艾灸膈俞穴对寒凝血瘀证模型大鼠血液流变学的实验研究

【作者】 金末淑；

【导师】 黄建军；

【作者基本信息】 北京中医药大学 ， 针灸推拿学， 2009， 硕士

【摘要】 目的:本实验以八会穴之一,血会—膈俞穴为研究目标,以寒凝血瘀证大鼠模型为观察对象,以血瘀证作为切入点,采用艾灸疗法,通过分组对照方法,观察膈俞穴及与之相关的委中、血海穴(两穴别名均为血郄),以及无关的丘墟穴对血液流变学的影响,探讨血会膈俞穴对血瘀证的调节作用及活血化瘀作用机理,从而进一步科学地阐明腧穴主治特异性的内涵,为临床辨证取穴提供客观的实验依据。方法:健康雄性SD大鼠96只,根据实验要求将大鼠随机分为3组:对照组(对照A、B组)、模型组(模型A、B组)、艾灸组(膈俞A、B组;血海A、B组;委中A、B组;丘墟A、B组)。除对照组16只,余80只装入小笼子里,放入低温冷柜,在-20℃的冷环境中连续受冻4h,连续冻5天,造成寒凝血瘀证模型。艾灸A组于造模成功后次日上午只治疗1次,艾灸B组于造模成功后次日上午起开始治疗,每天治疗1次,共治5次,每次灸5壮。将所有大鼠剪去穴位上被毛,穴区标记颜色,将大鼠装入自制小铁丝笼内,选取血海、委中、丘墟穴,将艾粒贴在各穴上,动物安定后施灸;艾灸膈俞穴时,用双手按住大鼠上下肢,将艾粒贴在膈俞穴上,动物安定后施灸,待大鼠扭动挣扎时换艾粒。对照和模型组动物每天同样抓取1次,不做任何处理。所有A组第7天上午均取材,所有B组第11天上午均取材,每只取腹主动脉血液4ml血,检测血液流变学4项,有全血粘度、血浆粘度、红细胞聚集指数及红细胞压积,观察其疗效及治疗前后血液流变学指标的变化。主要实验结果:1.对照组与模型组血液流变学结果全血粘度结果显示:与对照组比较,模型A组大鼠在所有切变率下的全血粘度升高明显,经统计学处理,差异显著(P＜0.05)。模型B组大鼠全血粘度低切升高明显,经统计学处理,差异显著(P＜0.05);模型B组全血粘度中切和高切有所升高,经统计学处理无显著性差异(P＞0.05)。血浆粘度、红细胞聚集指数、红细胞压积结果显示:与对照组比较,模型A组大鼠血浆粘度、红细胞聚集指数有所升高,经统计学处理无显著性差异(P＞0.05);模型A组大鼠红细胞压积升高明显,经统计学处理,差异显著(P＜0.05)。模型B组大鼠血浆粘度和红细胞聚集指数有所升高,经统计学处理无显著性差异(P＞0.05);模型B组大鼠红细胞压积升高明显,经统计学处理,差异显著(P＜0.05)。2.治疗1次组(艾灸A组)血液流变学结果全血粘度结果显示:与模型组比较,膈俞组全血粘度低切有所降低,经统计学处理无显著性差异(P＞0.05);膈俞组全血粘度中切和高切降低明显,经统计学处理,差异显著(P＜0.05)。