| ObjectiveMyocardial ischemia is one of the most important factors in the cardiovascular disease which threaten the life and health of human beings.Incidence population tend to be younger and the mortality rate is instantly rising.Acupuncture which has a history of thousands of years is recognized as a prevention treatment for myocardial ischemia.In recent years,the effect of acupuncture in curing of disease has been always controversial and talked as a hot spot by contemporary scholars.However,the mechanism of prevention and treatment of diseases is still not clear,which affected the promotion and application of treating myocardial ischemia by Acupuncture and moxibustion in clinical to a certain extent.Related studies have shown that ventricular reconstruction happened in the process of myocardial ischemia,including vascular remodeling and electrical remodeling.VEGF is associated with the expression of HIF-1 as a major vascular growth factor? Acupuncture can stimulate angiogenesis by stimulating the expression of VEGF and HIF-1.Regulating the expression and distribution of Cx43 by using the application of acupuncture can improve electrical remodeling and protect myocardial tissue which is the major gap junction protein.It is necessary to pay more attention on this issue in our future study.Therefore,under the guidance of the theory according to the traditional Chinese medicine acupuncture "zhiweibing" and the Biao-Ben acupoints compatibility method I choose the chronic myocardial ischemia rat model as the research object,setting ventricular remodeling as a starting point and using Western blotting(Western blot)and immunohistochemistry to observe the effect of Electroacupuncture on vascular remodeling and electrical remodeling,in order to explore the treatment and prevention mechanism of acupuncture on chronic myocardial ischemia and to provide theoretical support and scientific basis for the prevention and treatment of chronic myocardial ischemia by acupuncture.MethodsSixty Wistar rats were randomly divided into a control group(control,n=15),a model group(CMI,n=15),a chronic myocardial ischemic group treated with electroacupuncture on Neiguan(PC6)(CMI+PC6,n=15)and a chronic myocardial ischemic group treated with electroacupuncture on Neiguan(PC6),Guanyuan(CV14)and Zusanli(ST36)(CMI+EA,n=15).The control group was treated with a subcutaneous injection of 0.9% NaCl(0.004ml/g)for 14 consecutive days,while the other rats received 0.004ml/g of isoprinosine hydrochloride(ISO)by intraperitoneal injection for 14 days.The CMI+PC6 and CMI+EA groups were given acupuncture treatment before injection for 21 days.They were also connected to a HAN-200 EA device,with a frequency of 2Hz,voltage 1.6V and intensity 1mA for a period of 10 min each time,which is suitable for rat limb tremor.Meanwhile,rats in the control group and CMI group were treated at the same time as the CMI+EA group,once daily for 21 days.The electrocardiogram and ST voltage change of rats was recorded before and after treatment.The left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD)and left ventricular ejection fraction(LVEF)were detected by Sonos Agilent 5500 color Doppler echocardiography,with LVEF?45% as a successful model.An enzyme-linked immunosorbent assay(ELISA)was used to examine the content of the serum MOD,SOD and VEGF,while HE staining was performed to observe the pathological changes of myocardial tissue.Protein VEGF,HIF-1? and Cx43 in the myocardial infarction area was detected by Western blot analysis,while the distribution of Cx43 in the myocardial infarction area was detected by immunohistochemistry.RESULTS 1.(1)Compared with Control group,the mortality rate of CMI group was significantly higher(P<0.01).(2)After modeling ST segment voltage of CMI rats was significantly higher than Control group(P<0.01).The ST segment voltage of CMI+PC6 group was lower than the CMI group(P<0.05).The ST segment voltage of CMI+EA rats was less than CMI rats(P< 0.01).(3)The LVEDD and LVESD in CMI group were higher than in Control group(P < 0.01)and LVEF is lower than Control group(P < 0.01).LVEDD and LVESD values in CMI+PC6 and CMI+EA groups were lower than in CMI group(P < 0.01),LVEF value were higher than the CMI group(P < 0.01).LVEDD value of CMI+EA group was lower than that of CMI+PC6 group(P < 0.01),LVESD value was lower than that of CMI+PC6 group(P < 0.05)and the LVEF value is higher than that of CMI+PC6 group(P < 0.05).