摘要
背景对于经穴效应规律的研究一直是针灸学领域的研究重点和热点,怎样运用多学科交叉,采用现代医学最先进的技术和方法对传统针灸最基本的理论问题,经穴的效应规律,开展研究,为临床应用提供有力的理论依据,已成为现代针灸急需解决的问题。
腧穴特异性及腧穴主治的双向性是经穴效应规律研究的重要组成部分。如果能够按照由动物实验研究提出假说到大规模临床试验验证的模式,进行相关腧穴特异性和腧穴主治双向性研究,总结针刺调整效应的规律,阐明腧穴效应规律性以及腧穴针刺信号的始动、传导、整合及效应产生的机制,将为现代针灸学理论的建立提供重要依据。
目的通过观察针刺十二原穴和非穴对高、低血压大鼠模型血压影响的不同,来研究代表不同经脉的“原穴”对血压影响的特异性及针刺作用的双相性,为针灸调节血压的腧穴效应规律研究领域增加新的理论依据,也为今后更深入探讨腧穴效应规律的机理研究提供切入点。
方法研究分为高血压部分和低血压部分。两部分均分为十二原穴组、非穴组、模型组和空白组,每组6只。各原穴及非穴组大鼠每日接受相应部位的针刺治疗,各原穴及非穴均取双侧;模型组、空白组大鼠同样固定,但不予针刺。针刺时用1寸30号不锈钢毫针直刺,平补平泻法连续刺激5分钟,连续治疗7天。每日治疗结束后所有动物均进行BP检测,每只大鼠连续测量5次,取平均血压值。应用统计软件SPSS13.0进行统计学处理。
结果与分析
1、原穴降压作用特异性的比较:非穴组与模型组血压比较,差异有统计学意义(P＜0.05),说明针刺具有降压作用。十二原穴组中,阳池、太冲、太溪组的降压效果最优,且降压效果接近,三组比较差异无统计学意义(P＞0.05),说明其降压程度类似;太渊、神门、太白、合谷、腕骨组降压效果稍次,但优于非穴组,五组间血压相互比较,差异无统计学意义(P＞0.05),说明其降压水平在一个层次;大陵、丘墟、冲阳组虽与模型组血压比较无统计学意义(P＞0.05),但仍具有一定的降压作用,且其降压效果与京骨、非穴组比较差异无统计学意义(P＞0.05),说明其降压效果接近。
2、原穴升压作用特异性的比较:非穴组和十二原穴组与模型组血压比较,差异有统计学意义(P＜0.05),说明针刺具有升压作用。十二经原穴组中,神门、大陵、合谷、阳池组的升压效果最优,且升压效果接近,四组比较差异无统计学意义(P＞0.05),说明其升压程度类似;太渊、太冲组升压效果稍次,两组间血压相互比较,差异无统计学意义(P＞0.05),说明其升压水平在一个层次;腕骨、太溪、太白组升压效果再次,三组比较差异无统计学意义(P＞0.05),说明其升压效果接近;京骨、冲阳、丘墟组在十二原穴中升压作用最差,但仍优于非穴组,组间比较差异均有统计学意义(P＜0.01)。
3、原穴对血压双向性调节作用的比较:十二经原穴组及模型组、非穴组比较,差异有统计学意义(P＜0.01),说明其对血压双向性调节的作用有差异。模型组、非穴组对血压双向调节的作用不明显。而十二经原穴对血压有较好的双向调节作用。十二经原穴中以合谷穴、阳池穴、神门穴双向调整作用为最好,三组比较差异无统计学意义(P＞0.05),说明合谷穴、阳池穴、神门穴对血压的双向调节作用接近;太渊穴、太冲穴、腕骨穴次之,三组比较差异无统计学意义(P＞0.05),说明太渊穴、太冲穴、腕骨穴对血压的双向调节作用类似;大陵穴、太溪穴、太白穴再次之,三组比较差异无统计学意义(P＞0.05),说明大陵穴、太溪穴、太白穴对血压的双向调节作用接近;冲阳穴、京骨穴、丘墟穴对血压的双向调节作用最差,与非穴组比较较差异无统计学意义(P＞0.05),说明冲阳穴、京骨穴、丘墟穴的双向调节作用与非穴组类似。
结论
1、针刺对高血压有良性调整作用,且针刺的即时降压作用特别明显,但其持续降压作用还有待临床进一步证实。十二原穴在调治高血压方面具有特异性,十二原穴中阳池、太冲、太溪穴的降压作用最优,太渊、神门、腕骨、太白、合谷穴的降压作用稍差,大陵、京骨、丘墟、冲阳穴的降压作用最差,与非穴类似。
2、针刺非穴和原穴除了对高血压有良性调整作用外,也具有很好的升压作用,并且针刺对低血压的调节相对高血压更加平稳、持久。低血压部分,十二原穴中神门、大陵、阳池、合谷穴的升压作用最优,太冲、太渊穴的升压作用稍差,太白、太溪、腕骨穴的升压作用再次,京骨、丘墟、冲阳穴升压作用最差,但也优于非穴组。
3、针刺非穴与原穴对血压调节具有双向调节作用,且原穴对血压的双向调节要优于非穴。另外,十二原穴对血压调节的双向性也具有差异,十二原穴中以合谷、阳池、神门穴的双向调节作用最优,太渊、太冲、腕骨穴的双向调节作用稍差,大陵、太溪、太白穴的双向作用再次,冲阳、京骨、丘墟穴对血压的双向调节作用最差。
Background: Mechanism study of meridian points is always the investigative emphasis and hot spot in the domain of acupuncture and moxibustion. How to apply multi-subject and the best advanced technology and method of modern medicine to investigate fundamental theory of traditional acupuncture and moxibustion, mechanism study of meridian points, and to provide emphatic theoretical evidences for clinical application is a question that needs to be solved urgently by experts in acupuncture and moxibustion.
Mechanism study of meridian points includes the specificity and dual-directional regulation of acupoints. According to the mode that studying from proposing hypothesis through animal experiment to authenticating it through large scale clinical test, carrying out studies on the specificity and dual-directional regulation of acupoints, summarizing the effective regularity adjusted by acupuncturing, elucidating the effective regularity of acupoints and the mechanism of began, conducted, conformed and generated by acupuncturing signal, we will provide significant foundation for contemporary acupuncture and moxibustion.
