艾灸神阙穴对运动性疲劳大鼠心肌重构及心肌功能的影响

Effect of moxibustion at Shenque(CV 8)on myocardial remodeling and function in exercise-induced fatigue rats

目的:探讨艾灸神阙穴对运动性疲劳大鼠心肌结构及功能的影响.方法:采用12周跑台训练方式制造运动性疲劳大鼠模型.将符合条件的60只无特定病原体级雄性Sprague-Dawley大鼠随机分为空白组、对照组、模型组、非经非穴组、足三里组和神阙组,每组10只.空白组大鼠不进行运动训练也不进行艾灸,对照组大鼠不进行运动训练但温和灸神阙穴,模型组大鼠进行运动训练但不进行艾灸,非经非穴组、足三里组及神阙组大鼠于每次运动后即刻分别温和灸非经非穴点、足三里及神阙,每次15 min,1次/d,每周连续干预5 d后休息2 d,共治疗60次.测量运动前及末次运动后各组大鼠左室舒张末内径(LVEDd)、左室收缩末内径(LVESd)、左室舒张期体积(LVDv)、左室收缩期体积(LVSv)、射血分数(EF)、每搏输出量(SV)、二尖瓣舒张早期峰值血流速度(E)和舒张晚期峰值血流速度(A);于末次运动6 h后取血,检测血清C反应蛋白(CRP)、肌红蛋白(Mb)、肌酸磷酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)和肌钙蛋白T(cTnT)含量;最后摘取心脏,测量心脏质量(HM),检测心肌组织cTnT含量,透射电镜观察左室心肌超微结构变化,计算左室短轴缩短率(LVFS)、E/A和心脏质量指数(HMI).结果:与同组治疗前比较,模型组和非经非穴组大鼠治疗后心脏的LVEDd、LVESd、LVDv、LVSv、SV、E及A均显著升高(均P<0.01),LVFS、E/A和EF均降低(均P<0.01);足三里组治疗后心脏的SV、LVDv、LVSv、E及A均升高(均P<0.01),E/A和EF均降低(均P<0.01);神阙组大鼠治疗后心脏的LVDv、E和A均升高(P<0.01或P<0.05),E/A降低(P<0.01).治疗后,与空白组比较,模型组大鼠心脏LVEDd、LVESd、SV、LVDv、LVSv、E及A,血清CRP、Mb、CK-MB、cTnI、cTnT和HMI,及心肌cTnT均升高(均P<0.01),LVFS、E/A和EF均降低(均P<0.01);与模型组和非经非穴组比较,足三里组和神阙组大鼠LVEDd、LVESd、SV、LVDv、LVSv、E和A,血清CRP、Mb、CK-MB、cTnI、cTnT和HMI,及心肌cTnT均降低(P<0.01或P<0.05),LVFS、E/A和EF均升高(均P<0.01);与足三里组比较,神阙组大鼠Mb和A均降低(均P<0.01),E/A和EF均升高(P<0.01,P<0.05).透射电镜显示空白组和对照组肌原纤维排列整齐,明暗带清晰;模型组和非经非穴组均出现不同程度肌原纤维崩解、断裂,线粒体增多聚集,且大小不一,电子密度增高.神阙组和足三里组肌原纤维排列整齐,明暗带清晰,线粒体代偿性增生.结论:艾灸神阙和足三里均可有效改善运动性疲劳大鼠心肌重构的发生,在改善心功能方面艾灸神阙效果更优.

Objective To explore the effect of moxibustion at Shenque(CV 8)on myocardial structure and function in exercise-induced fatigue rats.Methods A 12-week treadmill running training was performed to create an exercise-induced fatigue rat model.Sixty eligible male specific-pathogen-free grade Sprague-Dawley rats were randomly divided into a blank group,a control group,a model group,a non-meridian non-acupoint group,a Zusanli(ST 36)group and a Shenque(CV 8)group,with 10 rats in each group.Rats in the blank group did not receive treadmill running training or moxibustion.Rats in the control group did not receive treadmill running training but received mild moxibustion at Shenque(CV 8).Rats in the model group received treadmill running training but no moxibustion.Rats in the non-meridian non-acupoint group,the Zusanli(ST 36)group and the Shenque(CV 8)group received moxibustion at the non-meridian non-acupoint points,Zusanli(ST 36)or Shenque(CV 8)immediately after each treadmill running training,15 min each time,once a day for 5 consecutive days a week at a 2-day interval,60 times of moxibustion in total.Left ventricular end-diastolic diameter(LVEDd),left ventricular end-systolic diameter(LVESd),left ventricular diastolic volume(LVDv),left ventricular systolic volume(LVSv),ejection fraction(EF),stroke volume(SV),early diastolic peak flow velocity of mitral valve(E)and late diastolic peak flow velocity of mitral valve(A)of each group before and after the last treadmill running training were measured.Blood was collected 6 h after the last treadmill running training,and serum C-reactive protein(CRP),myoglobin(Mb),creatine kinase-myocardial band(CK-MB),cardiac troponin I(cTnI)and cardiac troponin T(cTnT)levels were detected.Finally,the heart was separated,the heart mass(HM)was measured,the cTnT level of the myocardial tissue was detected,the ultrastructural changes of the left ventricular myocardium were observed by transmission electron microscope,the left ventricular fraction shortening(LVFS),E/A and heart mass index(HMI)were calculated.Results Compared with the same group before treatment,the rat cardiac LVEDd,LVESd,LVDv,LVSv,SV,E and A were significantly increased(all P<0.01),and the rat LVFS,E/A and EF were significantly decreased(all P<0.01)in the model group and the non-meridian non-acupoint group after treatment;the rat cardiac SV,LVDv,LVSv,E and A were all increased(all P<0.01),while E/A and EF were decreased(all P<0.01)in the Zusanli(ST 36)group after treatment;the rat cardiac LVDv,E and A were significantly increased(P<0.01 or P<0.05),and E/A was significantly decreased(P<0.01)in the Shenque(CV 8)group after treatment.After treatment,compared with the blank group,the rat cardiac LVEDd,LVESd,SV,LVDv,LVSv,E,A,the serum CRP,Mb,CK-MB,cTnI,cTnT and HMI,and the myocardial cTnT were increased(all P<0.01),and the LVFS,E/A and EF were all reduced(all P<0.01)in the model group;compared with the model group and the non-meridian non-acupoint group,rats in the Zusanli(ST 36)group and the Shenque(CV 8)group showed decreased LVEDd,LVESd,SV,LVDv,LVSv,E,A,serum CRP,Mb,CK-MB,cTnI,cTnT and HMI,and myocardial cTnT(P<0.01 or P<0.05),along with increased LVFS,E/A and EF(all P<0.01);compared with the Zusanli(ST 36)group,Mb and A of the Shenque(CV 8)group were decreased(both P<0.01),while both E/A and EF were increased(P<0.01,P<0.05).Transmission electron microscopy examination showed that myofibrils in the blank group and the control group were neatly arranged with clear light and dark bands;the model group and the non-meridian non-acupoint group showed different degrees of myofibril disintegration and breakage,increased and aggregated mitochondria of different sizes,and increased electron density.The myofibrils in the Shenque(CV 8)group and Zusanli(ST 36)group were arranged neatly with clear light and dark bands,and compensatory hyperplasia of mitochondria.Conclusion Moxibustion at Shenque(CV 8)and Zusanli(ST 36)both can effectively improve the occurrence of myocardial remodeling in exercise-induced fatigue rats,and the effect of moxibustion at Shenque(CV 8)is better in improving cardiac function.