航天医学与医学工程

目的 观察电针内关穴联合补阳还五汤对急性高原缺氧性心肌损伤小鼠心肌水肿相关蛋白的影响及对心肌的保护作用，探讨电针内关穴联合补阳还五汤改善急性高原缺氧性心肌损伤的机制。方法 将45只健康SPF级雄性C57BL/6小鼠随机分为正常对照组、低氧模型组、电针内关穴组、补阳还五汤组、电针内关穴+补阳还五汤组，除正常对照组外，均建立急性高原缺氧性心肌损伤小鼠模型。入舱前4 d，电针内关穴组予以内关穴双侧电针干预，补阳还五汤组予以补阳还五汤灌胃干预，电针内关穴+补阳还五汤组予以联合干预，连续干预7 d，正常对照组和低氧模型组每天正常抓取不做其他处理；采用HE染色和透射电镜进行心肌组织病理学及超微结构观察；ELISA检测心肌损伤标志物肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTn-I)的含量；Western blot检测心肌组织β₁肾上腺素受体(β_1-AR)、环磷酸腺苷(cAMP)、蛋白激酶A(PKA)、水通道蛋白1(AQP1)的表达。结果 与正常对照组比，低氧模型组出现心肌组织与细胞损伤，血清中CK-MB、cTn-I含量显著升高，心肌组织中β_1-AR、cAMP、PKA、AQP1蛋白表达均显著上调(均P<0.01)。与低氧模型组比，电针内关穴+补阳还五汤组心肌组织与细胞损伤显著改善，血清中CK-MB、cTn-I含量均显著降低，心肌组织中β_1-AR、cAMP、PKA、AQP1蛋白表达均显著降低(均P<0.01)。结论 电针内关穴联合补阳还五汤能够降低急性高原缺氧性心肌损伤小鼠血管通透性，减轻心肌水肿，改善心肌损伤，其机制可能与抑制β_1-AR/cAMP/PKA信号通路，降低AQP1的表达有关。

Objective To investigate the effects of electroacupuncture at Neiguan(PC6) combined with Buyang Huanwu Decoction on myocardial edema-related proteins and its cardioprotective role in mice with acute high-altitude hypoxic myocardial injury,and to explore the potential mechanisms by which this combined therapy ameliorates acute hypoxic myocardial damage.Methods Mice were randomly divided into control,hypoxia model,electroacupuncture at Neiguan,Buyang Huanwu Decoction,and electroacupuncture at Neiguan + Buyang Huanwu Decoction groups.Except for the normal control group,all other groups were subjected to the establishment of an acute high-altitude hypoxia-induced myocardial injury model.Four days before entering the low-pressure hypoxia animal simulation chamber,the electroacupuncture at Neiguan group was treated with bilateral electroacupuncture at Neiguan,the Buyang Huanwu Decoction group was treated with Buyang Huanwu Decoction by gavage,and the electroacupuncture at Neiguan + Buyang Huanwu Decoction group was treated with a combination of electroacupuncture at Neiguan and Buyang Huanwu Decoction.The intervention lasted for 7 days.The normal control group and the hypoxia model group were handled normally without any other treatment.Myocardial pathology and ultrastructure were evaluated using HE staining and transmission electron microscopy.Serum levels of creatine kinase-MB(CK-MB) and cardiac troponin I(cTn-I) were measured by ELISA.Western blot was performed to quantify β_1-AR,cAMP,PKA,and AQP1 protein expression.Results Compared with normal control group,the hypoxia model group exhibited significant myocardial damage,elevated cardiac biomarkers,and upregulated β_1-AR/c AMP/PKA pathway proteins with increased AQP1 expression(all P <0.01).The electroacupuncture at Neiguan + Buyang Huanwu Decoction group demonstrated attenuated myocardial injury,reduced biomarker levels,and downregulated target proteins(all P<0.01) versus the hypoxia model group.Conclusion Electroacupuncture at Neiguan combined with Buyang Huanwu Decoction alleviates myocardial edema and injury in acute hypobaric hypoxia by reducing vascular permeability,potentially via suppression of the β_1-AR/cAMP/PKA pathway and subsequent inhibition of AQP1 expression.