Objective: To investigate the specificity and dual-directional regulation of Yuan-primary points through observing the effect of Yuan-primary points and non-points on blood pressure in rats with hypertension and hypotension. This research provided the new theoretical basis for the domain of the mechanism study of acupoints of acupuncture in effecting blood pressure, as well as establishing a breakthrough for the further research on the mechanism of the effective regularity of acupoints.
Methods: This research included two parts of hypertension and hypotension. Both of parts were assigned into twelve Yuan-primary points groups, non-points group, model group and normal group. Each group had 6 rats. Rats in Yuan-primary points groups and non-points group received acupuncture at corresponding position, Yuan-primary points and non-points selected both sides. The rats in model group and normal group were put in the fixer, but not received acupuncture. No. 30 and 1 cun needles were used to puncture perpendicularly. Uniform reinforcing and reducing methods were applied for 5 minutes. The treatment had been conducted successively for 7 days. All rats' blood pressure was detected 5 times in succession. Recording general average of BP. Statistical analysis was carried out using SPSS 13.0 for Windows. Results and analyses:
1. Comparison of the specificity of Yuan-primary points in depressing BP: Comparing with non-points group and model group, the significant difference indicated that acupuncture can depress BP (P<0.05). In twelve Yuan-primary points groups, Yangchi, Taichong and Taixi groups' effect of depressurization was the best. Comparing with three groups, the difference was not statistically significant (P>0.05). The result indicated that effect of depressurization of Yangchi, Taichong and Taixi was similar. Taiyuan, Shenmen, Taibai, Hegu and Wangu groups' effect of depressurization was better than non-points group's. Comparing with five groups, the difference was not statistically significant (P>0.05). The result indicated that effect of depressurization of Taiyuan, Shenmen, Taibai, Hegu and Wangu was similar. Comparing with Daling, Qiuxu, Chongyang groups and model group, the difference was not statistically significant (P>0.05). As well as comparing with Daling, Qiuxu, Chongyang groups and Jinggu, non-points group, the difference was not statistically significant too (P>0.05). These results indicated that Daling, Qiuxu, Chongyang can depress BP and its' effect was similar.
