初步探究劳宫穴刺激对调节心血管功能的作用机制
Journal: Basic Medical Theory Research DOI: 10.12238/bmtr.v7i5.16497
Abstract
心血管疾病(Cardiovascular Diseases,CVDs)是全球发病率和死亡率最高的疾病之一,其病理机制涉及神经-体液调节失衡、炎症反应激活及氧化应激等多个层面[1]。中医理论认为,经络系统与心血管功能密切相关,而劳宫穴作为手厥阴心包经的荥穴,在调节心脏气血运行中具有重要作用。本研究通过综述现代医学实验证据与中医经络理论,初步探讨劳宫穴刺激对心血管功能的调节机制,发现其可能通过激活自主神经系统、调节下丘脑-垂体-肾上腺轴(Hypothalamic-Pituitary-Adrenal Axis,HPA轴)、抑制炎症因子释放及改善氧化应激状态等途径发挥作用。研究结果为心血管疾病的中医辅助治疗提供了理论依据,也为探索经络-心血管交互作用的科学内涵奠定了基础。
Keywords
劳宫穴；心血管功能；作用机制；经络；自主神经
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[39] Xu M,Li X,Zheng M,et al.Standardization of acupuncture parameters for cardiovascular diseases: a systematic review [J].Journal of Traditional Chinese Medicine,2022,42(6):1009-1018.
[2] Libby P,Ridker P M,Maseri A.Inflammation and atheroscl erosis[J].Circulation,2002,105(9):1135-1143.
[3] World Health Organization. Cardiovascular diseases (CVDs) [EB/OL].2023.
[4] 国家心血管病中心.中国心血管健康与疾病报告2022[M]. 北京:科学出版社,2022.
[5] 孙国杰.针灸学[M].北京:人民卫生出版社,2016:120-122.
[6] 王启才.针灸治疗学[M].北京:中国中医药出版社,2012: 85-87.
[7] Li X,Zhang Y,Wang Y,et al.Electroacupuncture at Laogong (PC8) regulates heart rate variability in healthy adults: a randomized controlled trial[J].Evidence-Based Complementary and Alternative Medicine,2017,2017:1-7.
[8] 丁自海,刘树伟.临床解剖学图谱[M].北京:人民卫生出版社,2014:345-347.
[9] Standring S.Gray's anatomy: the anatomical basis of clinical practice[M].Elsevier,2016:1234-1236.
[10] Han J S.Acupuncture and endorphins[J].Neuroscience & Biobehavioral Reviews,2003,27(4):309-320.
[11] Wu B,Li X,Jin Y,et al.Neural correlates of acupuncture at Laogong(PC8) for heart rate regulation: a functional MRI study[J].Neuroimage,2015,111:296-305.
[12] Huang G,Liu G,Wang S,et al.Segmentally related inner vation between acupuncture points and internal organs[J]. Chinese Journal of Integrative Medicine,2009,15(6):679-684.
[13] Zhang L, Wang Y, Liu X, et al. Electroacupuncture at Laogong (PC8) modulates autonomic nervous system in rats: a heart rate variability analysis[J].Journal of Ethnopharmacol ogy,2018,226:172-178.
[14] Chen Y,Li Y,Sun X,et al.Electroacupuncture at Laogong (PC8) reduces blood pressure in spontaneously hypertensive rats by regulating the sympathetic nervous system[J].Chinese Journal of Integrative Medicine,2020,26(12):905-912.
[15] Wang Z,Li X,Zhang Y,et al.Effects of acupressure at Lao gong (PC8) on heart rate and blood pressure in healthy volun teers: a randomized controlled trial[J].Complementary Therap ies in Medicine,2019,43:102108.
[16] Liu G,Huang G,Wang S,et al.Effects of electroacupunct ure at Neiguan (PC6)and Laogong(PC8)on GABAergic neurons in the hypothalamic paraventricular nucleus of rats[J].Acupunc ture in Medicine,2011,29(3):250-255.
[17] Xu M,Zheng M, Li X,et al.Electroacupuncture at Laogo ng(PC8)modulates prefrontal cortex activity in anxiety-relat ed hypertension: a functional MRI study[J].Hypertension Res earch,2021,44(12):1307-1316.
[18] Chrousos G P, Kini S, Koliaki C. The hypothalamic-pit uitary-adrenal axis and metabolism[J].Metabolism, 2018,86: 13-23.
[19] Sun Y,Li X,Wang Y,et al.Electroacupuncture at Laogong (PC8) attenuates stress-induced hypertension by inhibiting the hypothalamic-pituitary-adrenal axis in rats[J].Journal of Psychosomatic Research,2020,132:110092.
