脉左前降支结扎法建立心肌缺血模型。模型建立成功率为60%,存活48只,将其随机分为模型组、循经针刺组、旁经针刺组和非穴位组,每组12只。空白组不进行手术,仅行捆绑固定;假手术组行假手术(不结扎冠状动脉);模型组行捆绑固定;循经针刺组于“内关”(PC 6)行电针治疗,旁经针刺组于“合谷”(LI 4)行电针治疗,非穴位组于前肢背侧足第3、4跖骨间隙的非穴位处治疗。每次捆绑固定或电针治疗30 min,每天1次,连续5天。检测各组心电图;采用Tunel法检测心肌细胞凋亡率;采用高效液相色谱法检测心肌组织中ATP、ADP和AMP含量。
造模后ST段电压高于造模前(均P<0.05)。干预后,与模型组比较,循经针刺组、旁经针刺组和非穴位组ST段均升高(P<0.01,P<0.05),但心肌细胞凋亡率均显著降低(均P<0.01)。与旁经针刺组和非穴位组比较,循经针刺组心肌细胞凋亡率显著降低(均P<0.01)。干预后,与模型组比较,循经针刺组ATP含量升高(P<0.05);与非穴位组比较,循经针刺组ATP含量升高(P<0.05);与模型组比较,循经针刺组、旁经针刺组和非穴位组ADP和AMP含量均降低(均P<0.05);循经针刺组能量负荷EC高于模型组(P<0.05)。
循经针刺可有效减轻心肌组织损伤;其可能机制是增加心肌细胞ATP含量,降低ADP、AMP含量,使EC水平升高,抑制心肌细胞凋亡,从而对心肌组织和细胞起到保护作用。