针刺胃扩张模型大鼠内关、足三里等穴位下丘脑室旁核相关神经元的反应

背景：既往有关针刺对胃功能调节的神经机制研究多以外周神经为主,涉及中枢,尤其是高位中枢的研究较少。目的：探讨针刺“内关”、“足三里”等穴位对下丘脑室旁核胃相关神经元作用的影响。方法：运用微电极细胞外记录技术,在大鼠胃扩张的基础上,找出室旁核胃相关神经元,予以手针刺激“内关”、“足三里”等穴位各30 s,观察其对室旁核胃相关神经元的影响。结果与结论：60只大鼠共记录到109个下丘脑室旁核神经元放电,109个下丘脑室旁核神经元中与胃扩张相关的神经元有56个,56个胃扩张相关神经元中,对针刺足三里、内关、脾俞、胃俞有反应的神经元个数分别是44,47,29,33,有反应的神经元出现的比例分别是78.57%,83.47%,51.79%,58.93%。结果表明下丘脑室旁核中存在同时对胃扩张刺激和针刺刺激起反应的躯体内脏汇聚神经元,且参与针刺对胃功能的调节作用。     

针刺对大鼠不同状态血压调节作用的机制

目的：探讨针刺对大鼠不同状态血压所产生的效应及神经机制。方法：健康成年雄性SD大鼠42只，采用微电极细胞外记录大鼠孤束核单个神经元的活动及动脉插管观察血压变化。药理学方法制造不同血压的大鼠模型，分别在正常血压（正常模型）、高血压（高血压模型）及低血压（低血压模型）状态下，针刺大鼠耳甲、曲池、内关及足三里穴，并观察孤束核神经元放电及血压的变化。结果：与针刺前比较，正常模型及高血压模型针刺耳甲、曲池穴均有显著的降压效应（P〈0．01）；低血压模型针刺内关穴有显著的升压效应（P〈0．05）。针刺足三里对高血压模型有显著降压效应，对低血压有显著升压效应（P〈0．05～0.01）。针刺各穴均能有效激活孤束核神经元放电，尤以耳甲穴最为明显。结论：针刺耳甲、曲池、内关及足三里穴对血压的调节作用与孤束核神经元的激活密切相关；穴位的双向调节作用并不一定表现为同一穴位对不同病理状态下的内脏器官有双向调节效应，可能表现为不同穴位的综合作用是纠正机体机能活动向正常平衡与稳态状态方向的良性调节。     

针刺治疗急性胰腺炎13例

作者近年来采用针刺治疗急性胰腺炎13例,取得较好疗效。治疗方法①上脘、脾俞、足三里、合谷;②中脘、胃俞、下巨虚、大椎;③胆俞、内关、阳陵泉、大横。以上3组穴位,每组穴位针刺10～15分钟,间隔2小时,轮流交替针刺,强刺激,     

基于R语言数据挖掘技术分析针灸治疗咳嗽变异性哮喘的取穴规律

目的:基于R语言数据挖掘技术分析针灸治疗咳嗽变异性哮喘的取穴规律,为临床治疗方案的制定和优化提供参考。方法:计算机检索PubMed、EMbase、The Cochrane Library、中国知网、万方数据库、中文科技期刊数据库,筛选针灸治疗咳嗽变异性哮喘相关文献,依据标准方案提取针灸处方,建立针灸治疗咳嗽变异性哮喘处方信息数据库;基于R语言对数据库取穴频次、聚类和关联等情况进行规律挖掘。结果:共收集78篇文献,提取87个处方;干预措施包括艾灸、针刺联合中药及3种以上干预措施联合运用;使用频次>25次的高频腧穴依次为肺俞、足三里、肾俞、大椎和脾俞;经脉使用频次以足太阳膀胱经、足阳明胃经、手太阴肺经、任脉和督脉为主;特定穴频次以背俞穴和五腧穴为主。关联分析和聚类分析形成以大椎-脾俞-肾俞-肺俞-足三里为基础的核心腧穴组合。结论:针灸治疗咳嗽变异性哮喘以肺俞、足三里、肾俞、大椎和脾俞为核心腧穴组合,针刺、艾灸、中药结合多种疗法综合运用临床疗效较好。     

