谢莉娜 谢志强 郭鑫 魏歆然 岳增辉

摘要：目的 观察循经选穴针刺对失眠大鼠下丘脑腹外侧视前区褪黑素（MT）含量及其受体MT1、MT2基因表达的影响，探讨针刺治疗失眠症的作用机制及循经选穴针刺对腧穴配伍的效应。方法 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。大鼠腹腔注射DL-4-氯苯基丙氨酸混悬液建立失眠模型，各治疗组针刺相应腧穴，每次30 min，治疗7 d。采用ELISA检测大鼠下丘脑腹外侧视前区MT含量；采用实时荧光定量PCR检测大鼠下丘脑腹外侧视前区MT1、MT2 mRNA表达。结果 与空白组比较，模型组MT含量及MT1、MT2 mRNA表达明显降低（P<0.05，P<0.01）；与模型组比较，各针刺组MT含量及MT1、MT2 mRNA表达明显升高（P<0.05，P<0.01），且以百会+神门组升高最为明显。结论 针刺通过调节失眠大鼠下丘脑腹外侧视前区MT含量及其受体MT1、MT2 mRNA的表达发挥治疗作用，且循经选穴针刺可能是腧穴配伍效应的影响因素之一。

关键词：针刺；失眠；褪黑素；褪黑素受体1a；褪黑素受体1b；循经选穴；大鼠

DOI：10.3969/j.issn.1005-5304.2018.12.011

中图分类号：R245 文献标识码：A 文章编号：1005-5304（2018）12-0040-05

Abstract： Objective To observe the effects of acupuncture treatment based on meridians and acupoint selection on the melatonin （MT） content and the expression of MT1 and MT2 genes in the ventrolateral preoptic area （VLPO） of insomnia rats； To investigate the therapeutic mechanism of acupuncture in treating insomnia and the effect of acupuncture treatment based on meridians and acupoint selection on compatibility effect of acupoints. Methods Totally sixty SD rats were randomly divided into blank group， model group， Baihui + Shenmen group， Baihui + Sanyinjiao group and Baihui + non-acupoint group， with 12 rats in each group. Chlorophenylalanine suspension was intraperitoneal injected to establish insomnia model rats. Each treatment group received acupuncture in relevant acupoints， 30 min each time， for 7 d. Levels of MT in the VLPO were detected by ELISA， and real-time fluorescence quantitative PCR was used to measure the expressions of MT1 and MT2 mRNA in VLPO of rats. Results Compared with blank group， levels of MT and expressions of MT1 and MT2 mRNA in model group decreased significantly （P<0.05， P<0.01）； Compared with model group， levels of MT and expressions of MT1 and MT2 mRNA in acupuncture groups increased significantly （P<0.05， P<0.01）， and Baihui + Shenmen group increased the most obvious. Conclusion Acupuncture treatment can play a therapeutic role by regulating levels of MT and the expressions of MT1 and MT2 mRNA in the VLPO of insomnia rats， and acupuncture treatment based on meridians and acupoint selection may be one of the factors that cause the difference of compatibility effect of acupoints.

Keywords： acupuncture； insomnia； melatonin； MT1； MT2； meridians and acupoint selection； rats

失眠是一種最常见的睡眠障碍，主要特点为持续长时间不能获得正常睡眠或对睡眠质量不满意。其病因和发病机制复杂，患病率在快节奏生活方式的现代社会中有逐年增高趋势，世界范围内失眠障碍临床患病率约为10%～12%[1]。研究表明，睡眠是大脑中调节睡眠-觉醒周期的多个中心共同参与的神经化学过程，而下丘脑腹外侧视前区（ventrolateral preoptic area，VLPO）为其中一主要结构[2-3]。褪黑素（melatonin，MT）于1959年被国外学者首次发现，在人体广泛分布，主要存在于视交叉上核，为松果体分泌的吲哚类激素，研究发现其有镇静催眠和调节睡眠觉醒周期的作用[4]。研究表明，褪黑素调节睡眠是通过与褪黑素受体1a（MT1）、褪黑素受体1b（MT2）作用来实现，而这两受体作用方式不同，前者主要抑制神经元活动，后者主要诱导相位转变[5]。……