【作者】 黄学宽；

【导师】 卓廉士；

【作者基本信息】 重庆医科大学 ， 针灸推拿学， 2008， 硕士

【摘要】 抑郁症是一种以持续性心境低落为主要表现的综合征,已成为全球性的精神疾患。据WHO报告,在全世界发病率约为11%,目前已成为世界第四大疾患,到2020年抑郁症可能成为仅次于心脏病的第二大疾病。在美国,由于“抑郁”每年造成的损失高达400亿美元以上,与冠心病相当。本实验在文献研究的基础上,提出肝气郁结证是抑郁症最常见的证型,肝失疏泄则是抑郁症发生的基本病机。筛选出以四关穴作为针刺实验治疗用穴,从血液流变学、肝脏组织、胃肠功能、记忆能力、性功能等方面研究电针对抑郁模型大鼠肝主疏泄功能的影响,从而探讨电针治疗抑郁症的作用机理。将SD雄性大鼠,体重200±20g,40只,随机分为4组:正常组、模型组、药物组、电针组,每组10只。模型组、药物组和电针组大鼠制造慢性应激抑郁模型,电针组在造模同时取四关穴进行电针治疗,药物组在造模同时予以百优解治疗,共21天。结果如下:1、血液运行方面:与正常组比较,模型组大鼠全血比粘度、血浆比粘度、红细胞压积、血沉及血沉K值均明显升高(P<0.05);与模型组比较,电针组和药物组的全血比粘度、血浆比粘度、红细胞压积、血沉及血沉K值均明显下降(P<0.05);而电针组与药物组比较,两者间无显著性差异(P>0.05)。提示电针四关穴具有改善抑郁状态下大鼠血液流变学的作用。2、肝脏组织方面:与正常组比较,模型组肝脏组织Bcl-2蛋白阳性表达率明显低于正常组,p53蛋白阳性表达率却明显高于正常组(P<0.05),提示抑郁状态抑制了Bcl-2蛋白的表达,增强了p53蛋白的表达,从而诱导肝脏细胞凋亡;与模型组比较,电针组和药物组肝脏组织Bcl-2蛋白阳性表达率明显增加,p53蛋白阳性表达率却明显降低(P<0.05);而电针组与药物组比较,两者间无显著性差异(P>0.05)。提示电针四关穴可激发Bcl-2蛋白的表达,抑制p53蛋白的表达,从而抑制肝脏细胞凋亡,达到保护肝脏组织的作用。3、胃肠功能方面:与正常组比较,模型组大鼠结肠组织中iNOS活性、NO含量增加,GSH-Px活性降低(P<0.05);与模型组比较,电针、药物可降低抑郁模型大鼠结肠组织中iNOS的活性及NO的含量,提高结肠组织中GSH-Px的活性(P<0.05);而电针组与药物组比较,两者间无显著性差异(P>0.05)。提示电针四关穴具有保护抑郁状态下结肠组织的作用。4、记忆功能方面:与正常组比较,模型组大鼠脑组织AchE活性明显升高,NOS活性及NO含量明显降低(P<0.05);与模型组比较,电针和药物可降低抑郁模型大鼠脑组织中AchE的活性,提高脑组织NOS的活性及NO的含量(P<0.05),而电针组与药物组比较,两者间无显著性差异(P>0.05)。提示电针四关穴具有改善抑郁模型大鼠大脑记忆功能的作用。5、性功能方面:与正常组比较,模型组的嗅舔次数、爬背次数明显减少(P<0.05);与模型组比较,电针组及药物组的嗅舔次数、爬背次数却明显增高(P<0.05);但电针组与药物组两者之间比较无显著性差异(P>0.05)。因此可以得出结论,电针四关穴具有调节雄鼠性功能的作用。从上述实验可以看出,肝失疏泄的表现可能与下丘脑-垂体-肾上腺轴功能失调有关,即与中枢多种神经递质及其合成酶、神经肽、激素、环核苷酸系统的变化有关,而电针的调节作用机理还有待进一步研究。更多还原

