世界中医药

作者	单位
秦庆广王海萍刘坤赵玉雪贲卉高昕妍朱兵	1 中国中医科学院针灸研究所，北京，100700； 2 湖北中医药大学，武汉，430065； 3 山西中医学院，太原，030024

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中文摘要:

目的：研究针刺曲池、上巨虚、天枢及大肠俞对空肠和远端结肠运动的调节作用，在此基础上探索穴位间配伍的协同及拮抗效应，为临床腧穴配伍提供相关的实验依据。方法：20只SD大鼠，用水囊测压技术和多导电生理记录系统记录正常大鼠空肠和远端结肠的运动。单穴选取曲池、上巨虚、天枢、大肠俞，穴位配伍分别选取曲池＋上巨虚、天枢＋大肠俞、曲池＋大肠俞、曲池＋天枢、大肠俞＋上巨虚、天枢＋上巨虚。随机选取单穴或组穴，进行针刺操作，捻转行针1min，施平补平泻手法，频率约2Hz，记录针刺前后肠运动的改变。结果：1）针刺单穴对空肠运动的影响：针刺曲池、上巨虚增加了空肠的运动波幅（P＝0011，P＝0003）；针刺天枢降低空肠的运动波幅（P＝0000）；针刺大肠俞对空肠的运动波幅没有明显影响。针刺组穴对空肠运动的影响：针刺曲池+上巨虚使空肠的运动波幅增加（P＝0009），但并不表现出明显的协同效应；针刺天枢+曲池、天枢+上巨虚及天枢+大肠俞均使空肠的运动波幅降低（P＝0000～0001），组穴之间并不表现出明显的拮抗作用，配穴中天枢对空肠的抑制具有同神经节段的优势调节作用。2)针刺单穴对远端结肠运动的影响：针刺曲池、上巨虚、天枢及大肠俞均增加了远端结肠的运动频率和波幅（P＝0000～0039）。针刺组穴对远端结肠运动的影响：针刺曲池+上巨虚、曲池+天枢增加了远端结肠的运动频率和运动波幅（P＝0050，0000）；针刺大肠俞+上巨虚、曲池+大肠俞远端结肠运动的波幅增加（P＝0002，007）。只有曲池+上巨虚对结肠的运动表现为协同作用，其余穴位配伍均未出现明显的协同作用。结论：针刺曲池、上巨虚、天枢、大肠俞对空肠、远端结肠的调节作用不同，单元穴位为抑制效应，集元穴位为促进作用。穴位之间的组合作用不是单穴作用的简单相加。本研究中配穴对空肠没有明显的协同或拮抗效应，而对于远端结肠，集元配穴（曲池+上巨虚）有协同作用，与大肠俞有关的配穴对于运动频率调节有拮抗作用，在节段相近的配伍中，与天枢有关的配穴对于运动幅度调节有相互拮抗作用。

English Summary:

To observe the effects of single points as LI11, ST37, ST25, BL25 and agonism and antagonism of their adjunct points on the motilities of jejunum and the diatal colon in anesthetized rats.Methods:In 20 SD（Sprague Dawley）rats anesthetized with urethane (1～1.2g/kg), the intestinal contractility were monitored with manometric balloons put into the jejunum and distal colonic lumens. Acupuncture was randomly performed at four single points as hetertopic points or homotopic points LI11(Quchi), ST37(Shangjuxu), ST25(Tianshu) and BL25(Dachangshu), and six adjunct points as LII+ST37, ST25+BL25, IL11+BL25, IL11+ST25, BL25+ST37, ST25+ST37. Acupuncture manipulation was performed by rotating needles clockwise and anti clockwise at 2 Hz for 1 min.Results:1) Effects of single points on jejunum motility: Acupuncture at either IL11 or ST37 significantly increased the amplitude of jejunum waveform （P＝0011，P＝0003）, and the acupuncture at ST25 significantly decreased jejunum motility（P＝0000）, whereas BL25 had no significant effect on the amplitude of jejunum. Effects of adjunct points on jejunum motility: Acupuncture at LII+ST37 increased amplitude of jejunum（P＝0009）, but there was no obvious agonism effect compared to single points; ST25+LI11, ST25+ST37, ST25+BL25 significantly depressed peristaltic wave amplitudes（P＝0000～0001）, similar to the effect of ST25 single point, indicating that ST25 had dominant effect for adjunct points. 2) Effects of single points on the distal colon motility: Acupuncture at IL11 ST37, ST25 or BL25 accelerated diatal colonic frequencies and amplitudes compared with pre treatment baseline, respectively（P＝0000～0039）. Effects of adjunct points on the diatal colon motility: Acupuncture at IL11+ST37, LI11+ST25 respectively increased the frequencies and amplitudes of the distal colon peristaltic wave（P＝0050,0000）, BL25+ST37, IL11+BL25 increased the amplitude（P＝0002，007）s. And IL11+ST37 showed agonism effect. Conclusion: Findings of the present study indicate that acupuncture at heterotopic points IL11, ST37 produced excitatory effect and at homotopic points ST25, BL25 produced inhibitory effect on jejunum motility respectively, acupuncture at homotopic points IL11, ST37,ST25, BL25 produced excitatory effect on the distal colon motility respectively. The effects of adjunct points are not simply equal to overlying of single points. All adjunct points had neither agonism nor antagonism effect on jejunum, whereas for distal colon, heterotopic adjunct points (LI11+ST37) evoked agonism effect to increase amplitude of motility, and adjunct points with BL25 had antagonism effect to decease frequency and adjunct points (except IL11) with ST25 had an antagonism effect to decrease amplitude

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