Effect of electroacupuncture at Neiguan(PC6)at different time points on myocardial ischemia reperfusion arrhythmia in rats

OBJECTIVE:To observe the effects of electroacupuncture at Neiguan(PC6)at different time points on reperfusion arrhythmia(RA)after myocardial ischemia and reperfusion in rats,and to investigate the correlation of this protective effect with nerve growth factor(NGF),tyrosine kinase A(Trk A),tyrosine hydroxylase(TH),and norepinephrine(NE).METHODS:A total of 72 Sprague-Dawley male rats were randomly divided into six groups(n=12 rats/group):normal group(Norm),sham operation group(Sham),ischemia reperfusion group(I/R),pre-ischemic electroacupuncture group(EAI),pre-reperfusion electroacupuncture group(EAII),post-reperfusion electroacupuncture group(EAIII).The myocardial ischemia-reperfusion injury(MIRI)model was induced by occlusion of left anterior descending coronary artery for 20 min followed by reperfusion for 40 min in rats.With no intervention in the Norm group and only threading without ligation in the Sham group.Electroacupuncture pretreatment at 20 min/d for 7 d before ligation in the EAⅠgroup,20 min of electroacupuncture before reperfusion in the EAII group and 20 min of electroacupuncture after reperfusion in the EAIII group.The electrocardiogram(ECG)of each group was recorded throughout the whole process,and the success of the MIRI model was determined based on the changs of J-point and T-wave in the ECG.The arrhythmia score was used to record premature ventricular contractions,ventricular tachycardia and ventricular fibrillation during the reperfusion period to assess the reperfusion induced arrhythmias.The expression levels of NGF,Trk A,TH protein were measured by Western blot.Moreover,the expression levels of plasma and myocardial NE levels were detected by enzyme linked immunosorbent assay.RESULTS:The differences between Norm group and Sham group were not statistically significant in all indexes.Arrhythmia score,myocardial NGF,Trk A,TH,and NE expression were significantly higher in the I/R group compared with the Sham group.Arrhythmia score,myocardial NGF,Trk A,TH,and NE expression were significantly lower in each EA group compared with the I/R group.CONCLUSION:Electroacupuncture at Neiguan(PC6)at different time points can reduce the incidence and severity of reperfusion arrhythmias in rats.This protective effect is related to electroacupuncture regulating NGF,Trk A,TH,NE expression and reducing sympathetic hyperactivation.

针刺内关穴治疗低脉压综合症106例临床观察

平均动脉压正常而脉压差降低，可以产生一系列临床表现，可谓之低脉压综合症。针刺双侧内关穴具有升高收缩压、降低舒张压、增大脉压差并消除相应的临床症状的作用，有效率在９２％以上。

Effect of Acupuncture at Acupoint Neiguan(PC6)on the Myocardial c-fos Gene Expression of Acute Myocardial Ischemia in Rats

Objective：To investigate the mechanism of improvement effect of electro acupuncture at acupoint Neiguan （PC 6） on acute myocardial ischemia （AMI）. Methods： Ninety-six rats were randomly divided into sham-operation group, myocardial ischemia model group and myocardial ischemia model plus electro-acupuncture group, the rat model of AMI was established by occlusion of the anterior descending branch of the left coronary artery, then electro-acupuncture therapy was performed at bilateral acupoint Neiguan （PC 6）. The myocardial enzyme activities in plasma was detected with biochemical method, and the myocardial c-fos gent expression was detected with reverse transcription polymerase chain reaction（RT PCR） method. Results： The myocardial enzyme activities in plasma and the myocardial c-fos gene expression in myocardial ischemia model group were obviously higher than those in sham group（P〈 0.05）, after electro-acupuncture treatment, the myocardial enzyme activities in plasma and the myocardial c-fos gene expression were decreased, there was a significant difference （P〈 0.05）. Conclusion. The mechanism of improvement effect of electro acupuncture at acupoint Neiguan （PC 6） on AMI is related to down-regulation of the myocardial c-fos mRNA expression.

