单穴与双穴调节大鼠不同结肠段运动的效应差异及机制研究

发布时间：2018-02-11 12:02

本文关键词： 腧穴配伍结肠效应差异内脏大神经迷走神经脊髓侧角交感中枢　出处：《南京中医药大学》2017年博士论文　论文类型：学位论文

【摘要】：研究目的:本研究以大鼠升结肠、横结肠、降结肠的运动为观察目标,观察单穴与双穴调节大鼠不同结肠段运动的效应差异,并观察针刺过程中左侧内脏大神经、左侧迷走神经及左侧脊髓侧角神经元的放电变化,以探索不同部位双穴配伍的效应规律及其可能的神经生物学整合机制,为临床合理应用腧穴配伍提供科学依据。研究方法:1.在不同结肠段置入压力感受水囊,观察针刺单穴(左右天枢、左右上巨虚、左右曲池)与双穴配伍(左右配伍:双侧天枢、双侧上巨虚、双侧曲池;上下配伍:曲池+上巨虚;远近配伍:天枢+上巨虚、天枢+曲池)对大鼠不同结肠段(升结肠、横结肠、降结肠)肠内压的影响。2.通过引导电极记录左侧内脏大神经、左侧迷走神经的电活动,观察针刺单穴与双穴配伍对自主神经自发放电的影响。3.通过玻璃微电极记录左侧脊髓侧角神经元的放电活动,观察针刺单穴与双穴配伍对脊髓侧角神经元自发放电的影响。实验结果:实验一:1.手针腹部单穴天枢抑制升结肠、横结肠运动,对降结肠作用不明显;手针上下肢单穴曲池、上巨虚可兴奋各结肠段运动;2.手针左右天枢均对升结肠抑制效应最明显,手针左上巨虚对横结肠兴奋效应最明显,手针左曲池对降结肠、右曲池对升结肠兴奋效应最明显;3.手针左右天枢对降结肠有效应差异,手针左右上巨虚对升结肠有效应差异,手针左右曲池对升结肠、降结肠有效应差异;4.左右配穴对各肠段的效应量及效应方向均无明显差异;上下配穴对升结肠的抑制效应最强,对降结肠的兴奋效应最强;远近配穴对升结肠、横结肠均有抑制趋势,对降结肠的兴奋作用最强;5.配穴效应量均小于至少某一单穴效应量,效应方向与单穴效应方向基本一致;6.配穴效应总与某侧单穴效应呈正相关关系。实验二:1.手针天枢对内脏大神经放电的兴奋作用最强,手针曲池、上巨虚对迷走神经放电的兴奋作用最强;2.手针左侧天枢对内脏大神经的兴奋作用强于右侧,手针右侧曲池对迷走神经的兴奋作用强于左侧;手针左右上巨虚对自主神经的放电均有兴奋趋势;3.左右配伍中,对于内脏大神经放电的调节,双天枢的兴奋效应量小于左天枢、双曲池的兴奋效应量大于单曲池、双上巨虚的兴奋效应量与单穴相比无差异;对于迷走神经放电的调节,双天枢、双曲池、双上巨虚的效应量与单穴相比均无明显差异;4.上下配伍中,双穴与单穴对自主神经放电的调节效应均无明显差异;5.远近配伍中,对于内脏大神经放电的调节,双穴的效应量均小于天枢;对于迷走神经神经放电的调节,双穴的效应量均小于上下肢单穴;6.不同部位单穴对内脏大神经放电、迷走神经放电的调节效应均有显著差异;双穴配伍对内脏大神经放电、迷走神经放电的调节效应大致无明显差异。实验三:1.手针天枢对脊髓侧角神经元放电的兴奋效应最强,总有效率达87.5%;手针曲池对脊髓侧角神经元放电的兴奋效应最小;2.单穴与双穴配伍对脊髓侧角神经元的放电变化均有兴奋效应。结论:1.不同部位单穴的效应差异与自主神经系统关系密切,腹部单穴天枢主要通过兴奋脊髓交感中枢-内脏大神经通路抑制结肠运动;上肢单穴曲池主要通过迷走神经通路兴奋结肠的运动;下肢单穴上巨虚可同时兴奋内脏大神经通路及迷走神经通路,对结肠运动的调节为无效或兴奋。2.左右腧穴效应差异可能与左右腧穴对自主神经自发放电的效应差异有关。左天枢对内脏大神经的兴奋作用最强,对结肠运动抑制效应最强;右曲池对迷走神经的兴奋作用最强,对结肠运动兴奋效应最强。3.左右配伍与上下配伍出现较单穴效应量减低的现象可能与腧穴配伍后兴奋相拮抗的自主神经有关:四肢部单穴以兴奋迷走神经为主,而双曲池、双上巨虚、曲池+上巨虚均出现了兴奋内脏大神经的效应,内脏大神经与迷走神经效应相拮抗,因此配穴效应量均小于某侧单穴或任一单穴。4.远近配伍、左右配伍、上下配伍出现较单穴效应量减低的现象可能与配穴效应在脊髓侧角交感中枢的会聚有关:天枢对脊髓侧角神经元放电变化的兴奋效应较强,与曲池、上巨虚配伍使用后,脊髓侧角神经元放电变化率减小,相应配穴效应量也降低;左天枢对脊髓侧角神经元放电变化的兴奋效应最强,与右天枢配伍使用后脊髓侧角神经元放电变化率减小,相应配穴效应量也降低。综上所述,应用不同部位单穴可以兴奋不同的自主神经,从而引起不同效应方向的结肠运动;应用不同部位双穴配伍可以通过脊髓侧角交感中枢的汇聚整合与自主神经的相互拮抗作用,从而产生效应量比较均衡的结肠运动。本次研究结果提示临床中可以应用单穴针对性治疗某一肠段疾病,也可以应用腧穴配伍进行全身调节。
[Abstract]:Objective: in this study, rat ascending colon, transverse colon, descending colon movement as the observation target, observe the difference effect of single point and double cavity adjusting different rat colon movement, and to observe the left splanchnic nerve during acupuncture, the left vagus nerve and left lateral horn of spinal cord nerve discharge in yuan, in effect to explore different parts of two acupoints and nerve biology possible integration mechanism, provide scientific basis for the clinical application of acupoints compatibility. Methods: 1. different pressure in the implantation of colon segment feel the water sac, observation of single point acupuncture (left and right Tianshu, around about double and Shangjuxu, Quchi acupoints (left and right) with bilateral Tianshu bilateral, bilateral Shangjuxu, Quchi; upper and lower compatibility: Quchi Shangjuxu; distance compatibility: Tianshu Shangjuxu, Tianshu) of rat Quchi + colon (colon, transverse colon, descending colon) effect of enteral pressure.2. Through the guide electrodes to record the left splanchnic nerve, vagus nerve electrical activity, and observation of single point acupuncture and acupoints in spontaneous discharge discharge effect of.3. by glass microelectrode recording of left