【作者】 范春；

【导师】 张宏；

【作者基本信息】 广州中医药大学 ， 针灸推拿学， 2011， 博士

【摘要】 目的：衰老为一切多细胞生物随着时间的推移在机体和组织的各级水平出现有害的改变,并表现功能、适应性和抵抗力的减退。在人类则表现为人体成年以后随着年龄增长而发生的一系列生理学和形态学方面的退行性改变。应激一词,原为物理学术语,意为紧张或压力,由Han Salye在20世纪30年代引入医学,指的是一种在内外环境剧变的刺激下,机体出现的综合应答状态,包括精神、神经、内分泌和免疫等方面的反应。20世纪以来,随着社会经济的发展和科学技术的进步,人类平均寿命逐渐延长,世界人口结构的老龄化趋势日益明显,一个人口老龄化的时代已经来临。届时老年人庞大的医疗费用支出将成为各国的沉重负担,而解决这个问题的唯途径就是提高老年人的健康水平。同时,随着社会的现代化,高效率快节奏的生产方式加重了人们的心理负荷,使人类处于普遍的应激状态。心理、社会、环境等因素严重影响着人类的健康,加速了衰老的进程。在“生物—心理—社会”模式下,从神经—内分泌—免疫角度探讨情志和应激致衰的病理生理机制,并通过改善应激对老年机体造成的损害来延缓衰老,有助于在更深层次上揭示衰老本质,发展中医抗衰理论,从而为中医抗衰研究拓展更广阔的领域。我国针灸保健抗衰历史悠久,尤其是穴位埋线具有省时方便、作用柔和持久的特点,在对抗应激损伤、防治老年病和延年益寿方面有着无可比拟的优势。因此进行此项研究将为延缓衰老和减少应激导致的神经内分泌免疫功能障碍提供新的思路和方法。方法：一、文献研究采用近20年的文献研究方法,全而阐述祖国医学衰老理论,深入探讨祖国医学衰老机制与现代医学衰老学说的相关性。详细总结祖国医学抗衰方法和针灸抗衰机理以及对现当代抗衰研究的指导意义,完成现代文献综述的分析和讨论。二、实验研究本研究通过观察穴位埋线对D-半乳糖致衰大鼠行为学、胸腺指数、HPA轴、大脑皮质和海马形态结构在正常情况下和慢性应激状态下之差别,探讨穴位埋线对衰老模型大鼠和应激性衰老模型大鼠神经内分泌功能的调节作用,并探讨其抗衰机理,为从神经内分泌学角度探讨慢性应激对衰老的促进作用以及埋线对其调节作用提供科学依据。(一)实验动物与分组：运用随机数字表,将实验动物随机分为4组：空白对照组(生理盐水腹腔注射组)、模型一组(D-半乳糖腹腔注射组)、模型二组(D-半乳糖腹腔注射+制动+声光刺激组),模型三组(D-半乳糖腹腔注射+制动+声光刺激+穴位埋线),每组12只。(二)造模方法：空白对照组：每天给予腹腔注射等量生理盐水,连续6周。半乳糖衰老模型组：连续6周给予腹腔注射5%D-半乳糖溶液(120mg/kg/d),每天一次。复合衰老模型组：给予6周腹腔注射D-半乳糖,同时从第3周开始给予制动应激,应激每天一次,共应激4周。从第3周开始进行噪声刺激,每天一次,每次30分钟,共4周。从第3周开始,进行昼夜颠倒的光刺激,共4周。(三)埋线处方与方法：依据中医肝肾脑虚损致衰理论和情志致衰学说,选取“肾俞双”、“百会”、“足三里双”、“命门”作为穴位埋线处方。“肾俞”和“百会”一组,“足三里”和“命门”一组,两组交替埋线。对复合衰老模型组进行穴位埋线,穴位埋线7天一次,共埋线6次。(四)观察大鼠造模前后、埋线前后体重、毛发、精神、进食、活动等一般行为学的变化。(五)通过Y迷宫实验测定各组大鼠学习认知能力方面的差异。(六)通过测定大鼠胸腺指数、脾脏指数,观察各组大鼠免疫功能的变化。(七)通过测定大鼠血清中超氧化物歧化酶(SOD)活性、丙二醛(MDA)含量,观察各组大鼠体内自由基改变的情况。(八)观察各组大鼠血清皮质醇、血浆ACTH、下丘脑CRH三种激素水平的改变,测定HPA轴功能变化。(九)利用荧光定量PCR技术观察各组大鼠海马糖皮质激素受体基因表达的不同。(十)分析上述相关指标改变的意义及其指标之间的相互关系,探讨穴位埋线的延衰作用及其作用机制。结果与结论(一)祖国医学在抗衰延年方而积累了宝贵的经验。其中针灸保健抗衰历史悠久,因其操作简便、疗效确切、适应症广泛、无毒副作用的独特优势而越来越被重视。尤其是穴位埋线作为针灸方法之一,具有省时方便、作用柔和持久的特点,在对抗应激损伤、防治老年病和延年益寿方面有着无可比拟的优势。(二)从一般行为学来看,D-半乳糖衰老模型大鼠出现了精神倦怠、动作迟缓、体重增长缓慢、毛发无光泽和饮食量减少等表现,复合衰老模型大鼠的衰老变化更加明显。穴位埋线可减轻大鼠的老化现象。(三)从学习认知能力来看,D-半乳糖衰老模型大鼠Y迷宫实验中正确反应时间明显比空白对照组慢,复合衰老组大鼠Y迷宫实验中正确反应时间明显比D-半乳糖组慢。对复合衰老模型大鼠进行穴位埋线后,Y迷宫实验中正确反应时间明显比复合衰老组快。说明穴位埋线可通过提高衰老大鼠和应激大鼠的学习认知能力来延缓衰老。(四)从胸腺指数、脾脏指数来看,D-半乳糖衰老模型大鼠的胸腺指数、脾脏指数明显低于空白组大鼠,复合衰老模型大鼠的胸腺指数、脾脏指数明显低于D-半乳糖衰老模型大鼠。说明慢性应激可通过进一步抑制衰老机体的免疫功能加速机体衰老。对复合衰老组穴位埋线后,胸腺指数、脾脏指数明显高于复合衰老组。说明穴位埋线可升高复合衰老模型大鼠的胸腺指数、脾脏指数,从而提高机体的免疫功能。(五)从大鼠血清中超氧化物歧化酶(SOD)活性、丙二醛(MDA)含量来看,D-半乳糖衰老模型组的SOD活性明显低于空白对照组,MDA含量明显高于空白对照组。而复合衰老组的SOD活性明显低于D-半乳糖衰老模型组,MDA含量明显高于D-半乳糖衰老模型组。穴位埋线可以升高复合衰老组大鼠的SOD活性,降低复合衰老模型大鼠的MDA含量。说明穴位埋线可以增强大鼠清除自由基的能力,从而延缓衰老。(六)从HPA轴的功能变化来看,大鼠在经受6周腹腔注射D-半乳糖以及6周D-半乳糖联合4周慢性应激复合致衰老处理后,下丘脑CRH、垂体中ACTH、血清中CORT均有所升高,提示HPA轴处于亢进状态。对复合衰老大鼠穴位埋线后,以上三个指标均有所下降,且差异具有统计学意义,说明穴位埋线能有效调节慢性应激大鼠亢进的HPA轴,改善复合衰老模型大鼠的HPA轴功能紊乱,从而延缓衰老。(七)从大鼠海马糖皮质激素受体经过荧光定量PCR检测后的结果来看,与空白对照组相比,D-半乳糖衰老模型组、复合衰老模型组的GR-mRNA基因表达均减少,组间比较有统计学差异。与复合衰老模型组相比,埋线后的复合衰老模型组的GR-mRNA基因表达升高。文献报道,长期精神紧张刺激可导致海马糖皮质激素结合力及GR-mRNA水平下降,本实验说明穴位埋线可以减少海马糖皮质激素结合力,提高GR-mRNA水平,减少应激对海马的损害。(八)D-半乳糖致衰老模型大鼠的神经内分泌功能、免疫功能和抗应激能力均出现下降,而长期的慢性应激动则会使其进一步加重,从而加速机体的衰老。穴位埋线可通过调节衰老机体的神经内分泌功能,提高免疫功能,增强抗应激能力来延缓衰老。(九)通过观察老年机体在衰老状态下和慢性应激状态下出现的行为学、免疫功能、神经内分泌功能紊乱和脑衰老变化,以及穴位埋线对衰老状态和应激状态下老年机体以上各种表现和功能的改善,利用中医抗衰老理论,为临床运用穴位埋线进行延缓衰老研究提供了科学依据。更多还原

