吴雪芬 岳增辉 郑雪娜 郭鑫 谢志强 谢莉娜

摘要：目的 观察按经选穴针刺对失眠大鼠下丘脑-垂体-肾上腺皮质（HPA）轴相关激素含量及腧穴配伍效应的影响，探讨针刺治疗失眠症的作用机制。方法 腹腔注射对氯苯丙氨酸混悬液建立失眠模型大鼠。将60只SD大鼠随机分为空白组、模型组、百会+神门组、百会+三阴交组、百会+非经非穴组，每组12只。各治疗组针刺相应腧穴，每次30 min，连续7 d。ELISA检测下丘脑促肾上腺皮质激素释放激素（CRH）及血清促肾上腺皮质激素（ACTH）、皮质酮（CORT）的含量。结果 与模型组比较，各针刺组大鼠下丘脑CRH及血清ACTH、CORT的含量均有一定程度降低；各针刺组间比较，百会+神门组的疗效优于百会+三阴交组及百会+非经非穴组。结论 针刺可能通过调节HPA轴相关激素水平起到镇静安神的作用，按经选穴针刺可能是影响腧穴配伍效应的影响因素之一。

关键词：针刺；失眠；下丘脑-垂体-肾上腺皮质轴；按经选穴；腧穴配伍；大鼠

DOI：10.3969/j.issn.1005-5304.2017.11.013

中图分类号：R245 文献标识码：A 文章编号：1005-5304（2017）11-0053-05

Abstract： Objective To observe the effects of acupuncture treatment on the levels of HPA axis related hormones and acupoint compatibility in insomnia rats； To discuss the mechanism of action for acupuncture treatment. Methods Chlorophenylalanine suspension was under intraperitoneal injection to establish insomnia model rats. Sixty SD rats were randomly divided into blank group， model group， Baihui+Shenmen group， Baihui+Sanyinjiao group， Baihui+non-acupoint group， with 12 rats in each group. Each treatment group received acupuncture in relevant acupoints， 30 min each time， for 7 d. ELISA was used to measure the levels of CRH， ACTH and CORT. Results Compared with the model group， the levels of CRH， ACTH and CORT of the acupuncture groups decreased to some extent. In the three acupuncture groups， the efficacy of Baihui+Shenmen group was better than that of Baihui+Sanyinjiao group and Baihui+non-non-acupoint group. Conclusion Acupuncture treatment may calm and soothe the nerves to release the insomnia through regulating HPA axis related hormones. Acupuncture acupoints at different meridians may be one of the factors that cause the difference of acupoints compatibility effect.

Key words： acupuncture； insomnia； HPA axis； acupoints at different meridians； acupoints compatibility； rats

失眠可導致人或动物思维紊乱，常伴有疲劳及不良的情绪变化等症状。自1969年国外学者提出5-羟色胺（5-HT）致眠学说后，有研究发现，下丘脑-垂体-肾上腺皮质（HPA）轴的兴奋-抑制状态是反应睡眠质量的重要指标，正常情况下，睡眠早期非快眼动

睡眠（NREM）占优势，此时HPA轴分泌活动受抑制，而睡眠后期快动眼睡眠（REM）占优势，HPA轴分泌活动则活跃[1]。氯苯基丙氨酸（PCPA）失眠模型大鼠在下丘脑5-HT含量降低的同时伴有HPA轴的功能紊乱，分布于下丘……