脾俞、足三里穴位注射对抑郁大鼠行为学及细胞因子IL-1β、IL-6的影响

目的：探讨穴位注射脾俞、足三里穴对慢性应激抑郁模型大鼠的调节作用。方法：复制慢性应激抑郁大鼠模型,用黄芪注射液穴位注射动物脾俞、足三里穴,观察其对该动物行为学及细胞因子IL-1β、IL-6改变方面的影响。结果：穴位注射组可显著改变动物模型的行为学指标,降低抑郁大鼠血浆中的IL-1β、IL-6的含量,使其接近正常水平。结论：抑郁大鼠的IL-1β、IL-6的含量高于正常,可能在抑郁症的发病中起一定作用;穴位注射治疗抑郁症有应用前景,可能是通过降低IL-1β、IL-6的含量而发挥抗抑郁作用的。     

基于数据挖掘的针灸治疗血脂异常选穴规律分析

目的:探讨针灸治疗血脂异常在现代临床研究中的选穴规律.方法:参考医学主题词表(MeSH)中与血脂异常及针灸相关的主题词并将其进行组合,用计算机检索中国知网、维普数据库、万方数据库、SinoMed及PubMed数据库中1979年1月-2019年12月针灸治疗血脂异常的文献并进行统计分析.结果:筛选出合格文献164篇,涉及92个俞穴,共使用916次.常用穴位为足三里、丰隆、三阴交、中脘、内关、脾俞、天枢、肝俞、肾俞、太冲.选用经络以足阳明胃经、足太阳膀胱经、任脉、足太阴脾经为主;选穴部位以下肢、胸腹部为主;针灸方法以针刺疗法为主.关联规则分析显示穴位间相关性最高的是三阴交一足三里、丰隆一足三里.通过聚类分析,可得到6个聚类群.结论:针灸治疗血脂异常注重远近配合、循经取穴、随证配伍,选穴方法多有调理中焦脾胃之气的特点.     

nesfatin-1对大鼠迷走复合体内葡萄糖感受神经元和胃扩张敏感神经元兴奋性的作用

目的观察nesfatin-1对大鼠迷走神经复合体（DVC）内胃扩张敏感神经元和葡萄糖感受神经元放电频率的调制作用,探讨其参与摄食调控的可能机制。方法采用多管玻璃微电极记录单个细胞单位放电的电生理学方法,观察大鼠DVC区微量注射nesfatin-1前后上述两种神经元放电频率的变化,以微量注射9 g/L NaCl作对照。结果在DVC中记录到经多管微电极给予葡萄糖的109个神经元,有46个神经元放电频率降低（鉴定为G-INH）;31个神经元放电频率升高（鉴定为G-EXC）;32个神经元对葡萄糖没有反应。在39个G-INH经多管微电极给予nesfatin-1,有33个神经元放电频率降低,1个神经元放电频率升高,5个神经元对nesfatin-1无反应。在26个G-EXC神经元中,有20个神经元放电频率升高,3个神经元放电频率降低,3个神经元对nesfatin-1无反应。对89个神经元进行胃扩张（GD）刺激,在DVC中记录到48个神经元被激活（鉴定为GD-EXC）,21个神经元被抑制（鉴定为GD-INH）,其余20个神经元对胃扩张无反应。在42个GD-EXC神经元中,32个神经元被nesfatin-1所兴奋,10个神经元对nesfatin-1无反应。在18个GD-INH神经元中,16个神经元被nesfatin-1所抑制,2个神经元无反应。上述两类神经元经多管微电极给予9 g/L NaCl,注射前后神经元放电频率的变化无统计学意义。结论 nesfatin-1能够调制DVC胃扩张敏感神经元和葡萄糖感受神经元的兴奋性,这可能是nesfatin-1抑制摄食的部分机制。     

心肺复苏后大鼠延髓心血管中枢NMDA受体的表达变化

目的 研究心肺复苏后大鼠延髓心血管中枢NMDA受体的表达变化。方法 以水封瓶密闭法制作大鼠心搏骤停模型，迅速进行心肺复苏，复苏后20min制备脑组织石蜡切片，行光镜观察，并应用原位杂交、免疫组化技术检测延髓心血管中枢迷走神经背核、孤束核内NMDA受体2A／2B两个亚型的表达变化。结果 实验组大鼠延髓心血管中枢迷走神经背核、孤束核内NMDA受体NMDA-2A、NMDA-2B两个亚型的mRNA表达与对照组相比明显增高，差异有显著性（P〈0．05）。结论 心肺复苏后大鼠延髓心血管中枢NMDA-2A、NMDA-2B两型受体在mRNA及蛋白质水平上发生了显著上调，心肺复苏后大鼠脑水肿形成可能与NMDA受体上调有关。     