【Abstract】 Objective:Senility is the bad change on all levels of multicellular organism and tissue along with the time, and represents the letdown of the function, adaptability and resistibility. On humankind, it represents a series of recessive change on aspects of physiological and morphological. Stress, which has been put forward in 1930s by Han Salye, is a all-around responsive state under stimulation of huge change on inside and outside circumstance. It includes the responses of energy, nerve, incretion, immunity and so on.Since the Twentieth Century, accompanying with the development of socioeconomy and technology, expectation of mankind’s life is protracting, the world population frame become elder, and a old era is coming. At the appointed time, huge fee-for-service of elder will be a heavy burden on every country. And the only way for this problem is advance the health of the elder. At the same time, high efficiency and fast rhythm of modern society aggravates the psychological burthen of mankind, makes us be in the universal stress. The factors such as mentality, social and circumstance affect the human’s health badly, accelerate the process of senility. Discussing the pathogenic and physiological mechanism of emotion and stress leading senility under the model of "biology—psychology—community", fall the damage of stress to the elder and prolonging life are help to open out the nature of senility in-depth, to develop the theory of Herbalist doctor and to exploit new fields of prolonging-life.In china, the acupuncture and moxibustion has watched a long history in senility-resistance, especially the catgut embedment in acupoint is save-time, softness and long-haul. It is of unexampled advantage on falling the stress damage, preventing and curing geriatrics and prolonging life. So this research will offer a new mind and means for those.The research has created an aging rat’s mode which results from multiple factors. Call it multiple aging rats’mode. In addition, this research reveals different aging between multiple rat mode and glactosum mode degrees related indexMethods:1 Research based on literaturePresenting Chinese traditional anti-aging theory in various aspects, which probes deeply into relativity between traditional anti-aging transaction and modern doctrinal about anti-aging, this is based on literatures which are published recent 20 years. By summarizing traditional anti-aging methods and transaction of acupuncture for anti-aging, this paper will give specific guidance, meanwhile, accomplish analyses, together with discussion for modern literature review。