心经经脉与心脏相关联系的形态学研究

Morphological Study on the Relationship between Heart Meridian and Heart

目的:从牵涉痛产生的机理出发,探讨心源性牵涉痛区(沿上肢内侧面分布)和心经与心相关的神经科学机制。方法:将三种荧光素(快蓝、碘化丙啶、双苯甲亚胺)分别注入心经、肺经穴位和心脏,观察C6～T5节段脊神经节中标记细胞的分布。结果:左右两侧标记心经穴位与心脏的双标细胞平均数均高于标记肺经穴位与心脏的双标细胞,而左侧心经穴位心脏的双标神经元与左侧肺经穴位心脏的双标神经元具有统计学差异(P<0.05)。左侧心经穴位心脏双标细胞明显多于右侧同节段的双标细胞(P<0.05)。结论:脊神经节细胞的轴突有分支现象,其一支分布于心脏,一支分布于上肢,这种现象是体表内脏相关和经脉脏腑相关的神经形态学基础;心经循行线与心脏之间的脊神经节细胞分支支配现象更明显,提示心经、心源性牵涉痛与心脏的联系有相对特异性,这种特异性联系的神经基础是神经节段的相同性和神经分布的密度。

Objective: To investigate the morphological relationship between cardiogenic referred pain and Heart Meridian of Traditional Chinese Medicine. Methods: A total of 11 SD rats anesthetized with 10% urethane (1 g/kg) were used in the present study. The fluorescent traces, fast blue (2～5%), propidium iodide (2～5%) and bizbenzimide (2～5%) were injected into heart and the acupoints “Shaohai” (HT 3) and “Qingling” (HT 2) of the Heart Meridian and “Xiabai” (LU 4) and “Chize” (LU 5) of the Lung Meridian respectively, with 5 μL in each acupoint. The labeled cells were observed in dorsal root ganglia (DRG) from C 6 to T 5 segments. Results: After injection of the abovementioned three fluorescent traces into the heart and the acupoints of the Heart Meridian and Lung Meridian of the left forelimb the ratios of the single-labeled cells over the total-labeled neurons in DRG of the C 6～T 5 segments were 29.07%, 24.03% and 24.42% respectively; the ratios of the double-labeled neurons over the total-labeled neurons were 12.14% and 7.5% following injection of the traces into the heart and the acupoints on the left Heart Meridian separately; and the ratio of triple-labeled cells over the total-labeled neurons was 1.16% after injection of the traces into the heart and the acupoints on the left Heart Meridian and Lung Meridian respectively. After injection of the three fluorescent traces into the acupoints with the same names as those mentioned above on the right forelimb the ratios of single-labeled over the total-labeled neurons were 26.98%, 26.89% and 21.97% respectively; the ratios of the double-labeled/total-labeled neurons after injection of the traces into the heart and right Heart Meridian, and the heart and right Lung Meridian were 10.81% and 9.58% respectively; and the ratio of the triple-labeled neurons to the total-labeled neurons following injection of the traces into the heart and the acupoints of the right Heart Meridian and the right Lung Meridian was 2.02%. Conclusion: The present study provides direct evidence showing the existence of dichotomized peripheral afferents that supply both visceral and somatic structures. The relationship between the Heart Meridian and the heart organ is closer than that between the Lung Meridian and the heart.