基于经穴特异性探讨循经取穴改善心肌缺血的腺苷受体机制

Mechanism of acupoint selection along meridians to improve adenosine receptor of myocardial ischemia based on acupoint specificity

目的:通过比较循经取穴、他经取穴、非经非穴对心肌缺血(myocardial ischemia,MI)大鼠腺苷受体表达水平的影响,探讨循经取穴改善MI的腺苷受体作用机制。方法:将120只SD大鼠随机分为空白组、假手术组、模型组、循经取穴组、他经取穴组、非经非穴组,每组20只。空白组不予缺血造模,假手术组开胸后不结扎冠状动脉左前降支,模型组进行缺血造模但不予针刺治疗,循经取穴组缺血造模后电针"内关",他经取穴组缺血造模后电针"合谷",非经非穴组缺血造模后电针前肢足背侧第3、4跖骨间隙凹陷处。电针治疗持续时间为20 min,每日1次,连续5 d。治疗完成后,采用TTC染色法检测心肌梗死,采用Tunel法检测心肌细胞凋亡,采用免疫组化法检测腺苷A1、A2a、A2b受体表达。结果:与空白组、假手术组相比,模型组的心肌梗死百分比、心肌细胞凋亡率均明显升高(P<0.01);电针干预后,循经取穴组的心肌梗死百分比、心肌细胞凋亡率较模型组明显降低(P<0.01),腺苷A1、A2a、A2b受体表达水平较模型组明显升高(P<0.01);循经取穴组的心肌梗死百分比、心肌细胞凋亡率较他经取穴组、非经非穴组均明显降低(P<0.01),腺苷A1、A2a、A2b受体表达水平较他经取穴组、非经非穴组均明显升高(P<0.01)。结论:与他经取穴或针刺非经非穴相比,循经取穴能更有效地调控腺苷A1、A2a、A2b受体表达,改善心肌梗死情况,抑制心肌细胞凋亡,进而保护缺血心肌。

Objective To explore the action mechanism of acupoint selection along meridians to improve adenosine receptor in myocardial ischemia(MI) rats by comparing the effects of acupoint selection along meridians, acupoint selection at other meridians and non-acupoint on expression of adenosine receptor. Methods A total of 120 SD rats were randomly divided into a blank group, a sham operation group, a model group, an acupoint-selection-along-meridians(ASAM) group, an acupoint-selection-at-other-meridians(ASAOM) group and a non-acupoint group, 20 rats in each group. The model of MI was not made in the blank group;the left anterior descending coronary artery was not ligated after thoracotomy in the sham operation group;the model of MI was made but acupuncture was not given in the model group. After the model of MI was made, electroacupuncture(EA) was applied at "Neiguan"(PC 6) in the ASAM group, at "Hegu"(LI 4) in the ASAOM group,and at the area between the third and fourth metatarsal bone in the non-acupoint group. EA was given 20 min per treatment,once a day for 5 days. After treatment, the TTC staining was used to detect myocardial infarction, the Tunel method was used to detect cardiomyocyte apoptosis, and the immunohistochemistry was used to detect the expression of adenosine receptors A1, A2 a and A2 b. Results Compared with the blank group and the sham operation group, the percentage of myocardial infarction and apoptotic rate of myocardial cells in the model group were increased significantly(P<0.01). After EA treatment, compared with the model group, the percentage of myocardial infarction and apoptotic rate of myocardial cells in the ASAM group were decreased significantly(P<0.01), and the expression levels of adenosine receptors A1, A2 a and A2 b were increased significantly(P<0.01). The percentage of myocardial infarction and apoptotic rate of myocardial cells in the ASAM group were significantly lower than those in the ASAOM group and the non-acupoint group(P<0.01), and the expression levels of adenosine receptors A1, A2 a and A2 b in the ASAM group were significantly higher than those in the ASAOM group and non-acupoint group(P<0.01). Conclusion Compared with acupoint selection at other meridians or non-acupoints,acupoint selection along meridians can effectively regulate the expression of adenosine receptors A1, A2 a and A2 b, improve the condition of myocardial infarction, inhibit myocardial cell apoptosis, and consequently protect ischemic myocardium.