揭示灸法作用的穴位物质基础与阐明灸法退热机理的研究

Study on Revealing Material Basis of Acupoint for Effect of Moxibustion and Expounding Mechanism of Antipyretic Action of Moxibustion

目的:①揭示灸法作用的穴位物质基础;②"系统"阐明灸法的退热机理;③为"热证可灸"论充实科学的理论依据;④探索灸法作用机理及其应用之研究的可行途径。方法:以内毒素致热兔为对象,以温热灸法产生明显退热效应为前提。首先检测12类皮肤感受器125个单位对灸热的反应性,仅见温觉感受器(WR)和多觉型感受器(PR,含δPR和CPR两种亚型而以后者为主)规律地产生兴奋反应。进而分析灸法退热与这两类感受器的关系。对所设灸法退热、散热及其中枢机制等3项研究(文中尚含与此紧密关联的另外3项工作),分别以直肠温度、耳廓温度和热敏神经元(HSN)放电变化为指标。根据感受器温度阈值等参数,设定由灸热引起皮温40℃和皮温47℃(或48℃)作为区分WR与PR反应的施灸强度。灸法采用自行研制的,由计算机自动调控可使穴位保持恒温并证实可与悬起灸互换的聚光灸,施灸于督脉某些穴位。3项研究均各设3个实验组:①每兔静注25EU内毒素作为对照组;②25EU内毒素+皮温40℃灸法组;③25EU内毒素+皮温47℃(或48℃)灸法组。将各组所得数据作组内、组间比较获取结果。结果:①3项工作中内毒素所生影响分列于下:①HSN放电频率显著下降,反映中枢温度敏感神经元机能受到明显的不良影响(同时体温调定点位移);②耳廓温度明显下降,体热发散显著减少;③直肠温度明显上升,出现发热反应。②皮温47℃(或48℃)灸法对上列内毒素影响均产生有效的拮抗作用(P<0.01)。③皮温40℃灸法则不能产生上述灸法所生效应(P>0.05)。结论:灸法对发热机体具有显著的退热作用,是项灸效是通过穴位PR产生的。也就是说灸法退热(以及以灸热为主而见效的各项灸法作用)的穴位物质基础是PR。PR传入信号能有效拮抗热原对中枢温度敏感神经元的不良影响,使其恢复正常机能和校正移位了的调定点,从而导致产热、散热效应器活动和体温水平之回复正常状态。上列事实表明,本项工作在揭示PR为灸法作用的穴位物质基础的基点上,"系统"地阐明了灸法退热的机理,同时为"热证可灸"论从退热层面(发热是热证共有的重要征象)充实了科学的理论基础,此外,亦为灸法作用的机理研究以及促进灸法的发展启示了一条有效和可行的途径。

Objective ： To reveal material basis of acupoint for effect of moxibustion and to expound mechanism of antipyretic action of moxibustion. Then to enrich the theoretical foundation of science for the opinion on ＂heat syndrome may be treated by moxibustion＂. Methods： The endotoxic rabbits which fever introduced by endotoxin can be revered by warm moxibustion were used. Firstly, the reactivity of 125 units of 12 groups of cutaneous receptors to moxibustion heat were examined the results indica ted that there only warm receptor （WR） and poly-modal receptor （PR, including 8PR and CPR subgroups） were regularly ex cited. Then the relation between antipyretic action of moxibustion and WR or/and PR was analyzed. There found three items for this research which were antipyretic action and therrnolytic action of moxibustion, and their central mechanism （ there also con- tained other three jobs which closely related to these works in this paper）. The rectum and ear temperatures and the discharge of heat sensitive neuron （HSN） were selected as the indexes for the items described above successfully. According to the parame- ters such as temperature thresholds of WR and PR, we set 40℃and 47℃ （ or 48℃） of skin temperature caused by moxibustion as the stimulating strength to excite WR and PR separatively. Each item of these work contained 3 experimental groups as follows ： ①25 EU endotoxin i. v. as contrast group. ②25 EU endotoxin i. v. ＋ moxibustion of 40℃ skin temperature. ③25 EU endo toxin i. v. ＋ moxibustion of 47℃ （48） skin temperature. A certain points of Governor Vessel were stimulated by spotlight moxi bustion which was controlled with computer to stabilize the point temperature. The results were obtained from the data of thesegroups to compare with each other. Results： （1） The endotoxin effect of 3 items were as following： ①The discharge rats of HSN were decreased markedly to indicate that the activity of central thermosensitive neurons suffered harmful effect. ②The ear temper ature lowered notably, thus the thermolysis sharply dropped. ③The rectum temperature increased strikingly, it indicated fever in body. （2） The reactions caused by endotoxin described above all were antagonized markedly by moxibustion of 47℃ （48） skin temperature （P〈0. 01 ）. （3） The moxibustion of 40℃ skin temperature can not produce the same effects of 47 （48℃） skin temperature （P〉O. 05）. Conclusion： The moxibustion possess distinct antipyretic action, this is traversed by poly-modal recep tor of the point. That is to say, PR is the material basis of point for antipyretic action （ and other effects of moxibustion essential ly produced by moxibustion heat） of moxibustion. Fever is due to the function of central thermosensitive neurons suffer injury by pyrogen. This harmful influence on these neurons can be antagonized by the afferent impulse from PR, on the same time, the set point is corrected to normal state, thus the effectors of heat production and heat loose as well as body temperature return to normal conditions. The above mentioned facts indicated that on the base to reveal PR was the material basis of acupoint for the effects of moxibustion, the essential mechanism of antipyretic action of moxibustion was successfully and systematical expounded, and thereby it also enriched the theoretical foundation of science for the opinion of ＂heat syndrome may be treated by moxibustion＂. In addition, this work had yet to enlighten an effective and feasible way for researches on the mechanism of effect of moxibustion and to promote the further advances of moxibustion itself.