Efficacy on rabbits with arrhythmia: needling acupoint of Neiguan(PC6) at shallow or deep depth, and retaining needles for 10, 20, or 30 min

OBJECTIVE:To compare the effects of Neiguan(PC6)acupuncture at different depths and retention time on arrhythmia duration,myocardial tissue morphology,mRNA expression level of L-type calcium channelα1C subunit and Ca^(2+)-Mg^(2+)-At Pase activity in tachirrhythmia model of rabbits.METHODS:The tachyarrhythmia model was made by intravenous injection of barium chloride into the ears of rabbits.A total of 56 healthy adult male New Zealand big-eared white rabbits,apply the random number table method,divided into normal control group(group A),model group(group B),shallow needling Neiguan(PC6)10 min group(group C),shallow needling Neiguan(PC6)20 min group(group D),shallow needling Neiguan(PC6)30 min group(group E),deep needling Neiguan(PC6)10 min group(group F),deep needling Neiguan(PC6)20 min group(group G),deep needling Neiguan(PC6)30 min group(group H),7 animals in each group.Electrocardiograms were used to collect the duration of arrhythmia;hematoxylin-eosin staining method was performed on myocardial tissue,RT-PCR tested the expression ofα1C subunit mRNA,and the activity of Ca^(2+)-Mg^(2+)-ATPase were quantified by phosphorus determination method.RESULTS:The duration of arrhythmia in each acupuncture treatment group was shortened to varying degrees.Compare to the model group,the tissue damage from barium chloride inducing was improved in the acupuncture group.Compared to the model group,except for group E,most treatment groups had varying degrees of improvement with significantly down-regulated L-type calcium channelα1C subunit mRNA expressions level and increased Ca^(2+)-Mg^(2+)-ATPase activity.CONCLUSIONS:The effect of acupuncture at Neiguan(PC6)with different depths and retention time can reduce the duration of arrhythmia induced by barium chloride relatively,improve the induced pathological changes,down regulate L-type calcium channelα1C subunit mRNA expressions level and increase Ca^(2+)-Mg^(2+)-ATPase activity.Both the shallow and deep tissues of Neiguan(PC6)may be involved in transmitting acupuncture information.There is an optimal induction period for shallow needling at Neiguan(PC6)to reach the best therapeutic effect.

Effect of electronic stimulation at Neiguan(PC 6) acupoint on gene expression of adenosine triphosphate-sensitive potassium channel and protein kinases in rats with myocardial ischemia

OBJECTIVE:To investigate the effects of electronic stimulation at acupoints Neiguan(PC 6) and Lieque(LU 7) on the gene expression of the adenosine triphosphate(ATP)-Sensitive potassium channel(KATP:Kir6.1,Kir6.2,SUR2 A,and SUR2B) and protein kinases(PKA,PKG,and PKCβ2) in myocardial cells of rats with myocardial ischemia(Ml) induced by isoproterenol(ISO).METHODS:Rats were randomly divided into a control,model,Neiguan(PC 6),Lieque(LU 7),and non-acupoint groups.The Ml model was established by injecting rats with ISO.Electro-acupuncture treatment was given to the acupuncture groups,once a day for 7 days.Gene expression was analyzed with real-time PCR.RESULTS:The gene expression of KATP and protein kinases in the model group was higher than those in the control group(P < 0.05).After acupuncture treatment,the KATP and protein kinase expression levels were significantly lower in the Neiguan(PC 6)and Lieque(LU 7) groups compared with the model group[P < 0.05).The Neiguan(PC 6) group lowered these levels significantly more than that of the Lieque(LU 7) group(P < 0.05).No significant differences were observed between the model and non-acupoint groups(P > 0.05).CONCLUSION:Our findings suggest that electronic needling of Neiguan(PC 6) can both reduce the gene expression of KATP and protein kinases in rats with ISO-induced Ml.

Effects of electroacupuncture at "Nèiguān" (内关 PC6) on the catecholamine neurotransmitters of rats with myocardial hypertrophy

Objective To study the neuroendocrine mechanisms of electroacupuncture （EA） at ＂Neiguan＂ （内关 PC 6） for preventing and treating myocardial hypertrophy. Methods Thirty 3-month-old Sprague-Dawley rats were randomly divided into a normal group, a model group and an EA group according to the random digit table, 10 in each group. Isoprenaline Hydrochloride （ISO） injection was subcutaneously injected to establish the model. EA at ＂Neiguan＂ （内关 PC 6） was applied for rats in the EA group, 20 min each time, once daily, for 14 successive days. No treatment was given to rats in the normal group and the observed. The plasma catecholamine neurotransmitters levels and c determined with high performance liquid chromatography model group. The electrocardiogram （ECG） was hanges of their metabolic products contents were （HLPC） method. Results Compared with the normal group, catecholamine neurotransmitters, such as epinephrin （E）, norepinephrine （NE）, and dopamine （DA） and metabolic products, such as 3-methoxy-4-hydroxyphenylglycol （MHPG）, homovanillic acid （HVA）, and 3,4-dihydroxy-phenyl acetic acid （DOPAC） were significantly increased in the model group （all P〈0.05）. These parameters decreased in the EA group when compared with the model group （all P〈0.05）. Conclusion EA at ＂Neiguan＂ （内关 PC 6） could improve the myocardial hypertrophy, which might be correlated with the neuroendocrine system.