与丘墟组比较,膈俞组在所有切变率下的全血粘度降低明显,经统计学处理,差异显著(P＜0.05)。血浆粘度、红细胞聚集指数、红细胞压积结果显示:与模型组比较,膈俞组血液流变学各项指标有所降低,经统计学处理无显著性差异(P＞0.05)。与丘墟组比较,膈俞组血浆粘度有所升高,经统计学处理无显著性差异(P＞0.05);膈俞组红细胞聚集指数有所降低,经统计学处理无显著性差异(P＞0.05);膈俞组红细胞压积降低明显,经统计学处理,差异显著(P＜0.05)。3.治疗5次组(艾灸B组)血液流变学结果全血粘度结果显示:与模型组比较,膈俞组在所有切变率下的全血粘度有所降低,经统计学处理无显著性差异(P＞0.05)。与丘墟组比较,膈俞组全血粘度低切降低明显,经统计学处理,差异显著(P＜0.05);膈俞组全血粘度中切和高切有所降低,经统计学处理无显著性差异(P＞0.05)。血浆粘度、红细胞聚集指数、红细胞压积结果显示:与模型组比较,膈俞组血液流变学各项指标有所降低,经统计学处理无显著性差异(P＞0.05)。与丘墟组比较,膈俞组血浆粘度和红细胞压积有所降低,经统计学处理无显著性差异(P＞0.05);膈俞组红细胞聚集指数降低明显,经统计学处理,差异显著(P＜0.05)。4.艾灸A、B组间血液流变学结果相比:结果显示,除丘墟组全血粘度高切和血浆粘度有显著性差异外,其余艾灸A、B组间血液流变学相关指标均无显著差异(P＞0.05)。结论:1.寒凝血瘀证模型大鼠血液流变学各项指标水平增高是导致血瘀证成因之一。2.膈俞穴与其他三穴(血海、委中、丘墟穴)比较,对寒凝血瘀证模型大鼠血液流变学相关指标的改善最显著,证实血会膈俞穴对血瘀证的调节作用及活血化瘀效应,揭示血会膈俞穴活血化瘀作用的机理,为临床治疗血瘀证的穴位选择提供实验依据。3.艾灸虽能改善模型的血液流变性与微循环、调节血管舒缩活动,起到活血化瘀作用,但本实验艾灸组每个穴位的结果相异,即与丘墟穴比较,膈俞、血海、委中穴三穴血液流变学各项指标均有降低趋势,且与模型组比较,丘墟穴除丘墟A组血浆粘度和丘墟B组全血粘度高切、红细胞压积外,其余血液流变学各项指标均有增高趋势,提示不同腧穴对艾灸的活血化瘀作用具有特异性的差异。综上所述,膈俞、血海、委中穴三穴在治疗寒凝血瘀证大鼠模型时,确实具有不同活血化瘀效应,其作用机制与改善寒凝血瘀证血液流变学的水平有关,且与这三穴比较,丘墟穴血液流变学各项指标均有增高趋势,说明丘墟穴对调血及活血化瘀效应方面远不及膈俞、血海、委中穴三穴,这为腧穴主治特异性的研究提供了依据。更多还原