2. Comparison of the specificity of Yuan-primary points in boosting BP: Comparing with non-points group, twelve Yuan-primary points groups and model group, the significant difference indicated that acupuncture can boost BP (P<0.05). In twelve Yuan-primary points groups, Shenmen, Daling, Hegu and Yangchi groups' effect of boosting BP was the best. Comparing with four groups, the difference was not statistically significant (P>0.05). The result indicated that effect of boosting BP of Shenmen, Daling, Hegu and Yangchi was similar. Taiyuan, Taichong groups' effect of boosting BP was not as good as Shenmen, Daling, Hegu and Yangchi groups' . Comparing with two groups, the difference was not statistically significant (P>0. 05). The result indicated that effect of boosting BP of Taiyuan, Taichong was similar. Wangu, Taixi, Taibai groups' effect of boosting BP was not as good as Taiyuan, Taichong groups' . Comparing with three groups, the difference was not statistically significant (P>0. 05). The result indicated that effect of boosting BP of Wangu, Taixi, Taibai was similar. Jinggu, Chongyang and Qiuxu groups' effect of boosting BP was the worst in twelve Yuan-primary points groups, but was better than non-points group. Comparing with Jinggu, Chongyang and Qiuxu groups and non-points group, the difference was significant (P<0. 05).
3. Comparison of the dual-directional regulation of Yuan-primary points in regulating BP: Comparing with twelve Yuan-primary points groups, model group and non-points group, the significant difference indicated that its' dual-directional regulation in regulating BP was different (P<0. 01). Twelve Yuan-primary points groups' dual-directional regulation in regulating BP was better than model and non-points groups' . In twelve Yuan-primary points groups, Hegu, Yangchi and Shenmen groups' dual-directional regulation was the best. Comparing with three groups, the difference was not statistically significant (P>0.05). The result indicated that the dual-directional regulation of Hegu, Yangchi and Shenmen was similar. Taiyuan, Taichong and Wangu groups' dual-directional regulation was not as good as Hegu, Yangchi and Shenmen groups' . Comparing with three groups, the difference was not statistically significant (P>0.05). The result indicated that the dual-directional regulation of Taiyuan, Taichong and Wangu was similar. Daling, Taixi, Taibai groups' dual-directional regulation was not as good as Taiyuan, Taichong and Wangu groups' . Comparing with three groups, the difference was not statistically significant (P>0.05). The result indicated that the dual-directional regulation of Daling, Taixi and Taibai was similar. Chongyang, Jinggu and Qiuxu groups' dual-directional regulation was the worst in twelve Yuan-primary points groups. Comparing with Chongyang, Jinggu, Qiuxu and non-points group, the difference was not statistically significant (P>0. 05). The result indicated that its' dual-directional regulation in regulating BP was similar.
Conclusions:
1. Acupuncture can depress BP. And its immediate effect of depressing BP was significant, but persistence effect of depressing BP need be authenticated by large scale clinical test. The specificity of Yuan-primary points in depressing BP was different. In twelve Yuan-primary points groups, Yangchi, Taichong and Taixi's effect of depressurization was the best; Taiyuan, Shenmen, Taibai, Hegu and Wangu's effect of depressurization was not as good as Yangchi, Taichong and Taixi's; Daling, Qiuxu, Chongyang's effect of depressurization was the worst, and was similar to non-points'.
2. Acupuncture can boost BP. And its effect of boosting BP was more steady and persistence than effect of depressing BP. The specificity of Yuan-primary points in boosting BP was different. In twelve Yuan-primary points groups, Shenmen, Daling, Hegu and Yangchi's effect of boosting BP was the best; Taiyuan, Taichong's effect of boosting BP was not as good as Shenmen, Daling, Hegu and Yangchi's; Wangu, Taixi, Taibai's effect of boosting BP was not as good as Taiyuan, Taichong's; Jinggu, Chongyang and Qiuxu' s effect of boosting BP was the worst, but was better than non-points group.
3. Acupuncture on non-points and twelve Yuan-primary points in regulating BP has dual-directional regulation. The dual-directional regulation of Yuan-primary points in regulating BP was different. In twelve Yuan-primary points groups, the dual-directional regulation of Hegu, Yangchi and Shenmen was the best; the dual-directional regulation of Taiyuan, Taichong and Wangu was not as good as Hegu, Yangchi and Shenmen; the dual-directional regulation of Daling, Taixi, Taibai was not as good as Taiyuan, Taichong and Wangu; the dual-directional regulation of Chongyang, Jinggu and Qiuxu was the worst.
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