基于TGF-β/Smads信号通路及rfMRI技术探讨电针心经心包经穴抗心脑缺血损伤及心脑关系的研究

The relationship between the heart and the brain in Chinese medicine has always been a popular research topic provoking great controversy. Among the correspondant relationships between channels and organs, the vitally important brain is classified only as an extraordinary organ, and does not have an corresponding channel. The heart, on the other hand, has the important functions of governing blood vessels and governing 'spirit brightness' (conciousness). Additionally, it has two corresponding channels: the hand jue-yin pericardium channel (PC) and the hand shao-yin heart channel (HT). The targeted corresponding relationship between these two channels and heart-brain has not yet been systematically compared and researched. Taking cardiocerebral ischemia as an entry point, and taking angiogenesis and nerve repair, frontier research topics from modern neurology, as well as resting state fMRI techniques as vehicle, in this research subject the following comparisons were carried out: the effect of electro-acupuncture of HT and PC channel acupoints on angiogenesis and nerve repair in cardiocerebral ischemia; the ability of the two channels to stimulate organic endogenous cell information transduction mechanism and related gene expression response; and the corresponding relationship between the two channels and their activated cerebral regions and brain network (brain functional connectivity) real-time changes. On the basis of revealing the mechanism of the effect on cardiocerebral ischemic damage by the induction of endogenous nerve protective materials by HT and PC channels, this research systematically, multi-angularly and multi-levelly investigates the special internal relationship between the two channels and heart-brain in order to provide scientific evidence for explaining the heart-brain correlation theory in traditional Chinese medicine.

中医对心脑关系的认识一直是颇具争议的研究热点。在经脉与脏腑的对应关系中，至关重要的脑只列为奇恒之府而无对应的经脉，而心有主血脉、主神明的重要功能，并有两条相关经脉- - 手厥阴心包经和手少阴心经，二者究竟与心脑有怎样的靶向对应关系，目前尚无系统比较与研究。本课题拟以心脑缺血为切入点，以血管新生、神经修复等现代神经科学的前沿研究及Resting state fMRI技术为载体，通过比较电针心经、心包经穴对心脑缺血损伤中血管新生和神经修复的影响；通过比较两经如何激发机体内源性细胞信息转导机制及相关基因表达的效应；通过比较两经与其激活脑区的对应关系及脑网络（脑功能连接）的实时变化，在揭示心经、心包经诱导内源性神经保护物质对心脑缺血损伤作用机制的基础上，从多系统、多角度、多层次探讨二者与心脑之间的内在特殊联系，为阐明中医心脑相关学说提供科学依据。

中医对心脑关系的认识一直是颇具争议的研究热点。在经脉与脏腑的对应关系中，至关重要的脑只列为奇恒之府而无对应的经脉，而心有主血脉、主神明的重要功能，并有两条相关经脉——手厥阴心包经和手少阴心经，二者究竟与心脑有怎样的靶向对应关系，目前尚无系统比较与研究。本课题以心脑缺血为切入点，以血管新生、神经修复等现代神经科学的前沿研究及Resting state fMRI技术为载体，通过比较电针心经、心包经穴对心脑缺血损伤中血管新生和神经修复的影响、两经在激发机体内源性细胞信息转导机制及相关基因表达的效应以及两经与其激活脑区的对应关系及脑网络（脑功能连接）的实时变化，发现:1.电针心包经穴、心经穴具有抗脑、心肌缺血损伤、抗炎性细胞凋亡的作用，且可能与电针能促进缺血半暗带血管新生---改善缺血组织缺血缺氧状态作用有关，TGF/β-Smads通路在这一过程中发挥着转化、调节的重要作用；这为针刺治疗脑血管病的机理提供了部分实验依据；2.我们临床应用与心相关经穴治疗脑血管病的机理提供了部分实验依据;而通过应用Resting-state fMRI比较电针不同经穴对脑缺血、心肌缺血的人的观察后，发现电针心经、心包经穴能使脑缺血损伤的人的高级认知功能（如情感、认知、记忆等）脑区激活，且激活与针刺持续状态作用链接紧密；也为我们中医理论“从心治脑”，“心主神志”“心脑同治”提供了部分影像学依据。上述这两个主要的结果在揭示心经、心包经诱导内源性神经保护物质对心脑缺血损伤作用机制的基础上，也多系统、多角度、多层次探讨二者与心脑之间的内在特殊联系，为阐明中医心脑相关学说提供科学依据。