电针足三里穴和内关穴对兔内毒素休克诱发心肌损伤的影响及血红素氧合酶-1在其中的作用  

Effect of electro-acupuncture at Zusanli and Neiguan acupoints on endotoxic shock-induced myocardial injury in rabbits and the role of heme oxygenase-1

作　　者：张桂诚[1] 余剑波[1] 

机构地区：[1]天津市南开医院麻醉科,300100

出　　处：《中华麻醉学杂志》2014年第2期211-215,共5页Chinese Journal of Anesthesiology

基　　金：天津市自然科学基金，天津市科技支撑计划重点项目

摘　　要：目的 探讨电针足三里穴和内关穴对兔内毒素休克诱发心肌损伤的影响及血红素氧合酶-1（HO-1）在其中的作用.方法 健康清洁级雄性新西兰大白兔60只,体重1.5～2.0 kg,2月龄,采用随机数字表法,将其分为6组（n=10）：假手术组（S组）、锌原卟啉-Ⅸ组（Z组）、内毒素休克组（ES组）、电针＋内毒素休克组（EES组）、假针刺＋内毒素休克组（SEES组）、电针＋内毒素休克＋锌原卟啉-Ⅸ组（EESZ组）.ES组、EES组、SEES组和EESZ组采用静脉注射脂多糖5 mg/kg的方法制备内毒素休克模型,S组和Z组给予等量生理盐水.EES组和EESZ组于模型制备前1～4d和模型制备当天（静脉注射内毒素开始至模型制备结束）电针双侧足三里穴和内关穴.疏密波,频率2/100 Hz,波宽0.2 ～ 0.6 ms,刺激强度2～3 mA,以免出现轻微肌颤为宜,30 min/次,1次/d.SEES组穴点定位于足三里穴和内关穴旁开0.5 cm处,刺激方法同EES组.EESZ组和Z组静脉注射脂多糖或生理盐水后2h时腹腔注射锌原卟啉-Ⅸ10 μmol/kg（溶于50 mmol/L的NaHCO3溶液1ml）,其余组给予等容量NaHCO3溶液.静脉注射脂多糖或生理盐水后6h时,取右颈总动脉血样,测定血清TNF-α、CK和LDH水平,处死动物后取心肌组织,进行病理学评分;采用Western blot法测定HO-1蛋白的表达;采用荧光定量PCR法测定HO-1 mRNA的表达.结果 与S组比较,ES组、EES组、SEES组、EESZ组心肌病理学评分、血清TNF-α、CK和LDH水平升高,心肌组织HO-1 mRNA及其蛋白表达上调（P＜0.05）,Z组上述指标差异无统计学意义（P＞0.05）;与ES组比较,EES组心肌病理学评分、血清TNF-α、CK、LDH水平降低,心肌组织HO-1 mRNA及其蛋白表达上调（P＜0.05）,SEES组和EESZ组上述各指标差异无统计学意义（P＞0.05）;与EES组比较,EESZ组心肌组织病理学评分、血清TNF-α、CK和LDH水平升高,心肌组织HO-1 mRNA及其蛋白表达下调（P＜0.05）.结论 电针足三里Objective To evaluate the effect of electro-acupuncture （EA） at Zusanli （ST-36） and Neiguan （PC6） acupoints on endotoxic shock （ES）-induced myocardial injury in rabbits and the role of heme oxygenase-1 （HO-1）.Methods Sixty healthy male New Zealand white rabbits,aged 2 months,weighing 1.5-2.0 kg,were randomly assigned into 6 groups （n =10 each） using a random number table：sham operation group （group S） ; heme oxygenase-1 inhibitor zinc protoporphyrin-Ⅸ （ZnPP-Ⅸ） group （group Z） ; group ES; EA ＋ ES group （group EES）; sham EA ＋ ES group （group SEES）; EA ＋ ES ＋ ZnPP-Ⅸ group （group EESZ）.The rabbits were anesthetized with intravenous 20% urethane 5 ml/kg.Right common carotid artery was cannulated for BP monitoring.Ear vein was cannulated for drug administration.ES was induced with lipopolysaccharide （LPS） 5 mg/kg injected intravenously in ES,EES,SEES and EESZ groups,while the equal volume of normal saline was given in S and Z groups.ES was confirmed by decrease in MAP to 75 % of the baseline value.ZnPP-Ⅸ 10 μmol/kg （in 1 ml of NaHCO3 50 mmol/L） was injected intraperitoneally at 2 h after LPS or normal saline administration in EESZ and Z groups,while the equal volume of NaHCO3 was injected intraperitoneally in the other groups.In EES and EESZ groups,bilateral 30 min EA stimulation （0.2-0.6 ms,2/100 Hz,2-3 mA） of ST36 and PC6 was performed once a day on days 1-4 before induction of ES and on the day of induction of ES （from the onset of LPS injection until the end of induction of ES）.In SEES group,electro-stimulation was performed at the points 0.5 cm lateral to the acupoints of ST36 and PC6 and the method was similar to those previously described in group EES.Blood samples were taken from the right common carotid artery at 6 h after LPS or normal saline administration for measurement of serum tumor necrosis factor-alpha （TNF-α）,creatine kinase （CK）,and lactic dehydrogenase （LDH） levels.Then the rabbits were sacrificed by exsa

关 键 词：电刺激疗法 穴 足三里 穴 内关 休克 脓毒性 心肌 血红素加氧酶-1 

分 类 号：R245[医药卫生—针灸推拿学]