针刺治疗脑梗死后顽固性呃逆32例分析

目的：评价针刺穴位治疗脑梗死后顽固性呃逆的临床疗效。方法：对32例脑梗死治疗过程中出现顽固性呃逆的患者针刺内关、中脘、膈俞、足三里及翳风5个穴位,观察治疗有效率。结果：总有效率84．4％,未发现不良反应,临床疗效满意。结论：针刺穴位治疗可以有效治疗脑梗死后顽固性呃逆,方法简便,值得推广。     

针刺配合心理护理治疗急性心肌梗死后顽固性呃逆36例分析

目的：评价针刺穴位配合心理护理治疗急性心肌梗死后顽固性呃逆的临床疗效。方法：对36例急性心肌梗死后顽固性呃逆的患者实施个性化心理护理,同时针刺内关、中腕、足三里及翳风4个穴位,观察治疗有效率。结果：总有效率88.9%,未发现不良反应,临床疗效满意。结论：针刺穴位配合心理护理治疗可以有效治疗急性心肌梗死后顽固性呃逆。方法简便,值得推广。     

Acupuncture stimulates the release of serotonin, but not dopamine, in the rat nucleus accumbens

Acupuncture has been introduced as one of the available therapies widely used in alternative medicine, but it has not achieved widespread acceptance with scientific evidence. Furthermore there are still many unanswered questions about the basic mechanisms of acupuncture. To investigate the neuropharmacological mechanisms of oriental acupuncture, we studied the acupuncture-induced changes of in vivo monoamine release in the rat brain. A microdialysis guide cannula was implanted into the nucleus accumbens (ACC), which plays an important role in the brain reward system. Acupuncture treatment at the unilateral or bilateral Shenshu (bladder urinary channel 23) acupoints, located on the both sides of the spinous processes on the lower back, was carried out for 60 min in freely moving rats, and the dopamine (DA) and serotonin (5-HT) contents of the microdialysates in the ACC were measured simultaneously. In rats subjected to acupuncture at bilateral Shenshu acupoints, increases of 5-HT release in the ACC were observed at 20 min of acupuncture treatment and continued until 40 min after acupuncture was ended. Acupuncture at a unilateral Shenshu acupoint increased the release of 5-HT at 20 min compared with that in the sham-control group. Five-HT release returned to the baseline level at 120 min. The effects of acupuncture at bilateral Shenshu acupoints on the release of 5-HT in the ACC were greater than that of unilateral acupuncture treatment. In contrast, DA release in the ACC was not changed following acupuncture treatment. Effective acupuncture increased and prolonged the activity of serotonergic neurons in the reward system pathway of the brain. This suggests that oriental acupuncture therapy may be effective for the treatment of emotional disorders, drug abuse and alcoholism.     

经皮电针刺激正常人耳甲迷走神经的功能MRI脑效应研究

目的探讨耳甲迷走神经刺激术的脑通路,为耳迷走神经刺激调制孤束核-边缘叶脑网络假说提供证据。材料与方法随机录用16名健康志愿者,参加经皮电刺激右耳甲部迷走神经分布区（t VNS）,以同侧上耳舟部刺激为对照,记录刺激的耳部感觉,观察全脑6 min扫描的Bold-f MRI信号变化,分析脑功能激活特点,应用SPM8处理f MRI数据。结果两组电流、感觉频率及强度未见明显区别。经皮电刺激耳甲部t VNS正常人激发了左侧孤束核及边缘叶脑区广泛而较强的负激活效应,局限性激活位于体感区及岛叶等,而对照部产生了右侧三叉神经核等脑干核团负激活及脑部体感区明显的激活现象。结论经皮电刺激迷走神经产生了孤束核-边缘叶脑网络的调制效应,为经皮电刺激耳甲部迷走神经治疗抑郁症等脑中枢机制打下基础。     

电刺激迷走神经对感染性休克大鼠钙结合蛋白S100A8表达的影响

目的:通过建立感染性休克大鼠模型,探索电刺激迷走神经对感染性休克大鼠血浆中钙结合蛋白S100A8表达水平的影响。方法:雄性成年SD大鼠30只,采用盲肠结扎穿孔法(CLP)建立感染性休克模型,将30只大鼠随机分为6组:1假电针正常组;2电针正常组;3假电针CLP组;4电针CLP组;5迷切假电针CLP组;6迷切电针CLP组。3~6组动物均行颈总动脉置管,连续监测平均动脉压;采用ELISA法检测各组大鼠的血浆钙结合蛋白S100A8。结果:CLP组手术后平均动脉压呈进行性下降,手术后12 h时血浆钙结合蛋白S100A8水平显著升高(P0.01);与CLP组比较,电刺激组动物平均动脉压下降程度较低(P0.01);迷切电针CLP组与迷切假电针CLP组相比,大鼠平均动脉压下降程度较低,血浆钙结合蛋白S100A8水平显著下降(P0.01)。结论:电刺激迷走神经可以缓解盲肠结扎穿孔导致的大鼠感染性休克所引发的进行性动脉压下降,降低血浆钙结合蛋白S100A8水平,对于治疗休克有辅助作用。     