2 Research based on experimentCatgut Embedment therapy stimulate certain part to distinguish pallium and hippocampus in 2 kind of condition, that one is normal while the other is under chronic stress in neuroendocrinology aspect of glactosum ethology, thymus exponent, HPA axis。This research is providing it scientific evidence, which is discussing chronic stress that facilitates the anti-aging process and Catgut Embedment commendation。(1) Grouping:Animal used as test and grouping:Using random number list, divides all animals in to 4 groups:Blank group (NS intraperitoneal injection), model group 1(glactosum intraperitoneal injection), model group 2 model (glactosum intraperitoneal injection, braking acousto-optic laser), group 3(glactosum intraperitoneal injection, braking acousto-optic laser, Catgut Embedment) 12 rats/group.(2)Modeling methods: Blank controller (groupl):equivalent NS intraperitoneal injection daily, continually for 6 weeksGroup 2:equivalent 5%D-glactosum (120mg/kg/d) intraperitoneal injection daily, continually 6 weeksGroup 3:equivalent 5%D-glactosum (120mg/kg/d) intraperitoneal injection daily, for six weeks; From the third week braking stimulation for 4 weeks; from the third week acoustic noise stimulation 30min/day, for 4weeks; From the third week photostimulation reverse day and nightfor 4weeks.(3)Embedment method:According to the traditional theory of spleen and kidney under TCM and sphycological academic thought, we select "shenshu" "baihui" as prescription 1, " zusanli and mingmen "as prescription 2. one time a week,5 times in total, embedment method therapy (4)Observe general behavior such as weight, hair, spirit, dining and movement.(5) By observing maze experiment, we can tell differences in cognitive ability among different groups.(6)To test the difference of rats’thymus splenic index, observe the change in immune ability.(7) Measure SOD activity degree and content of MDA in rat blood. Observe the changing of radical in rats.(8) Measure 3 kinds of hormones serum cortisol, serum ACTH, hypothalamus CRH. observe the changing of HPA s-function in all groups.(9) Find out the difference of receptor expressions’genes of Hippocampus glucocorticoid by using the PCR technology(10)After analyzing related index above we can find out potential relation to probe into the clinical result of catgut embedment in acupoint and its transaction.3、Result and Conclusion(1)There is abundant experience on anti-ageing, prevented illness and prolonging life in TCM. To use the acupuncture and moxibustion to delay ageing process is very special and strong.It is of many advantages and takes the lead in such way:cheap, easy and non-poison etc.