更年春治疗更年期综合征的临床和药理研究——对神经生殖内分泌免疫网络的调节

The clinical and experimental study of herbal formula gengnianchung in treating perimenopausal syndrome: regulation of neuroendocrine and immune network

按中医补肾清肝泻心法配制成“更年春”方在临床观察对更年期综合征有效并可提高免疫功能。本研究对更年春进一步的临床病例验证 ,并观察更年春对 1 5、1 8、2 1～2 4月龄雌性大鼠的神经内分泌免疫系统的作用。结果 :(1 )临床疗效达 92 %以上 ,对雌激素治疗无效者 ,本方也有效。治疗后患者血雌二醇 (E2 )水平无明显变化而血卵泡刺激素、黄体生成素水平下降明显。 (2 )老龄大鼠灌服更年春后血 E2 水平不上升 ,血睾酮水平下降 ,下丘脑、垂体、卵巢、脾脏的雌激素受体 (ER)及 ERm RNA均显著上升 ,血及下丘脑的低 β-内啡肽水平明显上升 ,代偿性增加的 P物质水平明显下降 ,中脑中缝背核内 5 -HT明显增加 ,脾细胞诱生的白细胞介素 (IL-2 )水平也上升。提示更年春治疗更年期综合征时 ,有通过提高

Objective: To study the regulation of herbal formula gengnianchung (GNC) on neuro endocrine and immune network in postmenopausal syndrome. Methods: The clinical and experimental studies were conducted with radioligand binding assay (hydroxylapatite absorption separation), immunohistochemistry, MTT, radioimmunoassay, and Northern blot. Results: (1)In 81 women with post menopausal syndrome, the symptoms were relieved or improved obviously after GNC were taken, 92 percent of them were cured for flush. In 7 cases who did not respond to estrogen treatment, GNC produced good curative effect in 6 of them. Even though levels of serum FSH, LH decreased obviously, serum E 2 remained unchanged in the patients treated with GNC, which suggested that GNC can enhance the estrogen like effects without increase of serum E 2.(2) In old female rats fed with GNC, the level of serum E 2 did not rise, level of serum T lowered, estrogen receptor(ER) and ER mRNA expression in hypothalamus, pituitary and ovary and spleen increased. The lowered β EP in blood and hypothalamus were elevated, the increased substance P significantly decreased, serotonin in dorsal raphe nucleus increased significantly. (3)Levels of splenic ER and IL 2 activities increased significantly. Conclusion: GNC can regulate neuroendocrine and immune network in postmenopausal syndrome by raising the level of ER and not by increasing serum E 2