“合谷”“内关”“扶突”穴与甲状腺的初级传入神经联系:荧光双标记法

Afferent Nerve Connection among "Hegu" (LI4),"Neiguan" (PC6),"Futu" (LI18) and Thyroid Gland Region:Fluorescent Double Labelling Method

目的:观察"合谷""内关""扶突"穴区与甲状腺区之间的传入神经联系途径,为针刺该3穴区行甲状腺针麻手术机制提供形态学依据。方法:30只Wistar雄性大鼠分为合谷-扶突穴组、内关-扶突穴组、甲状腺-扶突穴组、合谷-甲状腺组、内关-甲状腺组,每组6只。分别采用荧光素碘化丙啶(PI)及双苯甲亚胺(Bb)从上述穴区皮下和甲状腺周围微量注射。PI注射后60 h、Bb注射后12 h将动物以常规方法灌流固定,剥取颈节段脊神经节及脊髓,荧光显微镜下观察PI、Bb单双标记细胞。结果:所有组中PI及Bb单标记细胞在C1-T1脊神经节均可见到,其中"合谷"穴与"内关"穴PI单标记细胞集中分布在C4-C8脊神经节,"扶突"穴与甲状腺Bb单标记细胞集中分布在C1-C6脊神经节。合谷-扶突穴组、内关-扶突穴组、合谷-甲状腺组、内关-甲状腺组双标记细胞主要分布于C3-C7脊神经节,甲状腺-扶突穴组双标记细胞分布于C1-C4脊神经节。在脊髓前角也可见少量单标记细胞,约占同一节段脊神经节全部标记细胞数的8%左右,并可见散在的双标记细胞。结论:"合谷""内关""扶突"之间及3穴位与甲状腺之间均存在双标记细胞,即上述穴位之间及穴位与甲状腺之间存在由外周到脊髓的联系途径,为这些穴位组方配伍使用在甲状腺手术针麻过程中发挥镇痛作用的机制提供了形态学依据。

Objective To observe the peripheral and central neural connection of acupoint ＂Hegu＂ （LI 4）, ＂Neiguan＂ （PC 6）, ＂Futu＂ （LI 18） and the thyroid gland （TG） region with fluorescence double-labelling method. Methods Thirty male Wistar rats were divided into LI 4-LI 18 group, PC6- LI 18 group, TG-LI 18 group, LI 4-TG group, and PC 6-TG group, with 6 rats in each. Fluorescence dyes Propidium Iodide（PI, 10 μL） and Bisbenzimide（Bb, 10 pL） were, separately, injected into those acupoints mentioned above and the TG region. Sixty hours after PI-injection and 12 hours after Bb-injection, the rats under deep anesthesia were transcardiacally perfused with PBS containing 4% polyoxymethylene, followed by taking the spinal cord and dorsal root ganglia （DRGs） of the cervical segments （C1 -C8） and thoracic 1 （T1） segment. Fluorescent single- and dual-labeled cells of the sliced DRGs and cervical spinal cord were observed by fluorescence microscope. Results 1 ） All PI- and Bb-labeled cells were found to distribute in DRGs from C1 - T1 segments. PI single-labeled cells from LI 4 and PC 6 mainly distributed in DRGs from 04 to 08. Bb single-labeled cells from LI 18 and TG region distributed in DRGs from C1 - C6. 2） Dual-labeled cells in the LI 4-LI 18 group, PC 6- LI 18 group, LI 4-TG group, and PC 6-TG group distributed in DRGs from 03 to 07, suggesting bifurcate peripheral processes of the cervical DRG neurons to innervate LI 18, LI 4, PC 6 and the TG region. And the dual-labeled cells of the TG-LI 18 group distributed mainly in DRGs from C1 to C4. 3） A small number of single-labeled neurons（about 8% of total labeled cells in DRGs） and only several dual-labeled neurons were found in the anterior horn of the cervical spinal cord. Conclusion LI 18, LI 4 and PC 6 and the thyroid gland have the same peripheral cells in DRGs of C3 -- C7 segments, suggesting that the bifurcate periphe ral innervation may provide an anatomic evidence for the analgesic effect of acupuncture of LI 18, LI 4 and PC 6 on thyroidectomy.