电针下关穴改善犬迟发性脑血管痉挛的机制研究

Mechanism of Treating Delayed Cerebral Vasospasm by Acupuncture on Xiaguan Point

目的:探讨电针下关穴改善迟发性脑血管痉挛的作用机制。方法:将20只成年Beagle犬随机分为正常组(6只)、下关穴组(8只)、对照组(6只)。采用枕大池二次注血法制作蛛网膜下腔出血后脑血管痉挛模型。正常组不予干预,下关穴组于左侧下关穴植入电极并电刺激,对照组于皮下植入电极但不予电刺激。14 d后处死动物,观察各组犬大脑中动脉、基底动脉、蝶腭神经节乙酰胆碱酯酶(AchE)及一氧化氮类(NOS)神经元的变化,及脑脊液AchE、内皮素、NOS水平变化。结果:下关穴组蝶腭神经节、大脑中动脉NOS、AchE神经元分布密度较正常组和对照组增加。与正常组和对照组比较,下关穴组犬脑脊液AchE水平下降(P<0.05),而NOS水平上升(P<0.01);3组犬脑脊液ET-1水平比较无显著差异(P>0.05)。结论:电针下关穴可兴奋神经节内乙酰胆碱及一氧化氮类神经元及调节脑脊液中NOS、AchE水平以改善脑血管痉挛。

Objective： To explore the feasibility of treating cerebral vasospasm after subarachnoid hemorrhage by acupuncture on Xiaguan point. Methods： Twenty adult Beagle dogs were randomly divided into normal group （6 dogs）, Xiaguan point group （8 dogs） and control group （6 dogs）. The models were established by injecting blood at Dachi points twice. No intervention in normal group, dogs in Xiaguan point group were implanted needles and underwent electrical stimulation and dogs in control group were implanted needles without electrical stimulation. Sacrifice the dogs after 14 days, the middle cerebral artery （MCA） , basilar artery, acetylcholine in ganglion pterygoplatinum, nNOS, AchE, endothelin and NOS were observed. Results ： The ganglion pterygoplatinnm, NOS in MCA and distribution of AchE neuron in Xiaguan point group were higher than those in normal group and control group. Compared with normal group and control group, the level of Ache in Xiaguan point group was decreased significantly （ P 〈 0.05 ） ; the level of NOS was increased （ P 〈 0.01 ） ; there was no significant difference in ET-1 level between the three groups （P 〉 0.05 ）. Conclusion： Needling Xiaguan point can activate acetylcholine in ganglion pterygoplatinum, nNOS and regulate levels of NOS and AchE for cerebral vasospasm.