目的:观察针刺-22包经“内关”“郄门”穴治疗心肌缺血的作用机制。方法:将大鼠随机分为5组,假手术组、缺血-再灌注模型组、针刺“内关”治疗组、针刺“郄门”治疗组、针刺“支沟”对照组。后3组电针相应穴位20min后,结扎冠状动脉左前降支40min,心电图(ECG)监测,再电针穴位20min,松扎,恢复灌流60min,摘取心脏,取心室肌制备心肌细胞肌浆网,定磷法测定三磷酸腺苷酶(Ca^2+-ATPase)活性的高低;用Northen-Blot方法测定肌浆网Ca^2+-ATPasemRNA的相对含量。结果:模型组Ca^2+-ATPase活性明显降低,Ca^2+-ATPasemRNA的表达下降。针刺心包经“内关”穴组和“郄门”穴组Ca^2+-ATPase活性和Ca^2+-ATPasemRNA表达均发生明显变化,与模型组比较均有非常显著性意义(P〈0.01),针刺“支沟”穴组酶活性与基因的表达和模型组比较差异无显著性意义(P〉0.05)。结论:针刺手厥阴,22包经穴“内关”“郄门”穴可提高心肌细胞肌浆网Ca^2+-ATPase的活性,促进Ca^2+-ATPasemRNA基因的表达,减轻缺血再灌注损伤的程度,增强心肌的功能。
Objective To investigate the mechanism of acupuncture at "Neiguan" (PC 6) and "Ximen" (PC 4) of the Pericardium Meridian in treatment of myocardial ischemia. Methods Rats were randomly divided into 5 groups, sham-operation group, ischemia-reperfusion model group, Neiguan acupuncture group, Ximen acupuncture group and Zhigou acupuncture group. Electroacupuncture (EA) was given at corresponding acupoints for 20 min in the later 3 groups, followed by ligation of the left anterior descending branch of the coronary artery and 40 min later, acupuncture was given at the points for another 20 min, reperfusion for 60 min, with ECG monitoring. Then the myocardial tissue sample (below the ligationsite) of the left cardiac ventricle was taken for preparation of sarcoplasmic reticulum, and determination of Ca^2+-ATPase activity according to quantitative analysis of phosphorum. The relative mRNA levels were determined by Northerm Bolt analysis. Results In the acupuncture groups, both the activities of Ca^2+-ATPase and the gene expressions increased significantly as compared with the model group (all P〈0.01). Conclusion The points of the Pericardium Meridian can obviously improve the Ca^2+-ATPase activity and the gene expressions, reduce the degree of myocardial ischemia and reperfusion injury, and strength myocardial functions.