NEURAL MECHANISM OF THE EFFECT OF ACUPUNCTURE ON MYOCARDIAL ISCHEMIA

针刺治疗心肌缺血的神经机制

• 批准号: 7374241
• 负责人: John C Longhurst
• 金额: $ 0.74万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-01 至 2006-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7374241
• 关键词: arrhythmia; coronary disorder; human; hypertension; myocardial ischemia /hypoxia; oxygen; physicians; stress

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Coronary artery disease is the greatest cause of death in middle aged and elderly individuals in North America. Treatment for this disease is far from perfect and is often associated with side effects. In recent years there is increasing interest in alternative medicine and therapy for coronary artery disease including acupuncture. Acupuncture and its more potent alternative, electroacupuncture (EA), are therapies that have been recognized for centuries by physicians in Eastern countries to be effective in treating a number of diseases. The World Health Organization (WHO) lists more than 40 conditions for which acupuncture may be effective. With regard to the cardiovascular system, the management of cardiac pain, arrhythmias, and hypertension all fall into the latter category for which some clinical and basic science reports suggest efficiency. However, most Western physicians have been reluctant to accept acupuncture because the physiological mechanisms determining its actions have not been well described. The purpose of this study is to prove: (1) myocardial ischemia, cardiac arrhythmias, and hypertensive responses at rest and provoked by stress are decreased by EA; (2) the mechanism of the ischemic response is an imbalance between myocardial oxygen supply and demand originating as an increase in sympathetic autonomic neurons system activity causing increased oxygen demand. EA inhibits the sympathetic nervous system, decreases the blood pressure and reduces the oxygen demand; (3) EA leads to production of endorphins that antagonize neurotransmission in nuclei of brainstem that can be imaged in the human brain and which are concerned with regulation of sympathetic nerve activity. The investigator's prior data in animals shows that improvements in cardiovascular function during myocardial ischemia are mediated by an EA-induced sensory neural reflex originating in somatic nerves to reduce sympathetic nerve activity. The investigators' specific aims will allow us to better understand and modulate the sympathetic nervous discharge activity that precipitates coronary ischemia, arrhythmias and hypertension in psychological and exercise stress in humans. The investigators also will determine the central neural location of EA modulation of sympathetic outflow. Potential clinical application is the therapeutic value of EA in patients with ischemic heart disease, arrhythmia and hypertension.

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。冠状动脉疾病是北美中老年人死亡的最大原因。这种疾病的治疗远非完美，并且通常与副作用有关。近年来，人们对包括针灸在内的冠状动脉疾病的替代医学和治疗越来越感兴趣。 针灸及其更有效的替代品，电针（EA），是几个世纪以来被东方国家的医生公认为有效治疗许多疾病的疗法。世界卫生组织（WHO）列出了40多种针灸可能有效的条件。关于心血管系统，心脏疼痛、心律失常和高血压的管理都属于后一类，一些临床和基础科学报告表明其有效性。然而，大多数西方医生一直不愿意接受针灸，因为决定其行动的生理机制还没有得到很好的描述。 本研究的目的是证明：（1）EA可减轻静息和应激引起的心肌缺血、心律失常和高血压反应;（2）缺血反应的机制是心肌氧供需失衡，源于交感自主神经元系统活动增加，导致需氧量增加。电针抑制交感神经系统，降低血压，减少需氧量;（3）电针导致产生内啡肽，其拮抗脑干核团中的神经传递，可以在人脑中成像，并且与交感神经活动的调节有关。研究者先前在动物中的数据表明，心肌缺血期间心血管功能的改善是由EA诱导的感觉神经反射介导的，该反射起源于体神经，以减少交感神经活动。研究人员的具体目标将使我们能够更好地了解和调节交感神经放电活动，这些活动会在人类心理和运动应激中引起冠状动脉缺血，心律失常和高血压。研究者还将确定电针调节交感神经流出的中枢神经位置。电针对缺血性心脏病、心律失常、高血压等疾病的治疗价值具有潜在的临床应用价值。