基于心脑相关理论探讨电针心经、心包经穴对大脑中动脉梗阻大鼠心、脑细胞凋亡的影响

Observation of electroacupuncture intervention on cell apoptosis and Bax and Bcl-2 expression in cerebral and myocardial tissues in cerebral ischemia rats based on “heart-brain correlation” theory

目的:比较电针手厥阴心包经"内关"、手少阴心经"神门"、督脉"水沟"以及足少阴肾经"照海"对大脑中动脉梗阻(MCAO)大鼠的干预效应及对心脑细胞凋亡相关因子的影响,初步探讨电针心包经、心经与心脑的相关性。方法:SD大鼠随机分为内关组、神门组、水沟组、照海组、模型组及正常组,每组8只,采用颈外动脉插入线栓法建立MCAO大鼠模型,各穴位组分别在造模后每12h电针治疗1次,共治疗5次。采用免疫组化染色法检测各组心肌及脑组织细胞凋亡百分比及Bax、Bcl-2表达的变化。结果:与正常组比较,模型组心、脑组织细胞凋亡百分比、促凋亡因子Bax的表达均增多(P<0.01)。与模型组比较,内关组、神门组心、脑细胞凋亡百分比均不同程度减少(P<0.01,P<0.05),水沟组脑细胞凋亡百分比减少(P<0.05);内关组、神门组、水沟组脑组织Bax的表达减少(P<0.05),Bcl-2的表达增高(P<0.01,P<0.05);内关组心肌Bax的表达减少(P<0.05),内关组、神门组心肌Bcl-2表达增多(P<0.01,P<0.05)。与照海组比较,内关组心、脑细胞凋亡指数、Bax表达均减少(P<0.01,P<0.05),神门组心肌细胞凋亡的指数减少(P<0.05);内关组、水沟组脑组织Bcl-2表达高于照海组(P<0.05),内关组、神门组心肌Bcl-2表达高于照海组(P<0.01,P<0.05)。结论:脑缺血损伤继发心肌损害提示脑病及心,脑心二者之间具有密切的病理相关性。而针刺心包经、心经可较好地抑制脑心细胞凋亡。

Objective To compare the effect of electroacupuncture(EA)of"Neiguan"(PC6)of the Pericardium Meridian,"Shenmen"(HT7)of the Heart Meridian,"Shuigou"(GV26)of the Governor Vessel and"Zhaohai"(KI6)of the Kidney Meridian on myocardial and cerebral cell apoptosis in cerebral ischemia(CI)rats,so as to explore its mechanism underlying improvement of CI based on the theory of"Heart-brain Correlation".Methods Forty-eight SD rats(half male and half female)were randomly divided into normal control,model,PC6,HT7,GV26 and KI6 groups(n=8 in each one).The CI model was established by occlusion of the middle cerebral artery(MCAO).EA(4 Hz/20 Hz,1.5 mA)was applied to the right PC6,HT7,GV26 or KI6 respectively for 30 min,once every 12 hfor 5 times.The cell apoptosis of the ischemic myocardial and cerebral tissues was detected by TUNEL method,and the expression of cerebral and myocardial Bax and Bcl-2 was determined by using immunohistochemistry.Results Following modeling,the cell apoptosis percentages and Bax-positive cells of both myocardial and cerebral tissues were significantly increased in the model group in comparison with the control group(P<0.01).After EA intervention,the cerebral apoptotic percentage and cerebral Bax-positive cells in the cerebral tissue of the PC6,HT7 and GV26 groups,and the myocardial apoptosis percentage in the PC6 and HT7 groups,as well as the myocardial Bax-positive cells in the PC6 group were obviously decreased(P<0.05,P<0.01),while the cerebral Bcl-2 positive cells in the PC6,HT7 and GV26 groups,and the myocardial Bcl-2 positive cells in the PC6 and HT7 groups were significantly increased relevant to the model group(P<0.01,P<0.05).No significant changes were found in the KI 6 group in the cell apoptosis index and percentages and Baxand Bcl-2-positive cells of both myocardium and cerebral cortex tissues compared with the model group(P>0.05).Conclusion EA stimulation of PC6 and HT7 can inhibit CI injury induced cell apoptosis of cerebral and myocardial tissues in CI rats,which is possibly associated with its effects in down-regulating Bax expression and up-regulating Bcl-2 expression of both myocardial and cerebral tissues.