CNS AUTONOMIC REGULATION BY ELECTROACUPUNCTURE

电针对中枢神经系统自主调节

• 批准号: 6128401
• 负责人: John C Longhurst
• 金额: $ 24.8万
• 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/6128401
• 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）：针灸是有效的 东方文化中的治疗方式，但尚未实现 识别是西方医学中有用的治疗选择。此外 它在疼痛和麻醉中的用途已用于电针（EA） 高血压，低血压，心绞痛和心律不齐。最近，PL 实验室已开始探索EA的生理基础。最初的研究 证明低频EA通过减少来改善心肌缺血 可逆性缺血模型中的心肌氧需求。在这个 模型，刺激胆囊化学敏感传入神经末端 反射升高动脉血压，并增强心肌氧气 需求，部分冠状动脉后超出了冠状动脉血液供应 结扎。同时刺激Neiguan的中间神经 穴位降低了心肌缺血，以减少区域壁测量 增厚。采用EA的第二项研究表明内源性的作用 腹侧腹侧髓质（RVLM）中的鸦片系统。初步数据 从PL的实验室中表明，RVLM和围绕灰色（PAG） 调解内脏（胆囊）和体细胞（EA）之间的相互作用 传入的神经刺激，并提出MU-和DELTA-阿片类药物的作用 受体。此外，PL在初步研究中也证明了 识别从较大的RVLM中接收收敛输入的单元格 神经神经（提供胆囊）和中位神经。五 现在提出了假设：1）血液的效力顺序 EA的降压作用将与MU相等或大于 比卡帕 - 阿片类受体的三角洲果; 2）非NMDA兴奋性氨基酸 受体负责刺激其神经元亚群； 3）EA Neiguan的刺激输入产生后突触后的抑制作用 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和影响 同情兴奋性RVLM神经元； 5）深处但不是浅表的躯体神经 基本的特定穴位可为RVLM和PAG提供收敛输入 神经元，并通过阿片类药物机制调节神经元活性。研究 将以麻醉的猫和PAG接近的麻醉猫进行 立体定义用于细胞外记录并提供药理 对手和激动剂。与美国和中国当局合作 中央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 该临床上有益的基础的中央神经机制 EA，科学家和 临床医生将有更好的理解，这可能有助于接受 并使用这种替代疗法。 PL表示该项目有 重要的临床意义。