【作者】 武淑娟；

【导师】 辛随成；

【作者基本信息】 北京中医药大学 ， 针灸推拿， 2006， 硕士

【摘要】 目的：慢性疲劳综合征（简称CFS）是一种以原因不明的疲劳为主要特征的症候群，可伴有低热、咽痛、头痛、肌肉关节肿痛、抑郁、健忘、失眠或嗜睡等症状，而且体格及实验室检查常无异常表现。1988年美国疾病控制中心（CDC）正式将其命名为慢性疲劳综合征，并拟定了诊断标准。随着科学技术的迅速发展，社会竞争的日益激烈，人们生活、工作节奏的加快，来自各方面的压力日渐加大，以疲劳为主诉的人群也逐步扩大，CFS的患病率逐年增加，对社会和人群构成了极大的危害，造成了巨大的经济损失，有医学专家称其将是二十一世纪“健康的隐性杀手”，是人类健康的主要问题之一。由于CFS的病因和病理生理尚未完全明了，所以缺乏有效的预防和控制措施，而且在治疗上处于被动的初级处理阶段、试验阶段，现代医学在CFS面前束手无策。与现代医学相反的是，祖国医学不仅在经典理论中对CFS有深刻的认识，而且在临床实践中也有着比较好的治疗方法，但大多为个案报道和经验总结，相关机理研究较少，尤其是针刺对CFS的机理研究尚缺乏全面的报道。本实验基于对中医治疗CFS“临床有效”、作用小”的认识，从针灸治疗CFS临“副床有效这一实践基础出发，根据中医辨证论治原则，选取具有代表性的穴位组，用复合应激模型大鼠近似模拟肾虚型CFS状态，通过动态观察CFS模型大鼠的行为变化，测定脑内神经递质的变化情况，统计处理结果，讨论针刺调节的作用机理，通过客观化指标对“心理—神经—免疫”网络学说相互关联理论进行阐述，希望能够加深电针对CFS作用机理的认识并为临床治疗肾虚型CFS筛选出最佳选穴。方法：选取二级Wister雄性大鼠，由北京维通利华实验动物有限公司提供，体重160～180g，随机分为正常组、肾虚模型组、肾虚模型电针组。模型组与电针组大鼠采用冷水游泳加肾上腺皮质激素应用－停药法，建立肾虚型复合应激模型大鼠模型，具体的方法是使用醋酸氢化可的松进行肌肉注射，每日用药20mg/kg，用药9天后停药至21天，冷水游泳从肌肉注射醋酸氢化可的松的同时开始，水温定为21℃，时间定为30分钟。电针组在造模的同时进行针刺治疗。取穴为百会和太溪，共计21天。通过行为学检测对模型进行判定；用放免法检测大鼠脑组织中的神经肽Y的含量；采用分光比色法测定大鼠脑组织中乙酰胆碱酯酶的含量和活性；采用夹心ELISA法测定大鼠脑组织中去甲肾上腺素、多巴胺、5-羟色胺的含量。结果：1．肾虚模型组动物Open－Field法行为测定的水平运动次数和垂直运动次数与正常组相比显著减少，鼠尾悬挂不动时间较正常组明显延长；游泳至力竭的时间明显低于正常对照组。肾虚电针治疗组动物Open－Field法测定的水平运动次数和垂直运动次数呈增加趋势；鼠尾悬挂不动时间较模型组明显缩短；游泳至力竭的时间明显延长。与模更多还原

【Abstract】 ObjectiveChronic Fatigue Syndrome, which can be abbreviated to CFS, is a series of syndromeswith unclear reasons．It was officially named by Centers for Disease Control and Prevention(CDC) of the U.S government in 1988. The incidence of CFS rises year after year, whichcauses enormous economic losses. It has not been discovered the peculiar symptom and theabnormity of the laboratory examination. There are no effective treatment methods because ofits unclear etiology and pathogenesis. There is profound opinion in the theory of TCM, and itis seeking after the new effective treatment methods. Acupuncture and moxibustion has greatpredominance on treating CFS, but the study on mechanism of it has not been reported.As a non-pharmacologic therapy, with its good therapeutic effect and non-toxic andnon-side-effect characteristic, acupuncture and moxibustion has great predominance ontreating CFS. In recent years, many clinical reports illustrated that. Based on the clinicalefficiency of treating CFS by acupuncture and moxibustion and combined with the TCMclassical theory: the rat model was induced by complex stress factors to simulate the clinicalmanifestation of CFS, and then we choose the representative points to carry out theacupuncture experimental research. This paper explains the pathogenesis of CFS and theregulation mechanism of acupuncture.MethodsWister rats (male, weight 160~180g) were randomly distributed to control group, modelgroup and EA group．Model group and EA group include kidney deficiency syndrome．Allgroups except the control were exposed to complex stress,which include swimming in thecold water and ingjecting cortin for 21 days, and EA group accepted electro-acupuncturetreatment at the same time．The points were selected for electro-acupuncture: Baihui(GV20), Taixi(KI3)．Results1．Compared with control group, the model rats appeared not only physical strengthdeclining, but also hypo- activity of explore new environment and spontaneous activity, whichindicated that model rats were on the states of both physical and mental fatigue, same as theclinical manifestation of CFS patients．EA could improve the behavioral disorder andmarkedly reverse the fatigue states of the model rats．2．There were some metabolic disorders of central monoamine neurotransmitters inmodel rats----decrease of the content of NE, DA and 5-HT in the tissues of brain. EA couldregulate metabolic disorder of monoamine neurotransmitters in central nervous system.3．The level of NPY in the thalamencephalon and pituitary is higher than the control更多还原