下丘脑GABA A受体α亚基参与电针调节急性手术创伤 下丘脑-垂体-肾上腺轴功能紊乱的神经机制

目前10~50%手术急性应激患者可发展为慢性应激，微创技术，虽然做到术后疼痛更轻微、麻醉风险更小等优点，但仍无法显著减轻手术创伤对机体的危害。电针可减少手术麻醉用药，减轻手术创伤反应；电针不仅使术后下丘脑CRF表达恢复正常，并促进外周促肾上腺皮质激素、皮质酮释放水平的恢复。GABA是下丘脑主要的抑制性神经递质， GABA受体的功能和生理特性决定于其亚单位的组成，下丘脑室旁核的GABAA受体，尤其是GABAA受体的不同α亚基如何影响下级CRF神经元表达的机理还不清楚。此外，电针是否通过调节相关miRNA参与对CRF表达的调节值得深入研究。本研究通过完整手术过程建立手术创伤模型，采用神经药理学、神经形态学、分子生物学等方法，来探讨术后GABAA受体α亚基参与电针调节手术创伤时HPA轴功能的机理,为围手术期应激发生和缓解机制提供实验和理论依据；为电针辅助麻醉调节应激反应作用提供神经生物学基础。

Effect of electro-acupuncture on regulating the HPA axis in surgical trauma: mediation by the hypothalamic α subunits of GABAA receptor.Abstract: Today about 10~50% of surgical acute stress may develop into chronic stress. NOTES, the most advanced technology, is still unable to reduce surgical response. EA can attenuate acute stress response induced by surgery and anesthesia with efficiency and safety. Our previous studies show that the hypothalamic CRF is normalized within EA treatment, and the expression of glucocorticoid receptor (GR) in the hypothalamus, plasma adrenocorticotropic hormone (ACTH) and corticosterone (Cort) are also decreased after EA treatment. In addition, the expression of hypothalamic GABAA receptor are suppressed within EA in different period after surgerywhich indicates the important roles. In addition, whether EA participating in regulation of CRF related miRNA is worth intensive researching. So further work will focuses on the distribution and function of α subunits in the hypothalamus, as well as related synaptic and intracellular signaling pathways through immunofluorescence technology, western blot, real time PCR, RNAi technology. Thus, general pathophysiological mechanism of acute traumatic stress after surgery and acute effects of EA treatment will be provided rigorously.