针刺联合壮医药线点灸法治疗失眠的机制研究

Insomnia impairs seriously people's health in many ways, and pessimal stimulations often cause the prevalence of insomnia rising due to intense stress reaction. Recent researches have indicated that orexin was playing an important pole on adjusting sleep-wakefulness period and stress reaction . In our early researches we noticed that acupuncture combined with medicated thread moxibustion of Zhuang nationality medicine could down-regulate expression of orexin mRNA, inhibit activation of HPA axis, lessen stress reaction and so that can cure insomnia, so we had a hypothesis about its therapeutic mechanism where it can adjust orexin and other related signal moles , and further regulate stress reaction of HPA axis and LC-NE axis. Based on early research results ,this programme continued exploring and discussing the therapeutic mechanism by applying acupuncturing "Shenmen" point ,"Baihui"point combined with "Zusanli" point medicated thread moxibustion of Zhuang nationality medicine treating rats with insomnia , applying quantitative real-time PCR, ELISA, EEG,EMG techniques or methods to detect changes of orexin and signal moles of stress reaction of HPA axis and LC-NE axis. The results of the programme will provide basic theoretic guide for its treatment of insomnia.

失眠严重影响人们的身心健康，不良刺激导致应激反应性增强使失眠的患病率上升。近年研究表明增食素（orexin）参与睡眠-觉醒周期、应激反应的调节，我们在前期对失眠的研究观察到针刺联合壮医药线点灸能下调orexin mRNA表达，抑制下丘脑一垂体一肾上腺轴（HPA axis）激活，降低应激反应性，推测其机制可能是通过调控orexin及其调节的应激信号，进而调节HPA axis 及蓝斑-交感神经轴（LC-NE axis）的应激反应性。本课题在此基础上，应用针刺"神门"、"百会"联合壮医药线点灸"足三里"干预失眠模型大鼠，采用定量real-time PCR、ELISA 法、EEG、EMG技术检测orexin及其调控的HPA axis和LC-NE axis信号通路分子的变化，研究其治疗失眠的作用机制。研究结果为针刺"神门"、"百会"联合壮医药线点灸"足三里"治疗失眠的临床应用提供理论指导。

随着生活节奏加快和工作压力增大，失眠常困扰人们。失眠的治疗以药物为主，但药物治疗费用高、副作用多，因此急需一种安全、低廉的疗法。民族医药是传统医药的重要组成部分，壮族医药中的针刺与药线点灸疗法对治疗失眠有确切的疗效，但其起效机制有待阐明。本项目建立大鼠失眠模型，采用壮医针刺联合药线点灸疗法进行治疗，检测增食素及其调控的应激信号通路中的神经递质等相关分子表达水平，揭示其起效机制。研究结果显示治疗组大鼠增食素水平（449.21±39.56）下降、去甲肾上腺素水平（112.55±4.28）下降、5- 羟色胺水平（79.11±3.92）下降、促肾上腺皮质激素释放激素水平（35.01±6.24）下降、促肾上腺皮质激素水平（40.36±5.65）下降，增食素基因表达（0.79±0.02）下降，c-Fos 蛋白表达（32.04±4.88）下降，增食素1型受体阳性细胞百分率（0.36±0.08）下降，增食素2型受体阳性细胞百分率（0.25±0.03）下降，增食素单体A水平（193.48±48.06）下降，增食素单体B水平（126.56±26.35）下降，乙酰胆碱酯酶水平（82.03±14.06）下降，肾上腺糖皮质激素水平（125.36±13.69）下降。胆碱乙酰转移酶水平（82.14±12.68）升高，乙酰胆碱水平（96.36±14.29）升高，γ-氨基丁酸水平（192.33±10.25）升高。与模型组比较，差异均有统计学意义（P<0.05 或P<0.01）。研究结果提示针刺联合壮医药线点灸疗法通过调节增食素及其调控的应激信号通路中的神经递质等相关分子表达水平进而调控机体应激反应性而起效。本项目研究为针刺联合壮医药线点灸疗法治疗失眠的临床应用提供了基础研究的依据，也为失眠的治疗提供了一种较为简廉、安全的疗法。