(4)The content of MDA in CMI group was higher than the control group(P<0.05),the total activity of SOD was lower than the control group(P<0.05).Compared with CMI rats,the difference of the content of MDA and the activity of total SOD in CMI+PC6 and CMI+EA groups were statistically significant(P<0.05).Compared with CMI+PC6 group,the differences of the activity of total SOD in CMI+EA group were significant(P<0.05).2.(1)Compared with Control group,VEGF content in serum of CMI group increased(P<0.05).Compared with CMI group,the serum content of VEGF of CMI+PC6 group increased(P<0.05).The serum content of VEGF of CMI+EA group was significantly higher than that of CMI group(P<0.01).The difference of the serum content of VEGF between CMI+PC6 group and CMI+EA group were statistically significant(P<0.05).(2)The ratio of IS/LV and AAR/LV of CMI group were higher than those of Control group(P<0.01).IS/LV and AAR/LV ratio of CMI+PC6 and CMI+EA groups were lower than of CMI group(P<0.01).IS/LV,AAR/LV of CMI+EA group were lower than of CMI+PC6 group(P<0.01).Histological observation of the control group was stained by H&E,which showed that cardiac muscle cells were arranged in order,the nucleus was clearly visible and the myocardial fibers were compact.However,rats in the CMI group showed that muscle fibers were disordered,the gap was widened and showed local fibrosis,cells were ruptured,and exhibited dissolution and distribution disorder in more than 50% of the area of ischemic necrosis.The CMI+PC6 group had no obvious difference from the CMI group by histological evaluation.In contrast,compared to CMI and CMI+PC6 groups,rats in the CMI+EA group were obviously improved,which showed that the myocardial fibrosis was lighter,the nucleus was decreased and the ischemic area was significantly reduced.(3)Compared with Control group,the expression of protein VEGF and HIF-1?of CMI group increased(P<0.01).The expression of protein VEGF and HIF-1?of CMI+EA group were higher than those of CMI group(P<0.01).The expression of protein HIF-1?between CMI+PC6 group and CMI group had a very significant difference(P<0.01).The expression of VEGF protein CMI+EA group between CMI+PC6 group had very significant difference(P<0.01)and the expression of HIF-1 protein between them had significant difference(P<0.05).3.(1)Compared with Control group,Cx43 protein expression of CMI group decreased(P<0.05);Compared with CMI group,the expression of Cx43 protein of CMI+EA group had significant difference(P<0.05).Compared with CMI+EA group,Cx43 protein expression of CMI+PC6 group was lower(P<0.05).(2)Cx43 in CMI myocardium rats was scattered and sparse,the distribution in end-to-end connections significantly reduced and the distribution in side-side connection increased.The distribution of Cx43 in CMI+PC6 and CMI+EA groups improved.Compared with Control group,the average optical density of Cx43 in the CMI group was significantly lower(P<0.05).Compared with CMI group,the average optical density(P<0.05)of CMI+PC6 and CMI+EA group was significantly higher(Cx43).CONCLUSION 1.Electroacupuncture can improve the heart function by reducing ST voltage,the value of LVEDD and LVESD and increasing LVEF value of the model rats of chronic myocardial ischemia,while adjusting the content of MDA and increasing the activity of SOD in order to reduce the accumulation of lipid peroxides,which plays the important role in anti-injury mechanism.Effect of electroacupuncture on Biao-Ben acupoints compatibility is better than on single acupoint.2.Electroacupuncture can promote the regeneration of new blood vessels,the establishment of collateral circulation and the formation of new vascular network which applying oxygen and blood for tissue through stimulating the expression of VEGF and HIF-1.Effect of electroacupuncture on Biao-Ben acupoints compatibility is better than on single acupoint.3.Electroacupuncture can maintain the normal physiological function of gap junctions,improve electrical conduction and ventricular remodeling,and finally protect the normal physiological function of the heart and prevent from myocardial ischemia,through upregulating of Cx43 protein expression and improve the distribution of Cx43.Effect of electroacupuncture on Biao-Ben acupoints compatibility is better than on single acupoint. |
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