【Abstract】 Objection:This research is carried out with objects of Geshu(BL17,the blood meeting point),one of the eight meeting points,and rats with syndrome of cold congeal and blood stasis.It aims at comparing the effect on heomorheology caused by moxibustion to Geshu(BL17),and Xuehai(SP10), Weizhong(BL40),all of which have the similar function due to the specificity as blood cleft point,and Qiuxu(GB 40),which has no indication for the syndrome. It is also discussed about the regulation of Gehsu(BL17) on blood stasis syndrome,and provides the clinical experimental evidence for clinical treatment.Method:96 SD male rats were divided into 3 groups:control group(control groupA、B)、Model group(Model groupA、B)、Moxibustion group(Geshu(BL17) groupA、B;Xuehai(SP10) group A、B;Weizhong(BL40) groupA、B;Qiuxu(GB40) groupA、B). Excepting rats in control group(16),all the others(80) were kept staying in low-temperature freezer(-20℃) for 5 days of 4h each day for building model of cold congeal and blood stasis syndrome.In Moxbustion group A,the treatment was be given only once the day next to the end of 5 days model building.In moxibustion group B,the treatment was given 5 times(one per day),and 5 tips of moxa for one treatment,immediately the models building were finished.All the Point location was snipped the clothing hair off,and marked with color. The rats were confined into the cage with moxa plastered on the points(Xuehai SP10,Weizhong,BL40 and Qiuxu GB40).As soon as the rats calmed down,the moxibustion would be done.For moxibustion of Geshu(BL17),the limbs of rats should be fixed.The rats in both control group and model group should be captured without any manipulation.On the day next the end of moxibustion treatment,4 ml blood was drawn from abdominal aorta for the test of heomorheology,including blood viscosity,plasma viscosity,erythrocyte aggregation index and hematocrit.The comparison of indexes before and after treatment was done to detect the mechanism of moxibustion treatment.Result:1.Hemorheology comparison between control group and Model group:Blood viscosity:blood viscosity of model group A is higher than that of control group in each shear rate(P＜0.05);Low blood viscosity of model group B is higher than that of control group in each shear rate(P＜0.05);Moderate and high blood viscosity of model group B is higher than that of control group in each shear rate with no significant difference(P＞0.05).Plasma viscosity,erythrocyte aggregation index and hematocrit:plasma viscosity and erythrocyte aggregation index in model group A are higher than those in control group with no significant difference(P＞0.05);hematocit in model group A is much higher than that in control group(P＜0.05);plasma viscosityh and hematocrit in model Group B are higher than those in Control group with no significant difference(P＞0.05);hematocrit in model group B is obviously superior to that in Control group(P＜0.05).2.Hemorheology in Moxibustion group A:Blood viscosity:in low shear rate,blood viscosity in Geshu(BL17) group is lower than that in Model group with no significant difference(P＞0.05);in moderate and high shear rate,blood viscosity in Geshu(BL17) group are obviously lower than those in Model group(P＜0.05);in each shear rate,blood viscosity in Geshu(BL17) group is obviously lower than that in Qiuxu(GB40) group(P＜0.05).Plasma viscosity,erythrocyte aggregation index and hematocrit:all the these indexes are lower than those in model group with no significant difference (P＞0.05);plasma viscosity in Geshu(BL17) group is lower than that in Model group with no significant difference(P＞0.05);so is the erythrocyte aggregation index;hematocrit in Geshu(BL17) group is obviously lower than that in Model group(P＜0.05)3.Hemorheology in Moxibustion group BBlood viscosity:in low shear rate,blood viscosity in Geshu(BL17) group is lower than that in Model group with no significant difference(P＞0.05);blood viscosity in Geshu(BL17) group is lower than that in Qiuxu(GB40) group(P＜0.05); in moderate and high shear rate,blood viscosity in Geshu(BL17) group are lower than those in Model group with no significant difference(P＞0.05).Plasma viscosity,erythrocyte aggregation index and hematocrit:all the these indexes are lower than those in model group with no significant difference (P＞0.05);plasma viscosity and erhematocrit are lower than those in Qiuxu(GB40) group with no significant difference(P＞0.05),erythrocyte aggregation index in Geshu(BL17) group is lower than that in Qiuxu(GB40) group(P＜0.05).4.Hemorheology comparison between Moxibustion group A and B:Except blood viscosity in high shear rate and viscosity plasma,there are no significant difference of other indexes within the two groups(P＞0.05).Conclusion:1.The blood stasis is supposed to be caused by the increase of hemorheology indexes value in rates with syndrome of cold congeal and blood stasis as one of the factors.2.Geshu(BL17) is proved to have the function of improving blood circulation as the blood meeting point,due to its function of reducing hemorheology indexes values,which can provide experimental evidence for clinical treatment.3.Although moxibustion can improve blood circulation by regulation of rheology, micro-circulation and vasomotion.However,there are the differences in indexes of points in moxibustion group.The value of hemoreology indexes of Gehsu(BL17),Xuehai(SP10) and Weizhong(BL40) groups are lower than that of Qiuxu(GB40) group.Except blood viscosity and hematocrit in Qiuxu(GB40) groupA and Qiuxu(GB40) groupB,all the other indexes are superior to those in model group.All above indicate the difference of blood circulation improvement by moxbustion among the points.All above shows that Gehsu(BL17),Xuehai(SP10) and Weizhong(BL40) have indication of blood circulation improvement,the mechanism of which is to improve the blood circulation by reducing hemoreology indexes;the indication of regulating blood circulation of Qiuxu(GB40) is worse than that of Gehsu(BL17),Xuehai(SP10) and Weizhong(BL40) because that all the indexes in it are higher than those in the other 3 points.All these will provide the experimental evidence for clinical treatment.更多还原