Characteristics of Zusanli Dorsal Root Ganglion Neurons in Rats and Their Receptor Mechanisms in Response to Adenosine

Neural systems play important roles in the functions of acupuncture. But the unclear structure and mechanism of acupoints hinder acupuncture standardization and cause the acupuncture effects to be varying or even paradoxical. It has been broadly assumed that the efficacy of acupuncture depends on the biological signals triggered at acupoints and passed up along neural systems. However, as the first station to transmit such signals, the characters of the dorsal root ganglia (DRG) neurons innervating acupoints are still not well elucidated. We adopted Zusanli (ST36) as a representative acupoint and found most DRG neurons innervating ST36 acupoint are middle-size neurons with a single spike firing pattern. This suggests that proprioceptive neurons take on greater possibility than small size nociceptive neurons do to mediate the acupuncture signals. Moreover, we found that adenosine injected into ST36 acupoints could dose- and acupoint-dependently mimic the analgesic effect of acupuncture. However, adenosine could not elicit action potentials in the acutely isolated ST36 DRG neurons, but it inhibited I_D currents and increased the areas of overshoots. Further, we found that 4 types of adenosine receptors were all expressed by ST36 DRG neurons, and A1, A2b, and A3 receptors were the principal reactors to adenosine.PerspectiveThis study provides the major characteristics of ST36 DRG neurons, which will help to analyze the neural pathway of acupuncture signals. At the same time, these findings could provide a new possible therapy for pain relief, such as injecting adenosine or corresponding agonists into acupoints.     

The effect of electroacupuncture on pain behaviors and noxious stimulus-evoked Fos expression in a rat model of neuropathic pain.

Chronic-constriction injury (CCI) of the sciatic nerve causes mechanical and heat hyperalgesia and mechanical allodynia in the plantar surface of the hindpaw. The underlying mechanism thought to account for these phenomena include central sensitization induced by peripheral nerve injury, ie, the increase in neuronal activity of spinal dorsal horn neurons. As a marker of neuronal activation of the central nervous system, Fos expression has been used widely to monitor the change in neuronal activity evoked by peripheral input. In this study, we examined the antinociceptive effect of electroacupuncture (EA) on pain behavior and noxious stimulus-evoked Fos expression in dorsal horn neurons of the spinal cord in CCI rats 14 days after injury. Male Sprague-Dawley rats (180 to 200 g) received loose ligation of the left sciatic nerve. Heat and mechanical hyperalgesia and mechanical allodynia were examined by the plantar foot test, the pin-prick test, and the von Frey test before and after the EA treatment (100 Hz, 0.3 millisecond, 3 or 1 mA, 20 minutes) into the Zusanli point (S36). When EA stimulation to the Zusanli point was applied, the mechanical and heat hyperalgesia were significantly suppressed; however, mechanical allodynia was not affected. The EA stimulation to nonacupuncture point did not show any significant effect. Next, pinch stimulation was applied to the plantar surface of the operated hindpaw of the CCI rats for 10 minutes, and the stimulus-evoked Fos expression in dorsal horn neurons in L4-L6 spinal cord levels was then examined by using immunohistochemistry. The number of noxious stimulus-evoked Fos-labeled neurons in both the superficial and deep laminae of the dorsal horn in the CCI rats was increased significantly compared with those in sham-operated rats, suggesting an increased excitability of dorsal horn neurons to noxious stimuli. Concurrent EA treatment to the Zusanli point with the pinch stimulus suppressed the increase in the number of Fos-labeled cells in the spinal dorsal horn in the CCI rats. The present results show that EA treatment has antinociceptive effects on both pain behavior and neuronal activation of the spinal dorsal horn neurons in CCI rats.     

