【作者】 石力； 方继良； 赵吉平； 柳桂勇； 赵青； 张金玲； 佟海滨； 张今朝； 洪洋； 刘欢； 梁繁荣； 荣培晶；

【Author】 Li SHI;Jiliang FANG;Jiping ZHAO;Guiyong LIU;Qing ZHAO;Jinling ZHANG;Haibin TONG;Jinzhao ZHANG;Yang HONG;Huan LIU;Fanrong LIANG;Peijing RONG;Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences;Guang’anmen Hospital, China Academy of Chinese Medical Sciences;Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine;Chengdu University of TCM;

【机构】 中国中医科学院针灸研究所； 中国中医科学院广安门医院； 北京中医药大学附属东直门医院； 成都中医药大学；

【摘要】 背景:现代临床和基础研究表明针刺内关和足三里能够有效的治疗慢性心肌缺血,但是两穴的疗效差异目前尚不明确。方法:在本实验本研究中,12只中华小型猪接受了在左侧冠状动脉前降支置入防磁Ameroid环的手术,以制备慢性心肌缺血模型,将小型猪分为内关组、足三里组。分别于实验前、术后4周及6周进行心电图、心脏MRI检查,抽取静脉血检测心肌缺血标志物及AngⅡ。治疗方法为分别在内关和足三里实施持续两周的穴位埋线,并分别在术后的第四周和第六周进行两次电针治疗。结果:实验结果显示,在术后4周心电图ST段出现水平或斜形下移,T波出现倒置或双向。另外,病理性Q波出现于V1-V3导联。两组小猪血清CK-MB、cTnT、IMA升高,血清AngⅡ较正常值增加。术后4周心功能明显受损,左室舒张末容积(LEDV)和左室收缩末容积(LESV)均明显增加,而LESV与正常值比较有统计学差异(P<0.05)。针刺内关和足三里能够改善ST-T缺血性改变,减少病理性Q波出现频率,延长心室的复极时间(P<0.05,或P<0.01)。血清CK-MB,cTnT(P<0.05)和IMA(P<0.05,或P<0.01)较治疗前明显降低。血清AngⅡ仍然保持在较高的水平,内关组针刺后有降低的趋势。心脏cMRI结果显示,针刺内关、足三里对左心室功能没有明显的改善效应。结论:结果表明针刺内关和足三里对心肌缺血性损伤有保护作用,而对左心室功能受损无明显的改善作用。更多还原

【Abstract】 kground: Researches have provided evidences that acupuncture at PC6 and ST36 is beneficial for chronic myocardial ischemia(MI). But the differences of the effects between the two acupoints are unknown. Methods: The chronic MI model on minipigs were created by implanting Ameroid constrictor on the left anterior descending coronary artery(LAD) and bred for 4 weeks. The electrocardiograph(ECG), cardiovascular magnetic resonance imaging(c MRI) and venous blood sample were conducted to test the myocardial ischemia biomarkers at the 4th and 6th week after the operation respectively. The lasting acupuncture stimulation technique named as the needle-embedding(NE) was manipulated at PC6 or ST36 respectively for 2 weeks. Moreover, electroacupuncture(EA) was stimulated at the 4th and 6th week once. Results: At the 4th week after the operation, ECG showed the ST segment declined horizontally or slantly, and T wave inversed or became bidirectional. Furthermore, the pathological Q wave appeared at lead V1-V3. Serous creatine kinase-MB(CK-MB), cardiac troponin T(c Tn T) and ischemia modified albumin(IMA) increased in both groups. The heart function was impaired. Left ventricular end-diastolic volume(LEDV) and left ventricular end systolic volume(LESV) of the two groups increased without statistical differences compared with the baseline. The left ventricular ejection fraction(LVEF) of the both group decreased(P<0.05). At the 6th week, acupuncture at PC6 or ST36 improved the ischemic ST-T changes, decreased the incidence of pathologic Q wave, and prolonged the ventricular repolarization duration(P<0.05, or P<0.01). Serous CK-MB, c Tn T(P<0.05) and IMA(P<0.05, or P<0.01) decreased after acupuncture in both groups. The serous AngⅡ of the two groups did not change significantly after operation and acupuncture. From c MRI results, acupuncture at PC6 and ST36 had no significant effect on LVEF. LEDV and LESV enlarged progressively in both groups. Conclusion: The results indicated that acupuncture at PC6 and ST36 may protect cardiomyocytes from ischemic injury, maybe the PC6 is better. But there is no effects on improving the systolic function of the left ventricular.更多还原