(2)On general behavior, the senile model and stress model all appeared with listless spirit, lumberly movement, weight increase getting slow, their color turned reluster and appetite reduce. After stressing, the senile become more obviously. Catgut embedment in acupoint could reduce the ageing process on the experimental senile rats.(3) On spontaneous behavior maze experiment, group 2 is slower to find the way than group 1. After stressing, that becomes obvious. But after Catgut embedment in half of rats in group 2,result come that rat with catgut therapy use less time to find way comparing to the rest of the rats in group 2. That means Catgut embedment in acupoint could improve the ability of spontaneous behavior to resist senile.(4)On thymus and splenic index, index of group 2 is lower than that of the blank group. After stressing, it becomes obviously. It can be explained that the chronic stress can accelerate the senile. Catgut embedment in acupoint could hoist the thymus index to resist senile.(5)On the change of HPA axis function, the senile group’s blood plasma cortex is higher than that of the blank group obviously whereas its blood plasma ACTH and thalamencephalon CRH are close to those of young rats. After stressing, that become obviously. It shows that senile and chronic stress can make the HPA axis function become sthenic and accelerate senile. Catgut embedment in acupoint could decrease the level of blood plasma cortex, blood plasma ACTH and thalamencephalon CRH as to resist senile.(6)The observation on pallium by optical microscope shows that the senile group appears with some karyon solid crinkle. After stressing, that become obviously, and cells decrease obviously. Catgut embedment in acupoint could lighten the degree of solid crinkle.(7)On pyramidal cells counting, the pyramidal cells amounts of model group and model + stress group are lower than that of the blank group obviously, and the model + stress is the lowest. But catgut embedment in acupoint could make the higher amount.(8)The observation on hippocampi ultrastructure shows that the senile rat’s nerve cell dwindled, the cytochylema organelle reduced. After stressing, the cells become iiregular, the organelle reduced obviously, even vanished. Catgut embedment in acupoint could improve it(9)The senile group’s function of nerve, incretion, immunity and resist stress become disabled, and the long time chronic stress aggravated it. Catgut embedment in acupoint could adjust those functions to resist senility.(10)To observe the aging process on behavior, immunity, nerve incretion foul-up and brain senescence, use the catgut embedment in acupoint theory to improve those functions to resist senile. And provide science gist for clinical using of catgut embedment in acupoint to resist senility.更多还原