lateral horn of spinal cord neurons of the autonomic nervous system, acupuncture single point and double hole combined effects on the spontaneous discharge of neurons in lateral horn of spinal cord of experimental. Results: experiment one: 1. hand needle abdominal single point Tianshu inhibit transverse movement, ascending colon, descending colon is not obvious on the effect of hand acupuncture on the lower extremity; single acupoint Quchi, each can be excited Shangjuxu colon segment movement; 2. hand needle pivot on the ascending day about the most obvious inhibitory effect, the left hand acupuncture Shangjuxu on transverse effect is the most exciting obviously, the left hand needle Quchi of descending colon, right on the ascending excitatory effect most obvious Quchi; 3. hand needle on the left and right Tianshu descending colon effect difference, hand acupuncture has effect on the ascending difference about 37, Left and right hand needle Quchi of ascending colon, descending colon effect difference; there were no significant difference between the 4. points on the effect of various intestinal segments and the effect direction; on the coordination of the inhibitory effect of acupuncture on the ascending of the strongest of the strongest excitatory effect of the descending colon; distal acupoints on the ascending colon, transverse colon inhibited the trend of excitement the strongest effect of descending colon; 5. acupoints effect quantity were less than at least one single point effect, effect and direction effect of single point direction; 6. points total effect was positively correlated with a single point side effect relationship. Experiment two: 1. the strongest excitatory effect of hand acupuncture to Tianshu splanchnic nerve discharge, hand needle Quchi, Shangjuxu excited the strongest effects on excitatory effect of vagus nerve discharge; 2. hand needle on the left Tianshu splanchnic nerve on the right side of the strong, the excitatory effect of vagus nerve on the right hand needle Quchi is stronger than the left hand needle; around the giant virtual independent of God The trend of the discharge are excited; about 3. compatibility, for the regulation of splanchnic nerve discharge, the amount of excitatory effect is less than the left double Tianshu Tianshu, the amount of excitatory effect is greater than the single hyperbolic pool pool, the amount of excitatory effect and single point double 37 compared with no difference; the vagal discharge regulation, double Tianshu, double pool, double the amount and effect of Shangjuxu single point showed no significant difference; 4. on compatibility, there were no significant difference between the effects of double point and single point of autonomic nerve discharge; 5. distance formula, for the regulation of splanchnic nerve discharge, the effect of amount of acupoints were less than Tianshu for regulating; the effect of vagus nerve discharge, amount of double points are less than the upper and lower limbs of single point; 6. different parts of a single point on the splanchnic nerve discharge, there was significant difference in regulating effect of vagus nerve discharge; double acupoints on visceral Bryant after discharge, discharge of vagus