Clinical Application of Acupoint Neiguan (PC 6)

Acupoint Neiguan (PC 6) is first recorded in LingShu (Spritual Pivot). It is the Luo-Connecting pointof the Pericardium Meridian and communicateswith acupoint Waiguan (TE 15); it is also one ofeight confluent points, and associates with the YinLink Vessel. We often use Neiguan (PC 6) alone oras the cardinal acupoint to treat many disorders inclinical practice. It is now reported as follows.

电针内关和神门穴对脑功能成像不同影响的观察

目的 :观察针刺内关和神门对脑功能成像的影响作用。方法 :采用功能磁共振成像技术研究电针内关和神门对不同脑区的激活状态。结果 :电针刺激内关主要引起额叶的激活 ,刺激神门主要引起颞叶的激活。结论 :针刺刺激不同的穴位 ,可以激活不同的脑区 ,电针内关和神门穴激活脑区的功能与智能有关 ,提示应用内关、神门穴治疗智能障碍有一定的客观性。

电针“内关”对心肌缺血再灌注损伤内皮素及超微结构的影响

目的 :探讨“内关”在心肌缺血再灌注损伤过程中对心肌细胞的保护作用。方法 :电针家兔左右侧“内关”穴 2 0min后 ,结扎左冠状动脉前降支 ,心电图 (ECG)监测。 4 0min后恢复灌流 ,再灌注 1小时 ,取静脉血及心肌组织 ,观察血浆内皮素 (ET)及透射电镜下组织超微结构的变化。结果 :针刺“内关”组ET含量明显降低 (P <0 0 1) ,心肌组织损伤轻微 ,肌纤维正常走向 ,少量线粒体空泡变 ,肌丝无明显坏死、溶解。结论 :电针“内关”可明显降低缺血再灌注损伤的程度 。

针刺内关穴对机体不同功能状态下fMRI脑功能成像的影响

目的:观察机体在生理或病理状态下,针刺同一穴位时fMRI脑功能成像的变化,探讨内关穴的作用机制。方法:对老年健康人(正常组)和阿尔茨海默病患者(AD组)进行电针刺激内关穴,同时运用1.5T磁共振成像系统,采集两组被试者脑部的fMRI功能像数据,通过SPM99进行统计分析,获取正常组和AD组脑内不同区域的功能活动图像。结果:正常组两侧额叶及颞叶均被不同程度激活,AD组表现在额叶、颞叶和扣带回、小脑等部位不同程度的激活,其他脑区无明显激活。结论:针刺内关穴对正常组和AD组的脑功能活动激活区域表现不同,说明针刺内关穴对机体不同功能状态下fMRI脑功能成像影响不同。

不同针刺方法对中风患者手痉挛影响的对比研究

目的:观察内关穴不同针刺手法治疗中风患者手部痉挛的疗效。方法:将172例患者随机分为单纯针刺组(36例)、慢速捻针组(34例)、快速捻针组(30例)、单纯提插组(35例)和提插捻转组(37例)。均取内关穴,每天针刺2次,每次5分钟,并配合康复训练。以修订的Ashworth量表和Fugl-Meyer(FMA)手功能评分评定疗效。结果:手痉挛即刻有效率和治疗8周后有效率单纯针刺组分别为66.7%、55.6%,慢速捻针组为82.4%、85.3%,快速捻针组为96.7%、90.0%,单纯提插组为80.0%、82.9%,提插捻转组为94.6%、91.9%,快速捻针组与提插捻转组疗效优于其他3组(P<0.01)。治疗后Ashworth量表分级和FMA评分提插捻转组、快速捻针组均优于其余3组(P<0.05,P<0.01),且提插捻针组和快速捻针组之间差异无显著性意义(P>0.05)。结论:针刺内关穴有非常肯定的即刻效应,提插捻转手法与快速捻转手法对痉挛的抑制效果最佳。

