孤束核在針刺“足三里”調(diào)節(jié)胃運(yùn)動(dòng)中的作用機(jī)制

1、孤束核在針刺“足三里”調(diào)節(jié)胃運(yùn)動(dòng)中的作用機(jī)制         11-05-14 15:21:00     編輯：studa20            作者：王述菊,孫國(guó)杰,杜艷軍,胡和平,吳緒平,孔立紅【摘要】  目的 探討迷走神經(jīng)中樞孤束核在針刺“足三里”對(duì)胃運(yùn)動(dòng)障礙大鼠胃內(nèi)壓影響中的作用。方法 采用神經(jīng)電生理學(xué)方法,用微電極細(xì)胞外記錄大鼠孤束核

2、單個(gè)神經(jīng)元的活動(dòng),在正常生理狀態(tài)下及經(jīng)血管注射抑制胃運(yùn)動(dòng)的藥物阿托品或促進(jìn)胃運(yùn)動(dòng)的藥物胃復(fù)安后,觀察針刺“足三里”對(duì)孤束核神經(jīng)元放電及胃內(nèi)壓的影響。結(jié)果 在正常生理狀態(tài)下,針刺“足三里”有效激活了孤束核神經(jīng)元放電,并明顯促進(jìn)胃運(yùn)動(dòng)。靜脈注射阿托品后,孤束核神經(jīng)元背景放電減少,但針刺對(duì)放電的影響與藥物前相比變化不大, 靜脈注射阿托品后針刺“足三里”仍有效激活了孤束核神經(jīng)元放電,且靜脈注射阿托品后針刺“足三里”能明顯促進(jìn)胃運(yùn)動(dòng)。在靜脈注射胃復(fù)安后,孤束核神經(jīng)元背景放電增加,但針刺對(duì)放電的影響與藥物前相比,變化也不大, 靜脈注射胃復(fù)安后針刺“足三里”仍有效激活了孤束核神經(jīng)元放電,而且靜脈注射胃復(fù)安后

3、針刺“足三里”更明顯促進(jìn)胃運(yùn)動(dòng)。結(jié)論 針刺“足三里”對(duì)胃功能的調(diào)節(jié)作用以促進(jìn)胃運(yùn)動(dòng)為主,其調(diào)節(jié)作用與孤束核神經(jīng)元的激活密切相關(guān),且針刺“足三里”引起孤束核相關(guān)神經(jīng)元放電增加幅度不受周圍膽堿能受體阻滯劑阿托品及多巴胺受體拮抗劑胃復(fù)安的影響。 【關(guān)鍵詞】  孤束核；足三里；針刺；胃運(yùn)動(dòng)；大鼠    Abstract：Objective To research the function of the vagus nerve center nucleus of solitary tract (NTS) in the influence of gastric pr

4、essure by acupuncture at “Zusanli” in rats with motility disturbances of the stomach. Methods Adopting electrophysiological methods, the extracellular discharge signals of neuronic action in NTS were recorded with glass microelectrode. The influence of the discharges of NTS neurons and gastric press

5、ure responding to the acupuncture at “Zusanli” point were observed in normal status and the condition of Atropine or Metoclopramide intravenous injection. Results In the normal status, acupuncture at “Zusanli” activated the discharges of NTS neurons and promote the gastric pressure remarkably. After

6、 Atropine intravenous injection, the background discharges of NTS neurons decreased. There was no statistical difference in the discharges responding to the effect of acupuncture before and after Atropine administration. And the gastric motion reinforced obviously by acupuncture at “Zusanli” after A

7、tropine administration. But after intravenous injection of Metoclopramide, the background discharges of NTS neurons increased. There was also no statistical difference in the discharges responding to the effect of acupuncture before and after Metoclopramide administration. Moreover, the function of

8、promoting gastric motion by acupuncture at “Zusanli” got more obviously after Metoclopramide administration. Conclusion The function of adjusting gastric motion by acupuncture at “Zusanli” point has close relation to the activation of NTS neurons, and the increasing amplitude of the discharges of NT

9、S neurons wasnt influenced by cholinergic receptor blocker Atropine and dopamine-receptor antagonist Metoclopramide.    Key words：nucleus of solitary tract；Zusanli；acupuncture；gastric motion；rat“足三里”是足陽明胃經(jīng)五輸穴中的合穴,是四總穴之首。臨床和實(shí)驗(yàn)研究均表明,“足三里”對(duì)胃功能和疾患有顯著的調(diào)整和治療作用1-2,但以往的研究多集中于周圍神經(jīng)系統(tǒng)的作用,而對(duì)中樞的作用