针刺“足三里”对实验性脾虚大鼠胃排空及胃肠激素的影响

目的:观察针刺"足三里"穴对实验性脾虚大鼠胃排空及胃肠激素的影响。方法:对健康SD大鼠随机分为空白对照组、模型组和"足三里"组。用同位素99mTc灌胃测定大鼠胃液体排空率,用放射免疫法(RIA)测定胃黏膜中胃泌素、胃动素、生长抑素水平。结果:针刺"足三里"穴对实验性脾虚大鼠有加速胃排空作用(P<0.01)。同时胃肠激素水平发生改变,"足三里"组大鼠胃黏膜中胃泌素含量与模型组比较明显降低(P<0.01),胃动素含量升高(P<0.05),生长抑素水平下降(P<0.01)。结论:针刺"足三里"穴可导致脾虚模型大鼠胃排空加速和胃黏膜中胃泌素、胃动素、生长抑素含量发生变化。     

Substance P in the dorsal motor nucleus of the vagus evokes gastric motor inhibition via neurokinin 1 receptor in rat

Many gastrointestinal stimuli result in gastric fundic relaxation. This information is integrated at the interface of vagal afferents and efferents in the dorsal vagal complex. Substance P (SP) is present in this region, and the neurokinin(1) receptor (NK(1)R) is highly expressed in preganglionic neurons of the dorsal motor nucleus of the vagus (DMN). However, its functional effects on vagal motor output to the stomach have not been investigated. Therefore, we determined the gastric motor effects of stereotaxic microinjection of SP and selective tachykinin receptor agents into the DMN of anesthetized rats. Dose-related decreases in intragastric pressure and antral motility were obtained on the microinjection of SP (135 and 405 pmol) into the DMN, without cardiovascular changes. Similar decreases in intragastric pressure were noted after the microinjection of [Sar(9),Met(O(2))(11)]SP (NK(1)R agonist; 135 pmol) but not senktide (NK(3)R agonist; 135 pmol) or vehicle. The gastric motor inhibition evoked by SP (135 pmol) was attenuated by prior microinjection of 2-methoxy-5-tetrazol-1-yl-benzyl-(2-phenyl-piperidin-3-yl)-a mine (GR203040; 1 nmol; NK(1)R antagonist). Vagotomy or hexamethonium (15 mg/kg i.v.) completely abolished the gastric relaxation evoked by SP (135 pmol) microinjected into the DMN. We conclude that SP acts on NK(1)R preganglionic cholinergic vagal neurons in the DMN, which control enteric nonadrenergic noncholinergic motor inhibition of the fundus. The potential relevance is that an antiemetic site of action of NK(1)R antagonists may be in the DMN to prevent excitation of neurons controlling fundic relaxation, which is an essential prodromal component of emesis.     

恒温雷火灸配合姜汁对脾胃虚寒型胃脘痛患者疗效及体表温度的影响

目的 观察恒温雷火灸配合姜汁对脾胃虚寒型胃脘痛患者疗效及体表温度的影响。方法 将80例脾胃虚寒型胃脘痛患者按随机数字法分为恒温雷火灸组和姜汁恒温雷火灸组。恒温雷火灸组采用恒温雷火灸法,姜汁恒温雷火灸组采用恒温雷火灸配合姜汁治疗,持续干预14 d后比较2组的临床疗效;在干预前、干预第7天和第14天观察比较腋温和脾俞、胃俞、中脘、关元、足三里、涌泉等穴位的体表温度。结果 干预14 d后姜汁恒温雷火灸组的临床疗效高于恒温雷火灸组（P<0.05）。2组胃俞、中脘、关元、足三里、涌泉等穴位体表温度存在组间效应（P<0.05）,2组腋温和脾俞、胃俞、中脘、关元、足三里、涌泉等穴位体表温度存在时间效应和交互效应（P<0.01）。在干预第7天,姜汁恒温雷火灸组的胃俞、中脘、关元、足三里、涌泉等穴位体表温度高于恒温雷火灸组（P<0.05）;在干预第14天,腋温和脾俞、胃俞、中脘、关元、足三里、涌泉等穴位体表温度高于恒温雷火灸组（P<0.05）。结论 恒温雷火灸配合姜汁可显著提高脾胃虚寒型胃脘痛患者临床疗效,同时提高体表温度,改善机体寒性症状。     

低频电脉冲治疗原发性高血压的效果研究

目的观察低频电脉冲针刺穴位对原发性高血压病的即时降压效果,为该法用于高血压患者长期治疗提供参考。方法50例原发性高血压患者分为治疗组和对照组,治疗组选择3 d相应时段,电针刺激内关、足三里10 min、25 min以及拔除针后10 min,测量血压数值;对照组给予病人相应穴位贴电极片,启动低频机的刺激声音,但不导入电流。结果治疗组相比对照组,其收缩压和舒张压均比测试前有下降的趋势（P〈0.05）。结论低频电脉冲针刺内关、足三里穴位可有效降低血压。