小剂量吗啡内关穴注射治疗急性心肌梗死之胸痛

目的:探寻治疗急性心梗胸痛时吗啡的有效注射途径。方法:将临床确诊为心肌梗死的患者90例随机分为3组,每组30例。穴位注射组行双侧内关穴分别注射吗啡2 mg,静脉注射组采用吗啡5 mg静脉注射,皮下注射组采用吗啡5 mg皮下注射,其他治疗3组相同。采用视觉模拟评分法(VAS)观察3组病人治疗5、10、30、60、180 min后镇痛效果,并记录并发症。结果:治疗前3组VAS评分比较差异无统计学意义(均P>0.05);治疗后5 min、30 min、180 min镇痛效果穴位注射组优于其他2组(均P<0.01);穴位注射组恶心、呕吐发生率为3.3%,低于静脉注射组的40.0%和皮下注射组的20.0%(均P<0.01)。结论:小剂量吗啡内关穴注射治疗急性心梗时的胸痛疗效确切,镇痛效果好,吗啡用量少,镇痛时间长,吗啡并发症少。

大鼠“内关”穴注射硝酸甘油缓解心肌缺血作用的研究

目的 :了解“内关”穴注射硝酸甘油 (NTG)防治急性心肌缺血 (MI)的作用及其机制。方法 :静脉注入垂体后叶素 (PPT)造成MI模型 ,以“内关”注入NTG缓解MI的心电图变化为指标 ,观察保留与切断G6 ～T2 脊神经前后根 (VDS)、以及毁损脊神经节 (DRG)的影响 ,并与舌下运用NTG进行比较。结果 :切断VDS对“内关”注入NTG缓解MI影响不大 ,毁损DRG后MI加重并恢复延迟 ,“内关”比舌下运用NTG防治MI的持续时间更长。结论 :“内关”注射NTG可作为防治冠心病的有效方式之一 ,“内关” DRG 心脏间存在不依赖于中枢的神经短反射通路。

电针“内关”穴抗心肌缺血损伤中下丘脑室旁核内阿片肽的作用

目的探讨电针“内关”穴抗心肌缺血损伤的作用机理。方法取清洁级日本大耳白兔40只,按随机数字表法分为模型对照组10只;纳络酮对照组10只;电针加脑脊液组10只;电针加纳络酮组10只。观察下丘脑室旁核(PVN)微量注射纳络酮后电针“内关”穴对心肌缺血家兔心肌超微结构、Ⅱ导联心电图及心肌细胞跨膜电位的影响。结果PVN纳络酮微量注射对正常家兔心肌功能无影响,对缺血心肌功能影响轻微,在结扎(缺血)60min时发挥一定的保护作用(P<0·05);电针“内关”穴对缺血心肌有明显的保护作用,该作用可被PVN注射纳络酮所削弱(P<0·05),但不能完全阻断。结论(1)PVN在电针“内关”穴抗心肌缺血效应过程中发挥了重要作用;(2)PVN内阿片肽参与介导了“内关”穴抗心肌缺血的针刺效应;(3)除PVN及其内阿片肽外,PVN内的其他递质和中枢其他核团也可能在电针“内关”穴抗心肌缺血效应中发挥作用。

电针“内关"对急性心肌缺血大鼠心肌c-fos基因表达的影响

目的:探讨电针“内关”改善急性心肌缺血的机制。方法:将96只大鼠随机分为假手术组、心肌缺血模型组、心肌缺血模型加电针组,采用结扎冠状动脉左前降支建立急性心肌缺血实验模型,造模成功后,电针双侧“内关”。用生化方法检测血清心肌酶活性,逆转录聚合酶链反应(RT-PCR)方法检测心肌中c-fos基因的表达。结果:心肌缺血模型组血清心肌酶活性和心肌c-fosmR—NA表达显著高于假手术组(P<0.05),电针后降低,差异有显著性意义(P<0.05)。结论:电针“内关”改善急性心肌缺血的机制与下调心肌组织c—fosmRNA的表达有关。

Ⅳ型胶原酶心包经上预处理对“内关”穴注射胰岛素后降糖作用及GLUT4表达分布的影响

目的 :研究Ⅳ型胶原酶心包经上预处理对小鼠“内关”穴注射胰岛素后降糖作用及GLUT4表达、分布的影响。方法 :小鼠“内关”穴上方 5mm心包经上注射Ⅳ型胶原酶 ,30min后 ,“内关”穴注射胰岛素 ,间隔 5min后测血糖 ,取骨骼肌用Northernblot方法观察GLUT4mRNA表达 ,免疫组化法研究GLUT4分布 ,并与心包经旁预处理组、蒸馏水心包经上预处理组相比较。结果 :Ⅳ型胶原酶心包经上预处理几乎完全阻断“内关”穴注射胰岛素的降糖效应 ,其对骨骼肌GLUT4mRNA表达无影响 ,但可使GLUT4从胞内储存部位向细胞膜转运减少。结论

