逆针灸关元穴对去卵巢大鼠HPO轴的影响

【作者】 李娜；

【导师】 程凯；

【作者基本信息】 北京中医药大学 ， 针灸推拿学， 2012， 硕士

【摘要】 目的：逆针灸是指疾病发生前或机体无病时,预先用针灸的方法激发经络之气,扶助正气,提高机体抵御疾病的能力,从而预防疾病的发生、减轻疾病的损害,达到保健延年的目的,是一种注重机体自身潜能的激发与利用的方法。逆针灸对下丘脑-垂体-卵巢组成的生殖功能调节轴(HPO)出现的功能失调有较好的预防作用。围绝经期综合征是女性卵巢功能逐渐衰退直至完全消失的过程,由于这一过程中卵巢功能退行性的改变,卵巢停止排卵,雌激素缺乏,出现内分泌、代谢、神经、心理等各个系统失衡而引起的一组症候群。临床表现为月经的改变、潮热、汗出、手足心热、倦怠、易怒、头痛头晕、耳鸣、心悸、健忘、失眠等。西医通常应用雌激素替代疗法,但会引发各种副作用。于是,寻求有效并且安全的疗法逐渐成为研究热点。针灸治疗围绝经期综合征有确切的疗效,没有副作用,受到各研究人员的关注。但是临床及实验均以治疗为主,较少有报道预防为主的研究,且选穴缺少依据和客观标准本实验通过观察逆针灸关元穴对随后去卵巢大鼠的影响,以探讨逆针灸调节HPO轴的具体机制。方法：实验动物分为空白组,假手术组,去卵巢组,逆针去卵巢组,逆灸去卵巢组。用酶联免疫法测大鼠的下丘脑、垂体、子宫及血清中的GnRH、FSH、LH E2、ER的水平变化,进一步探讨逆针灸防治围绝经期综合征过程中逆针和逆灸调节HPO轴的具体机制,来阐释针灸预防治疗围绝经期女性内分泌失调的作用机理,为临床治疗围绝经期综合征选穴提供实验依据。结果：1与正常组比较,模型组大鼠的组织和血清中E2、ER和GnRH水平显著降低(p<0.01), FSH和LH的水平显著升高(p<0.01)。2与模型组比较,逆针和逆灸组的组织和血清中的E2、ER和GnRH水平均有不同程度地升高(p<0.05); FSH和LH水平有不同程度地降低(p<0.05)。3逆针组和逆灸组比较,组间无显著差异(p>0.05)；但对血清FSH的调节,逆针组和逆灸组组间有显著差异,逆针效果优于逆灸(p<0.01)。结论：1逆针和逆灸可有效调节去卵巢大鼠低下的雌激素水平,并抑制增高的促性腺激素水平,能良性地调节去卵巢大鼠HPO轴的紊乱。2逆针和逆灸关元穴对HPO轴的作用强度基本相同,没有显著差异。但是血清中FSH方面,逆针的效果优于逆灸。3围绝经期综合征的产生和发展与下丘脑-垂体-卵巢轴密切相关,涉及到肝、脾、肾多个脏腑。因此从本实验的研究结果证实,治疗女性的围绝经期综合征应从多经脉和脏腑考虑,重视先天和后天的共同调理,并注重交会穴的使用。更多还原

【Abstract】 Objective:’Preventive acupuncture and moxibustion’mean to stimulate some points of the body by acupuncture or moxibustion in advance, which can improve the capability of defending diseases and supplementing’Zheng Qi’. And make the body have the function of preventing and alleviating the injury by the subsequent disease.’Preventive acupuncture and moxibustion’have better preventive function to the disorder of HPO axis.Peri-menopausal syndrome (PMS) is a series of syndromes, which is caused by the ovarian failure and disorder of the endocrine system, external metabolizing system, nervous system and psychic system of women before and after menopause. Clinical manifestations are menstrual disorder, hectic fever with sweating, burning sensation of hands and feet, fatigue, testiness, headache, vertigo, sonitus, cardiopalmus, forgetfulness, insomnia, and so on. To western medicine, the application of hormone replacement therapy is the first choice for PMS, however, it has all kinds of side effects. So, to find a safe and effective treatment increasingly become the research highlight. As an effective therapy for PMS without any side effect, Acupuncture attracts much attention. But there is less report about how to prevent PMS. And the application of acupoints is in shortage of evidence and objective criteria.By observing the regulatory effects of the preventive acupuncture and moxibustion at Guanyuan(RN4) points in ovariectomized rats. The research purpose of this study was to discuss the mechanism of’preventive acupuncture and moxibustion’on HPO axis.Methods:Experimental feminine SD rats were divided into5groups, including the normal group, fake operation group, ovariectomized rats group, preventive acupuncture group and preventive moxibustion group. ELISA was used to determine the levels of E2> ER、GnRH、FSH and LH in the serum and tissues including hypophysis、hypothalamus and uterus. The purpose of this study was to investigate the specificity of acupoints, estimate the regulatory effects of ’preventive acupuncture and moxibustion’on HPO axis, and also provide research evidences for acupoints selection and application in clinical practice.Results:1In comparison with the normal group, E2、ER and GnRH level in the tissue and serum of the model group was significantly lower(p<0.01), the levels of FSH and LH increased obviously(p<0.01).2Compared with the model group, E2、ER and GnRH level of the’preventive acupuncture’group and’preventive moxibustion’group increased in different degree (p<0.05); FSH and LH level reduced in different degree (p<0.05)3There is no obvious difference between the’preventive acupuncture’and ’preventive moxibustion’groups (p>0.05), except FSH of the blood,’preventive acupuncture’group is better than ’preventive moxibustion’group (p<0.01).Conclusions:1The’preventive acupuncture’and’preventive moxibustion’could modulate the lower estrogen level, and restrain elevated gonadotropin levels in ovariectomized rats, and has benign modulation to disordered HPO axis.2The ability of the’preventive acupuncture’and’preventive moxibustion’ are almost the same, except FSH of the blood,’preventive acupuncture’group is better than’preventive moxibustion’group.3The origination and development of PMS is closely involved with the HPO axis, and relates to multiple organs, such as the liver, spleen and kidney. The results of this study suggest that meridians, multiple organs, and both innate and acquired functions should be considered in clinical acupoints election. And we should put the emphasis on the crossing acupoints for prevention and treatment of PMS.更多还原