脊髓在电针“内关-间使”改善缺血心脏功能活动中的作用观察

Role of the Spinal Cord in the Improvement of Performance of Ischemic Heart Induced by Electroacupuncture of "Neiguan"(PC 6)-"Jianshi"(PC 5)

目的:观察电针'内关-间使'对缺血心脏功能作用的相对特异性和切断脊髓对电针效应的影响.方法:第一批33只家兔随机分为对照组、'内关-间使'组和'外关-支沟'组. 第二批完整动物和脊髓动物各18只,分别随机分为对照组和电针组.第三批Wistar大鼠共18只,随机分为对照和电针两组.结扎冠状动脉左心室支(大鼠前降支)造成急性心肌缺血.于颈部C2～C3之间横断脊髓造成脊髓动物.测量颈-胸导联ECG-ST、左室内压(LVP)、左室内压最大上升速率(dp/dtmax)、平均动脉压(MAP).结果:①急性缺血后,ECG-ST显著抬高,LVP、dp/dtmax和MAP立即降低;电针'内关-间使'能显著促进ST段、LVP、dp/dtmax及MAP的恢复,与对照组及'外关-支沟'组相比差异显著(P<0.05);②在完整动物和脊髓动物上,电针'内关-间使'都可显著促进缺血性ECG-ST、LVP、dp/dtmax的恢复(P<0.05),并能明显促进脊髓动物MAP的恢复(P<0.05);③切断大鼠脊神经根后,电针的作用消失. 结论:在完整和脊髓动物上,电针'内关-间使'可显著促进缺血性心脏功能活动的恢复,和电针完整动物'外关-支沟'的作用相比,具有相对特异性;脊髓是实现电针上述作用的关键部位.

Objective： To observe the relatively specific effect of electroacupuncture（EA） of “Neiguan”（ PC 6 ）-“Jianshi”（PC 5） on the performance of ischemic heart and the influence of transection of the spinal cord on the therapeutic effect. Methods- This study was made up of 3 parts： ① 33 Japanese big-ear white rabbits were evenly divided into control, “NeiguanJianshi”（PC 6-PC 5） and “Waiguan-Zhigou”（TE 5-TE 6） groups; ② 36 normal （ 18 oases） and spinalized rabbits （ 18 cases） were respectively randomized into control and EA groups; and ③ 18 Wistar rats were randomized into control and EA groups. All the animals were anesthetized with urethane （420 mg/kg） plus chloralose （50 mg/kg）, and experienced experimental myocardial ischemia by occlusion of the ventricular branch （rabbit） and the anterior descending branch （rat） of the left coronary artery. The spinalized rabbits were made by transection of cervical segments （C2-C3） of the spinal cord. EA （40 Hz, loading voltage 3 V） was applied to bilateral PC 5- PC 6, TE 5-TE 6 for 20 min. ECG-ST, mean arterial pressure （MAP）, left ventricular pressure （LVP） and the maximum ascending rate of LVP （dp/dtrnax） were recorded. Results： ① Following myocardial ischemia, ECG-ST elevated significantly, while LVP, dp/dtrnax and MAP decreased considerably, EA of PC 5- PC 6 could significantly promote the recovery of ECG-ST, LVP, dp/dtrnax and MAP （P〈0.05）, and the therapeutic effect of EA of PC 5-PC 6 was significantly superior to that of EA of TE 5-TE 6. ② After transection of the spinal cord, EA of PC 5-PC 6 still could pramote the recovery of ECG-ST, LVP and dp/dtrnax and MAP （P〈0.05）. ③ Following sectioning the dorsal and ventral roots from C5 to T5, no signifioant difference was found between control and EA groups in ECG-ST （ P 〉 0.05）, suggesting that the therapeutic effect of EA of PC 5-PC 6 in promoting recovery of ECG-ST was eliminated. Conclusion： In both intact and spinalized rabbits, EA of PC 5-PC 6 can promote the recovery of the ischemic cardiac functional activities, and the effect of EA of PC 5- PC 6 possesses a relatively specificity in comparison with EA of TE 5--TE 6. The spinal cord is the key site for accomplishing the aforementioned therapeutic effects of EA of PC 5 - PC 6.