nerve Generally no significant difference between the moderating effect of electricity. Experiment three: 1. hand acupuncture Tianshu excitement effect on lateral horn of spinal cord neurons was the strongest, the total effective rate was 87.5%; excitatory effect of hand acupuncture Quchi on lateral horn of spinal cord neurons with 2. minimum; single point and double hole on the discharge change has the excitatory effect of lateral horn of spinal cord nerve yuan. Conclusion: the close relationship between the 1. different parts of the single point and the effect of autonomic nervous system, abdomen single point Tianshu mainly through the spinal cord - the central sympathetic splanchnic nerve pathway inhibition of colon movement; upper limb single acupoint Quchi mainly through vagal pathway excited colon movement; lower extremity single point simultaneously excited Shangjuxu splanchnic nerve pathway and vagal pathway, regulation of colonic motility is invalid or excited about.2. acupoint effect difference may be related to differences and effects about acupoints on the spontaneous discharge of autonomic nerve. Days left Most of the excitatory effects of pivot splanchnic nerve, the strongest inhibitory effect on colonic motility; the strongest excitatory effect of vagus nerve right Quchi, autonomic nerve excitatory effect on colonic motility strongest about.3. compatibility and lower compatibility compatibility may appear than single acupoint effect decreased after the combination of acupoints phenomenon and excited about: single limb acupuncture point to excite vagus nerve, while the double double Quchi, Shangjuxu, Quchi Shangjuxu appeared excited effect of splanchnic nerve and splanchnic nerve and vagus nerve effect combination of acupoints, so the effect of the volume were less than a single point or either side of single point.4. is about compatibility, compatibility, compatibility may appear upper and lower than single acupoint effect decreased with the effect of acupoints on the phenomenon of convergence in lateral horn of spinal cord: central sympathetic excitatory effect on Tianshu lateral horn of spinal cord neurons change strong, and Quchi, with 37 Wu after use, lateral horn of spinal cord neurons change rate decreases, the corresponding acupoints effect also decreased; left Tianshu excitatory effect on lateral horn of spinal cord neurons change the strongest, and the use of the right combination of spinal cord lateral horn neurons at the rate of change is reduced, the corresponding acupoints effect quantity is reduced. In summary, the application of different parts of a single points of autonomic nervous excited, which caused different effects of colonic motion direction; different parts of application of double acupoints by lateral horn of spinal cord and the integration of convergence of central sympathetic autonomic antagonism, resulting in the effect of a more balanced colonic motility. The results of this study suggest that the application of targeted therapy in a single point bowel disease can be clinically, can also be used for general acupint compatibility regulation.

【学位授予单位】：南京中医药大学
【学位级别】：博士
【学位授予年份】：2017
【分类号】：R245

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