CNS AUTONOMIC REGULATION BY ELECTROACUPUNCTURE

电针对中枢神经系统自主调节

• 批准号: 6390487
• 负责人: John C Longhurst
• 金额: $ 21.82万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-20 至 2003-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6390487
• 关键词: acupuncture /acupressure; afferent nerve; alternative medicine; autonomic reflex; blood pressure; cats; electrostimulus; gallbladder; medulla oblongata; neurophysiology; neuroregulation; opioid receptor; vascular smooth muscle nervous control; vasomotion

DESCRIPTION (Adapted from Applicant's Abstract): Acupuncture is an effective therapeutic modality in Eastern cultures, but has not achieved widespread recognition as a useful therapeutic option in Western medicine. In addition to its use in pain and anesthesia, electro-acupuncture (EA) has been used in hypertension, hypotension, angina and cardiac arrhythmias. Recently, the Pl's laboratory has begun to explore the physiological basis of EA. An initial study demonstrated that low frequency EA ameliorates myocardial ischemia by reducing myocardial oxygen demand in a feline model of reversible ischemia. In this model, stimulation of gallbladder chemosensitive afferent nerve endings reflexly increased arterial blood pressure, and augmented myocardial oxygen demand, which outstripped coronary blood supply following partial coronary ligation. Concurrent stimulation of the median nerves underlying the Neiguan acupoints reduced myocardial ischemia, measured as a reduction in regional wall thickening. A second study employing EA suggests a role of the endogenous opiate system in the rostral ventral lateral medulla (rVLM). Preliminary data from the Pl's laboratory indicate that the rVLM and periaqueductal gray (PAG) mediate the interaction between visceral (gallbladder) and somatic (EA) afferent nerve stimulation, and suggest a role for mu- and delta-opioid receptors. Also, the Pl has demonstrated in preliminary studies the ability to identify cells in the rVLM that receive convergent input from the greater splanchnic nerve (supplying the gallbladder) and the median nerve. Five hypotheses are now proposed: 1 ) The order of potency for the blood pressure-lowering effect of EA will be mu-equal to or greater than delta-greater than kappa-opioid receptors; 2) Non-NMDA excitatory amino acid receptors are responsible for stimulation of its neuronal subpopulation; 3) EA of Neiguan produces post-synaptic inhibition of an excitatory input to these neurons; 4) The ventrolateral PAG participates in EA modulation of reflex autonomic responses through an opioid mechanism and by influencing sympathoexcitatory rVLM neurons; and 5) Deep but not superficial somatic nerves underlying specific acupoints provide convergent input into rVLM and PAG neurons, and, through an opioid mechanism, modulate neuronal activity. Studies will be conducted in anesthetized cats whose rVLM and PAG are approached stereotaxically for extracellular recording and to deliver pharmacologic antagonists and agonists. Collaboration with both US and Chinese authorities on central neural electrophysiological and acupuncture research will significantly contribute to the ability to accomplish this investigation. By demonstrating the central neural mechanisms underlying this clinically beneficial modification of a cardiovascular reflex response by EA, scientists and clinicians will have a better understanding that will likely aid in acceptance and use of this alternative therapy. The Pl indicates that this project has important clinical implications.

描述（改编自申请人的摘要）：针灸是一种有效的治疗方法。 东方文化中的治疗方式，但尚未广泛传播 被认为是西医有用的治疗选择。此外 电针（EA）在疼痛和麻醉方面的应用 高血压、低血压、心绞痛和心律失常。最近，PL的 实验室已开始探索EA的生理基础。初步研究 证明低频电针可通过减少心肌缺血来改善心肌缺血 可逆性缺血猫模型中的心肌需氧量。在这个 模型，刺激胆囊化学敏感传入神经末梢 反射性地增加动脉血压，并增加心肌供氧 冠状动脉部分病变后的需求超过了冠状动脉的血液供应 结扎。同时刺激内关正中神经 穴位可减少心肌缺血，以局部壁的减少来衡量 增稠。使用 EA 的第二项研究表明内源性的作用 延髓头端腹侧外侧 (rVLM) 中的阿片系统。初步数据 来自 PL 实验室的结果表明 rVLM 和导水管周围灰质 (PAG) 介导内脏（胆囊）和躯体（EA）之间的相互作用 传入神经刺激，并表明 mu- 和 delta-阿片类药物的作用 受体。此外，PL 在初步研究中证明了 识别 rVLM 中接收来自更大的收敛输入的单元 内脏神经（供应胆囊）和正中神经。五 现在提出假设：1）血液的效力顺序 EA 的降压效果将 mu-等于或大于 δ-大于κ-阿片受体； 2) 非NMDA兴奋性氨基酸 受体负责刺激其神经元亚群； 3) EA 内关的兴奋性输入产生突触后抑制 神经元； 4) 腹外侧PAG参与反射的EA调节 通过阿片类药物机制并影响自主反应 交感兴奋性 rVLM 神经元； 5) 深层而非浅层躯体神经 底层特定穴位为 rVLM 和 PAG 提供汇聚输入 神经元，并通过阿片类机制调节神经元活动。研究 将在接近 rVLM 和 PAG 的麻醉猫中进行 立体定位用于细胞外记录并传递药理学 拮抗剂和激动剂。与美国和中国当局合作 中枢神经电生理和针灸研究将显着 有助于完成这项调查的能力。通过演示 这种临床有益的中枢神经机制 EA、科学家和科学家对心血管反射反应进行了修改 临床医生将有更好的理解，这可能有助于接受 以及使用这种替代疗法。 PL表明该项目已 重要的临床意义。