【Abstract】 Depression is one of the diseases characterized by constant down in spirits,and it has been the globally usual mental disease.In the light of the report from the World Health Organization:Today,depression has become the fourth disease in the world,it will be more serious causing disability than ischemic heart disease when it comes to 2020.In America,the expense for depression has reached over 4 billion dollars per year.It is based on literature studies,that the stagnation of Gan– energy is the commonest diagnostic type of dispersion,and the abnormal dispersion of Gan is a basic pathogenesis of dispersion.“Si-guan”points will be used in acupuncture experimental study. The effects of Electroacupuncture (EA) of“Si-guan”points on Gan in charge of dispersion in the depression model rats will be researched from hemorrheology,liver tissue, gastrointestinal function,memory function and sexual function . The function reason of curing dispersion of electroacupuncture is the aim of our study.Fourty male Sprague-dawley rats were randomly divided into there groups of 4 each: normal group,model group,medicine group and EA group.All rats except the control group singly housed and exposed chronically 21 days to a variety of mild unpredictable stressors, the rats of EA group accepted EA treatment at the same time,and the rats of medicine group accepted fluoxetine treatment at the same time.The results show that:1. Hemorrheology:The whole blood viscosity,plasma,the idex of crythrocytic aggregation and deformation,hematocrit,and plasma fibrinog- en of despression rats were increased significantly compared to the normal group (P<0.05);The hemorrheological quotas of EA and medication groups reduced significantly compared to the model group (P<0.05);There were not significant difference between the EA group and medication group(P>0.05). Electroacupuncture (EA) of“Si-guan”points can improve the hemorrheological characteristics of depression rats.2. Liver tissue:The expression of Bcl-2 protein of liver tissue in model group was obviously shorter,and the expression of p53 protein of liver tissue in model group was obviously stronger compared to the normal group (P<0.05).It gave that depression restrained the expression of Bcl-2 protein,strengthened the expression of p53 protein。guided the liver apoptosis . The positive expression of Bcl-2 protein of liver tissue in EA and medication groups increased significantly compared to model group (P<0.05);But the positive expression of p53 protein of liver tissue in EA and medication groups reduced significantly compared to the model group (P<0.05);There were not significant difference between the EA group and the medication group (P>0.05). It gave that Electroacupuncture (EA) of“Si-guan”points could strengthened the expression of Bcl-2 protein,restrained the expression of p53 protein,and restrained the liver apoptosis It was a important reason of protecting the liver.3. Gastrointestinal function:The levels of iNOS and NO increased significantly and the activity of GSH-Px reduced significantly in colon of the model rats compared to the normal group (P<0.05);also the levels of iNOS and NO reduced significantly,the activity of GSH-Px increased significantly in colon of EA and medication groups compared to the model group (P<0.05);There were not significant difference between EA group and medication group(P>0.05). Electroacupuncture (EA) of“Si-guan”points had protected the colon tissue function of the depression rats.4. Memory function:The activity of AchE increased significantly and the levels of NOS and NO reduced significantly in the brain tissue of the model rats compared to the normal group (P<0.05);the activity of AchE reduced significantly,the levels of NOS and NO increased significantly in the brain tissue of EA and medication groups compared to the model group (P<0.05);There were not significant difference between the EA group and the medication group(P>0.05). Electroacupuncture (EA) of“Si-guan”points had improved the brain memory function of rats with depression.5. Sexual function:All items (smelling and lapping,crawling backs) of the model rats were reduced significantly compared to the normal group (P<0.05); But all items (smelling and lapping,crawling backs)of EA and medication groups increased significantly compared to the model group (P<0.05); There were not significant difference between the EA group and the medication group(P>0.05). Electroacupuncture (EA) of“Si-guan”points had adjusded sexual function of the depression rats.It is considered based on analysis of materials obtained from experiment studies,that the abnormal dispersion of Gan is related to the abnormal regulation of hypothalamus-pitutary-adrenal gland axis. Concretely,related with the changes of multiple neurotransmitters and their compound enzyme,such as neuropeptides,hormones and cyclic nucleotide system,showing the characteristics of multiple links,multiple levels and multiple targets. The regulator reason of Electroacupuncture (EA) will be gone a step further study.更多还原