电针不同穴位对去卵巢大鼠HPO轴影响的实验研究

【作者】 宫静；

【导师】 程凯；

【作者基本信息】 北京中医药大学 ， 针灸推拿学， 2010， 硕士

【摘要】 更年期综合征是指妇女在绝经前后由于卵巢功能衰退、内分泌发生变化所引起的一系列躯体和精神心理的症候群。临床表现为烘热汗出,精神倦怠,烦躁易怒,头晕头痛,耳鸣心悸,失眠健忘,腰背酸痛,手足心热,或伴有月经紊乱等症状。近年来,由于人口老龄化趋势以及社会压力增加等诸多因素的影响,其发病率呈上升趋势。现代医学应用雌激素替代治疗女性更年期综合征有着几十年的历史,至今仍为首选方法。但近几年随着其各种副作用的相关报道越来越多,寻求更为安全有效的治疗方法逐渐引起人们的关注,并成为研究热点。针灸治疗更年期综合征疗效确切,不良反应少,显示了很好的前景。但临床选穴、配穴主要依据医生的主观判断,穴位应用繁杂多变,缺乏客观标准和依据。本实验通过观察电针太溪、三阴交、关元三个不同穴位对去卵巢大鼠血清E2、FSH、LH、GnRH的影响,评价电针疗法对更年期下丘脑-垂体-卵巢(HPO)轴的调节作用,并探讨腧穴主治作用的特异性,为穴位的临床选择和应用提供实验依据。主要实验结果如下：1与正常组对比,模型组大鼠血清E2水平显著降低(p<0.01),FSH、LH、GnRH水平明显升高(p<0.01；p<0.01；p<0.01)。2与模型组相比,各穴位组电针治疗后,E2水平显著升高(p<0.05；p<0.05；p<0.05)；FSH、LH、GnRH水平明显降低(p<0.05；p<0.05；p<0.05)。3三个电针组之间进行对比,血清E2含量无显著差异(p>0.05)；EA三阴交组与EA关元组FSH、LH含量无显著差异(p>0.05),两组FSH含量均明显低于EA太溪组(p<0.05),EA关元组LH含量显著低于EA太溪组(p<0.05)；EA三阴交组与EA关元组GnRH含量无显著性差异(p>0.05),但均明显低于EA太溪组(p<0.05)。结论：1电针可有效调节HPO轴功能,抑制去卵巢大鼠雌激素水平的下降和促性腺激素水平的升高。2电针不同穴位对HPO轴功能的调节作用不完全相同,证明了腧穴作用具有一定的特异性。三阴交、关元的作用较太溪穴更为明显,但三阴交和关元穴的作用强度未见明显差异。3更年期综合征的产生和发展涉及肝、脾、肾多个脏腑,并与冲任关系密切。由三阴交、关元的穴位特性以及本研究结果显示,治疗本病应从多脏腑、多经脉考虑,先后天并重,在临床选穴方面应注重交会穴的使用。更多还原

【Abstract】 Climacteric syndrome is a series of physical and psychological syndromes, which is caused by ovarian failure and endocrine disorder of women before and after menopause. Clinical manifestations are hectic fever with sweating, fatigue, listlessness, irritability, dizziness, headache, tinnitus, palpitation, insomnia, amnesia, lower back pain, burning sensation of hands and feet, menstrual disorder and so on. In recent years, due to aging of the population trends, the increasing social pressure and many other factors, the incidence rate of climacteric syndrome tends to increase.The application of hormone replacement therapy has a history of several decades in modern medicine, and today it is still the first choice for climacteric syndrome. However, in recent years, there are more and more reports on its various side effects. Therefore, to find safe and effective treatment gradually attracts people’s attention and becomes the research hotspot. Acupuncture is a kind of effective therapy for climacteric syndrome with less adverse reactions, and has very good prospects. But the selection of acupoints in clinical is primarily based on subjective judgments of doctors. The application of acupoints is complex, variable, and is lack of objective criteria and evidence.In this experiment, we have observed the influences of the levels of E2、FSH、LH and GnRH by EA at Taixi(KI 3), Sanyinjiao(SP 6), Guanyuan(RN 4) points in ovariectomized rats. The purpose of this study was to evaluate the regulatory effects of EA on HPO axis, investigate the specificity of acupoints and provide experimental evidences for acupoints selection and application in clinical practice.Main result are as following:1 In comparison with the normal group, E2 level in serum of the model group was significantly lower (p<0.01), the levels of FSH、LH and GnRH increased obviously(p<0.01; p<0.01; p<0.01).2 Compared with the model group, E2 level increased remarkably in each EA group (p<0.05; p<0.05; p<0.05); FSH、LH、GnRH levels decreased markedly (p<0.05; p<0.05; p<0.05).3 Comparison between the three groups, the serum E2 content was not significantly different (p>0.05); there were no obvious differences in the FSH、LH levels between EA Sanyinjiao group and EA Guanyuan group(p>0.05), FSH levels in both groups were remarkably lower than EA Taixi group(p<0.05), LH level in EA Guanyuan group was lower than EA Taixi group greatly(p<0.05); there was no apparently difference between EA Sanyinjiao group and EA Guanyuan group in GnRH content (p>0.05), but in both groups it was notably lower than EA Taixi group (p<0.05).Conclusions:1 EA could increase low estrogen level, inhibit elevated gonadotropin levels in ovariectomized rats and has benign regulation to disorganized HPO axis.2 The regulatory effect on the HPO axis of different acupoints is not identical. The role of acupoints has a certain specificity. Sanyinjiao and Guanyuan have the similar effect, which is obviously stronger than Taixi.3 The origination and development of climacteric syndrome involves in multiple organs, such as the liver, spleen and kidney, and is closely related with the Chong and Ren Meridians. The characteristics of Sanyinjiao, Guanyuan, and the results of this study can suggest that multiple organs, meridians, both innate and acquired fuctions should be considered all together, and in clinical acupoints election we should pay more attention to crossing acupoints for treatment of this disease.更多还原