[20] Zhang W,Li X,Liu X,et al.Electroacupuncture at Laogong (PC8) upregulates glucocorticoid receptor expression in the hypothalamus of hypertensive rats[J].Journal of Traditional Chinese Medicine,2021,41(5):782-788.
[21] Chen X,Li X,Wang Z,et al. Effect of electroacupuncture at Laogong(PC8)on serum cortisol and blood pressure in patie nts with anxiety-related hypertension: a randomized control led trial[J].Chinese Journal of Integrative Medicine,2022,28 (10):765-772.
[22] Liu Y,Li X,Zhang L,et al.Electroacupuncture at Laogong (PC8) reduces inflammatory response in atherosclerotic rabbi ts[J].Evidence-Based Complementary and Alternative Medici ne,2019,2019:1-9.
[23] Wang Y,Li X,Sun X,et al.Electroacupuncture at Laogong (PC8)protects against myocardial ischemia-reperfusion inju ry by inhibiting NF-κB pathway in rats[J].International Jour nal of Clinical and Experimental Medicine,2018,11(12):12607 -12615.
[24] Zhang L,Li X,Wang Y,et al.Electroacupuncture at Laogo ng (PC8) improves oxidative stress in hypertensive rats[J]. Journal of Cardiovascular Pharmacology,2019,74(2):145-152.
[25] Li X,Zhang W,Liu X,et al.Electroacupuncture at Laogong (PC8)activates Nrf2/HO-1 pathway in vascular endothelial cells [J].Chinese Journal of Integrative Medicine, 2023,29(3):215-223.
[26] Wang X,Liu G, Huang G. The meridian theory: a bridge between traditional Chinese medicine and modern science[J]. Evidence-Based Complementary and Alternative Medicine,2012, 2012:1-11.
[27] Hu S,Wang Y,Li X,et al.Tracing the propagation of injec ted tracer along the pericardium meridian: a preliminary stu dy[J].Journal of Acupuncture and Tuina Science,2017,15(6): 365-370.
[28] Zhang Y,Li X,Wang Z,et al. Electroacupuncture at Laogo ng(PC8) regulates nitric oxide and endothelin-1 in hyperte nsive rats[J]. Journal of Integrative Medicine,2020, 18(6):525 -532.
[29] Liu X,Li X,Zhang L,et al.Electroacupuncture-like stim ulation modulates cardiac ion channels in isolated rat ventric ular myocytes[J].Chinese Journal of Integrative Medicine,2021, 27(11):860-868.
[30] Sun X,Li X,Wang Y,et al.Electroacupuncture at Laogong (PC8)regulates MAPK and PI3K signaling pathways in the heart of hypertensive rats[J].Journal of Ethnopharmacology,2022,295: 15786.
[31] Li X,Wang Y,Zhang L,et al.Electroacupuncture at Laogo ng (PC8) suppresses arrhythmias induced by aconitine in rats [J].Acupuncture in Medicine,2018,36(6):365-371.
[32] Zhang Y,Li X,Wang Z, et al. Electroacupuncture at Laog ong (PC8) reduces QT interval dispersion in rats with myoca rdial ischemia[J].Journal of Cardiovascular Electrophysiology, 2019,30(10):2755-2763.
[33] Wang Y,Li X,Sun X,et al.Electroacupuncture at Laogong (PC8) reduces myocardial infarction size in rats[J].Chinese Journal of Integrative Medicine,2017,23(12):919-925.
[34] Liu Y,Li X,Zhang L,et al.Electroacupuncture at Laogo ng (PC8) promotes angiogenesis in the ischemic heart of rats [J].Evidence-Based Complementary and Alternative Medicine, 2020,2020:1-10.
[35] Chen X,Li X,Wang Z,et al. Efficacy of electroacupunct ure at Laogong (PC8) for essential hypertension: a randomized controlled trial[J].Hypertension Research,2021,44(7):705-713.
[36] Li X,Chen X,Wang Z,et al. Electroacupuncture at Laog ong (PC8) improves circadian blood pressure rhythm in hyperte nsive patients[J]. Journal of Integrative Medicine,2022,20(5): 435-442.
[37] Wang Z, Li X, Chen X, et al. Acupressure at Laogong (PC8) as an adjunctive therapy for chronic heart failure: a random ized controlled trial[J].Complementary Therapies in Medicine, 2023,72:102982.
[38] Li X, Wang Z, Chen X,et al.Effect of Laogong (PC8) acup ressure on exercise capacity and quality of life in patients with chronic heart failure[J]. Chinese Journal of Integrative Medicine,2023,29(8):635-643.
[39] Xu M,Li X,Zheng M,et al.Standardization of acupuncture parameters for cardiovascular diseases: a systematic review [J].Journal of Traditional Chinese Medicine,2022,42(6):1009-1018.
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