College of Acupuncture and Massage, Gansu University of Chinese Traditional Medicine, Lanzhou 730000, China.
J Tradit Chin Med. 2023 Jun;43(3):523-532. doi: 10.19852/j.cnki.jtcm.20230404.005.
To evaluate the effect of needling Baihui (GV20), Neiguan (PC6), Shenmen (HT7) and Taichong (LR3) on cerebral cortical blood oxygen level in rats with insomnia identified as liver- stagnation pattern in terms of Traditional Chinese Medicine.
Sixty Wistar rats were randomly divided into blank group ( 10), the rest of the rats were clamped tail as stimulation combined with injected intraperitoneally p-chlorophenylalanine (PCPA) to establish sleep deprivation model. After the successful replication of the model, they were randomly divided into model group, grabbing group, Western Medicine group, acupuncture group and sham acupuncture group, with 10 rats in each group. The model group was given normal saline; The grasping group was grasped in the same way as the two treatment groups; Western medicine group was given estazolam solution; The acupuncture group was treated with the acupuncture method of "soothing the liver and regulating mind" needling Baihui (GV20), Neiguan (PC6), Shenmen (HT7) and Taichong (LR3); The sham acupuncture group were needled with four non-acupoint sites. After 7 d of treatment of rats in each group, sodium pentobarbital sleep experiment was used to evaluate the sleep latency (SL) and sleep time (ST). The percentage of rats entering the open arm (OE%) and the percentage of time entering the open arm (OT%) in each group were monitored by elevated cross maze, and the vertical score, horizontal crossing times, central grid score and modification times were monitored by open field test, functional near infrared spectroscopy (fNIRs) was used to monitor the changes of oxygenated hemoglobin (Oxy-Hb), deoxyhemoglobin (Deoxy-Hb) and total hemoglobin (Total-Hb) in the cerebral cortex of rats in each group under light stimulation and dark stimulation, the statistically significant channel combinations were selected from 8 light sources and 12 detectors (S-D). According to the position of the light source detector covering the cerebral cortex, Preliminarily determine the key brain areas of insomnia (the preliminary experiment found that 6S-8D and 7S-9D were the key channels of insomnia under light stimulation, and the corresponding brain areas were prefrontal lobe and occipital lobe respectively; 7S-7D channel under dark stimulation, and the corresponding brain area was occipital lobe); The hemodynamic map of cerebral cortex was constructed through the absolute value of whole brain blood oxygen level. Further identify key brain regions for insomnia.
Compared with the blank group, ST, OE%, OT%, the vertical score, horizontal crossing times, central grid score, the concentration of Deoxy-Hb in prefrontal and occipital lobes were decreased significantly (<0.01), and the concentrations of SL, modification times, Oxy-Hb and Total-Hb were increased significantly (<0.01); There was no difference in the above indexes between the model group and the grabbing group (>0.05); After treatment, ST, OE%, OT%, the vertical score, horizontal crossing times, central grid score and Deoxy-Hb concentration in acupuncture group and Western medicine group increased significantly, while SL, modification times, Oxy-Hb and Total-Hb concentrations were decreased significantly (<0.01, <0.05), Compared with the Western Medicine group, the values of OE% and OT% were more significantly higher in the acupuncture group (<0.05), while the rest of the indexes were not significantly different between the two groups (>0.05); Compared with the acupuncture group, ST, OE%, OT%, the vertical score, horizontal crossing times, central grid score and the concentration of deoxy Hb in the sham acupuncture group decreased significantly (<0.01), and the concentrations of SL, modification times, Oxy-Hb and Total-Hb increased significantly (<0.01).
The needling method for soothing the liver and regulating mind could improve the abnormal behavior of insomnia rats with liver stagnation, and its effect on the improvement of abnormal mood caused by insomnia with liver stagnation is better than that of Western Medicine, and the mechanism of action may be related to the regulation of blood oxygen metabolism in the prefrontal and occipital lobes of the cerebral cortex by acupuncture.
从中医肝失疏泄的角度,观察针刺百会(GV20)、内关(PC6)、神门(HT7)、太冲(LR3)对失眠肝郁证模型大鼠大脑皮质血氧水平的影响。
60 只 Wistar 大鼠随机分为空白组(10 只),其余大鼠夹尾作为刺激结合腹腔注射对氯苯丙氨酸(PCPA)建立睡眠剥夺模型。模型复制成功后,随机分为模型组、抓挠组、西药组、针刺组和假针刺组,每组 10 只。模型组给予生理盐水;抓挠组与两组治疗方法相同;西药组给予安定溶液;针刺组采用“疏肝调神”针刺百会(GV20)、内关(PC6)、神门(HT7)、太冲(LR3);假针刺组针刺 4 个非穴位。治疗后,采用戊巴比妥钠睡眠实验评价各组大鼠的睡眠潜伏期(SL)和睡眠时间(ST)。采用高架十字迷宫监测各组大鼠进入开放臂的百分比(OE%)和进入开放臂的时间百分比(OT%),采用旷场实验监测各组大鼠的垂直评分、水平穿越次数、中央网格评分和修改次数,采用功能近红外光谱(fNIRs)监测各组大鼠在光刺激和暗刺激下大脑皮质氧合血红蛋白(Oxy-Hb)、脱氧血红蛋白(Deoxy-Hb)和总血红蛋白(Total-Hb)的变化,从 8 个光源和 12 个探测器(S-D)中选择有统计学意义的通道组合。根据光源探测器覆盖大脑皮质的位置,初步确定失眠的关键脑区(初步实验发现,光刺激下 6S-8D 和 7S-9D 为失眠的关键通道,对应的脑区分别为前额叶和枕叶;暗刺激下 7S-7D 通道,对应的脑区为枕叶);通过大脑整体血氧水平的绝对值构建大脑皮质的血流图。进一步确定失眠的关键脑区。
与空白组相比,ST、OE%、OT%、垂直评分、水平穿越次数、中央网格评分、前额叶和枕叶 Deoxy-Hb 浓度明显降低(<0.01),SL、修改次数、Oxy-Hb 和 Total-Hb 浓度明显升高(<0.01);模型组与抓挠组上述指标无差异(>0.05);治疗后,针刺组和西药组 ST、OE%、OT%、垂直评分、水平穿越次数、中央网格评分、Deoxy-Hb 浓度明显升高,SL、修改次数、Oxy-Hb 和 Total-Hb 浓度明显降低(<0.01,<0.05),针刺组 OE%和 OT%值明显高于西药组(<0.05),其余指标两组间无明显差异(>0.05);与针刺组相比,假针刺组 ST、OE%、OT%、垂直评分、水平穿越次数、中央网格评分和脱氧 Hb 浓度明显降低(<0.01),SL、修改次数、Oxy-Hb 和 Total-Hb 浓度明显升高(<0.01)。
疏肝调神针法可改善肝郁型失眠大鼠的异常行为,其改善肝郁型失眠引起的异常情绪的作用优于西药,其作用机制可能与针刺调节大脑皮质前额叶和枕叶的血氧代谢有关。