电针内关、公孙穴对冠心病Ⅱ导联心电图S－T段的影响

本文对５０例冠心病Ⅱ导联心电图Ｓ－Ｔ段下移的患者进行了针刺即刻作用的比较观察。结果表明，电针后，内关、公孙穴组，内关组，公孙组，Ⅱ导联心电图Ｓ－Ｔ段均较针前有明显即刻趋正常提高作用（均Ｐ＜０．０１），而电针非穴位组及静卧组则没有此作用（均Ｐ＞０．０５）；电针内关、公孙穴组疗效最佳。

电针内关、神门穴对海洛因依赖者稽延性戒断症状疗效观察

目的观察和分析针刺不同穴位对海洛因依赖者稽延性戒断症状的干预效果,为科研、临床筛选针刺治疗海洛因依赖稽延性症状的特异穴位提供临床依据。方法将60例男性海洛因依赖者随机分为对照组、针刺1组、针刺2组,采用稽延性戒断症状评分量表和汉密尔顿焦虑量表观察各组患者治疗前、治疗过程中及治疗3星期后的变化。结果针刺1组、针刺2组在控制稽延性戒断症状上与对照组相比有统计学差异(P<0.01,P<0.05);但针刺1组、针刺2组之间比较差异没有统计学意义(P>0.05)。结论 针刺可有效缓解海洛因依赖者稽延期戒断症状和精神焦虑症状;治疗海洛因依赖者稽延期诸症时,内关穴与神门穴具有同样显著疗效,并且神门穴对于心神的异常具有更快更好的显效趋势。

针刺内关穴对慢性心衰小鼠心功能及炎性因子的影响

目的研究针刺内关穴对慢性心力衰竭小鼠心功能及炎性因子的影响。方法动物分为正常组、模型组、针刺组,每组各15只,腹腔注射盐酸异丙肾上腺素注射液制备慢性心力衰竭模型。针刺组每日上午行针刺干预,针刺干预结束后,间隔30 min予以腹腔注射盐酸异丙肾上腺素注射液,连续针刺干预4周。正常组和模型组只予捆绑固定,不进行任何治疗。采用多普勒超声检测心功能;采用酶联免疫吸附法(ELISA)进行测定血清细胞因子IL-1β、IL-10、TNF-α含量。结果与模型组比较,针刺组在LVEDD、LVESD呈降低趋势,差异具有统计学意义(P<0.01);与模型组比较,针刺组在LVEF、LVFS呈升高趋势,差异具有统计学意义(P<0.01)。与模型组比较,针刺组小鼠血清IL-1β、TNF-α含量均明显降低,差异具有统计学意义(P<0.01)。与模型组比较,针刺组小鼠血清IL-10含量呈升高趋势,差异具有统计学意义(P<0.01)。结论针刺内关穴能够增加慢性心衰小鼠LVEDD和LVESD,从而改善心室重塑;降低LVEF和LVFS,改善心功能;还能提高血清中IL-10含量,抑制炎性因子的表达;降低促炎因子IL-1β、TNF-α含量,减缓炎性反应进程。

电针对全麻围气管插管期血流动力学的影响

目的观察电针内关等穴位对全麻围气管插管期血流动力学的影响。方法选择全麻气管插管病人60例随机分成电针组(麻醉诱导前电针刺激内关、合谷、曲池、神门)和对照组各30例,两组病人均用咪唑安定、芬太尼、异丙酚、琥珀酰胆碱等全身麻醉药物诱导,光导喉镜明视下行气管插管;于麻醉诱导、插管期不同时点监测血流动力学各项指标的变化。结果麻醉诱导期电针组血流动力学各项指标相对平稳,对照组则表现为显著下降(P<0.01)。气管插管过程中,电针组各项指标较麻醉诱导前有一定升高(P<0.05),而对照组则呈现显著上升(P<0.01)。插管后5分钟两组各项指标恢复正常。结论电针刺激内关等穴位可以稳定围插管期血流动力学变化,提高麻醉手术的安全性。