10、研究甚少。因此,本研究旨在觀察針刺“足三里”穴對(duì)孤束核神經(jīng)元放電的影響,探討腦的低級(jí)中樞延髓孤束核(nucleus of solitary tract,NTS)在“足三里”穴調(diào)節(jié)胃運(yùn)動(dòng)中的作用機(jī)制。1  材料與方法1.1  動(dòng)物健康成年Sprague-Dawley雄性大鼠32只,體重300350 g之間,中國(guó)中醫(yī)科學(xué)院實(shí)驗(yàn)動(dòng)物中心提供,為清潔級(jí)動(dòng)物。測(cè)量胃內(nèi)壓實(shí)驗(yàn)前禁食12 h,飼以5%葡萄糖鹽水。手術(shù)及實(shí)驗(yàn)過程中動(dòng)物體溫用計(jì)算機(jī)溫度時(shí)間控制儀維持在(37±1)。1.2  儀器及藥物腦立體定位儀(日本)、微電極操縱器、微電極推進(jìn)器(PF5-1,日本光電)

11、、微電極放大器(MEZ-8301,日本光電)、載波放大器(AP-601G,日本光電)、生物放大器(AB-621G,日本光電)、雙線記憶示波器(Vc-10,日本光電)、刺激器(SEN-7203,日本光電)、隔離器(SSl02J,日本光電)、雙芯玻璃毛坯(長(zhǎng)度100 mm,外徑1.5 mm,內(nèi)徑1.2 mm,南京)、玻璃微電極拉制儀(Model P-97,美國(guó))、壓力換能器(yp200,北京)、PowerLab計(jì)算機(jī)數(shù)據(jù)采集系統(tǒng)(愛德公司,澳大利亞)、華佗牌針灸針具(蘇州)、計(jì)算機(jī)溫度時(shí)間控制儀(STARC ST-360,日本)、臺(tái)式牙鉆車(307-6,上海)、37 液體石蠟、0.5 mol/L滂

12、胺天蘭醋酸鈉溶液、0.2%肝素、0.01%阿托品、0.1%胃復(fù)安、0.3%中性紅水溶液。1.3  孤束核細(xì)胞外記錄手術(shù)在室溫條件下,大鼠稱重后用10%烏拉坦腹腔注射麻醉(urethane,1.01.2 g/kg)。大鼠頭部用耳棒固定,頭頂部剃毛,沿正中矢狀線切開皮膚,分離皮下組織,刮除骨膜,暴露前后囟,將前后囟調(diào)至同一水平。根據(jù)大鼠腦立體定位圖譜(Paxinos和Watson,1998),在孤束核(A-11.3-14.3 mm；L 02.3 mm；H 47 mm)所在顱骨部位用臺(tái)式牙鉆車鉆孔,手下有落空感即停止。顯微鏡下分層剝離硬腦膜和軟腦膜,暴露的腦組織用溫的石蠟油覆蓋。在記錄孤束

13、核實(shí)驗(yàn)中,大鼠俯臥,將大鼠頭部用耳棒固定于腦立體定位儀上,下齒鉤掛在鼠頭夾中,口鼻部用鼠頭夾壓緊。1.4  血壓記錄手術(shù)動(dòng)物仰臥,于頸部中線偏左側(cè)一字切口切開皮膚,分離皮下組織和肌肉,暴露左側(cè)頸靜脈、頸總動(dòng)脈。用動(dòng)脈夾在頸總動(dòng)脈中段夾住血管阻斷血流,注意松緊適度以免夾傷血管。將頸靜脈、頸總動(dòng)脈的遠(yuǎn)心端用手術(shù)線結(jié)扎,眼科剪將血管剪開一斜口(大約為直徑的1/2),將靜脈插管和動(dòng)脈插管分別向心性插入頸靜脈、頸動(dòng)脈內(nèi)約810 mm,注意不能太深以避免動(dòng)脈插管對(duì)頸動(dòng)脈竇的機(jī)械刺激。動(dòng)脈插管內(nèi)預(yù)先充滿0.2%的肝素,排除懸浮氣泡。動(dòng)脈插管通過三通裝置與注射器和壓力傳感器相聯(lián),注射器內(nèi)留置2 mL

14、 0.2%的肝素,動(dòng)脈血管堵塞時(shí)少量推注。靜脈插管直接與注射器相連,以備靜脈用藥。1.5  胃內(nèi)壓記錄手術(shù)動(dòng)物仰臥,上腹部剃除毛,于劍突下腹正中矢狀線偏左側(cè)5 mm一字切口切開腹腔,以溫和的生理鹽水紗布推開肝臟暴露胃幽門部及十二指腸上段。將避孕套套在塑料導(dǎo)管一端,導(dǎo)管前端與避孕套之間留有一定空隙,在距離避孕套前端1 mm處用外科線結(jié)扎將兩者固定,制成直徑為20 mm的胃內(nèi)留置氣囊。胃囊內(nèi)及插管內(nèi)充滿雙蒸水,排除氣泡。在十二指腸距胃竇部1.52 mm處,避開腸壁上可見的血管,在腸系膜的對(duì)側(cè)做一個(gè)23 mm左右的一字型切口,將氣囊放入胃竇部,切口處荷包縫合固定。插管另一端通過三通裝置與注射器和壓力傳感器相連。1.6  孤束核神經(jīng)元細(xì)胞外記錄在記錄孤束核的實(shí)驗(yàn)中,根據(jù)大鼠腦立體定位圖譜,通過