基于经络、营卫学说探讨神经环路调控睡眠-觉醒的机制

Study on the Mechanism of Neural Circuit Regulating Sleep-Wake Based on the Meridian and Ying-Wei Theory

失眠是常见的睡眠障碍之一,其发病率逐年攀升。研究显示,以腹侧被盖区(VTA)为核心的多巴胺能系统调控着伏隔核(NAc)、前额叶皮质(PFC)、缰核(Hb)及吻内侧被盖核(RMTg)等相关脑区,构成了VTA-NAc-PFC及Hb-RMTg-VTA神经环路,该神经环路在睡眠-觉醒调控中发挥着重要作用。中医学中的经络学说与脑内神经环路在解剖及生理功能上具有相似性。经络调控着营卫、阴阳、气血津液,维持机体的营养代谢和信息传递,与脑内神经环路从各脑区不同类型神经元,投射不同神经纤维,释放多种神经递质,参与细胞、体液间的信息传递是极为相似的。中医整体观念认为不寐的病机为营卫失和、阴阳失调。调和营卫、阴阳的正常出入才能使人“昼精夜瞑”,而营卫又与经络密切相关,调控着经络生理功能的正常发挥。文章试从经络、营卫学说阐释脑内神经环路对睡眠-觉醒的调控,为中医药防治失眠提供新的研究思路。

Insomnia is one of the common sleep disorders,and its incidence is increasing year by year.Research shows that the dopaminergic system with the ventral tegmental area(VTA)as the core regulates the nucleus accumbens(NAc)and prefrontal cortex(PFC),habenula(Hb),rostromedial tegmental nucleus(RMTg)and other related brain regions constitute VTA-NAc-PFC and Hb-RMTg-VTA neural circuits.This neural circuit plays an important role in sleep-wake regulation.The regulation of meridians to Ying-Wei,Yin-Yang,Qi,blood,and body fluid maintains the body's nutrient metabolism and information transmission,which is very similar to the projection of neural circuits in the brain from various brain regions,different types of neurons and different nerve fibers until the release of various neurotransmitters,participating in the information transmission between cells and body fluids.The holistic concept of traditional Chinese medicine thinks the pathogenesis of insomnia is battalion defends disharmony,Yin and Yang maladjusted.Harmonize Ying-Wei and Yin-Yang of normal access to make people have a good sleep.And Ying-Wei are closely related to the meridian,regulating the normal play of the physiological function of the meridian.This paper tries to explain the regulation of brain neural circuit on sleep-wake from the theory of Meridian and Ying-Wei,and provides a new research idea for Chinese medicine prevention and treatment of insomnia.