电针心包经经穴改善急性心肌缺血机理的研究

本研究在兔、猫和大鼠急性心肌缺血（ＡＭＩ）的模型上,多学科协作,采用多项指标,从生理功能和形态结构相结合的角度,探讨了电针心包经经穴改善ＡＭＩ的外周和中枢作用机理。结果表明,①电针“内关”等心包经上的穴区及非穴区对缺血心脏的电活动和机械活动均具有良性调整作用;心包经在对心脏功能调整作用中是一个机能整体;心包经经穴的作用具有一定程度的相对特异性;②电针可改善心功能和心肌能量代谢,其关键是改善了缺血心肌微循环;③电针改善 ＡＭＩ的作用是与针刺抑制外周交感－肾上腺－ＣＡ系统及中枢的肾上腺素能和去甲肾上腺素能系统在心肌缺血时的过度活动分不开的,同时与针刺增强 ＡＭＩ时肾上腺皮质的功能,提高机体的抗病能力密切相关。因此,电针改善ＡＭＩ、保护心肌细胞、减轻损伤的局部作用是与其对机体的整体调节分不开的;临床在治疗冠心病时,应既要考虑心血管局部,又要注意到整体,努力提高病人全身的机能状态。

Study on Mechanisms of Electroacupuncture at Acupoints of Pericardium Channel for Improving Experimental Acute Myocardial Ischemia

In the present study, the mechanisms of electroacupuncture (EA)at acupoints of the Pericardium Channel (PC) for improving experimental acute myocardial ischemia (AMI) were studied in rabbits, cats and rats, from the view of combination of physiological functions and anatomical structures and by using multiple indexes. Results demonstrated that: 1 ) EA of "Neiguan" (PC 6), etc. and non-points of the PC was of favorable regulative action on the electrical and mechanical activities of the ischemic heart; the PC is a functional entirety in regulating physiological activity of the ischemic heart; the effect of acupoints of PC has a relative specificity to a certain degree; 2) EA could improve cardiac performance and myocardial energy metabolism, while its key action mainly lay in the improvement of the microcirculation of the ischemic myocardium; 3) the action of EA of PC acupoints in bettering AMI is closely associated with EA-induced inhibition on the hyperactivity of the periphery sympathy-adrenal gland-CA system, central adrenergic and noradrenergic systems during AMI, and also associated with EA-induced enhancement of functional activity of the adrenal cortex and increase in the organic antidisease ability. Therefore, the local actions of EA on ameliorating AMI, protecting myocardial cells from injury are definitely not separable from its regulative action on the functional activities of the whole body. This fact suggests that in treatment of coronary heart disease, both the performance of the cardiovascular system and the state of the whole body should be considered simultaneously.