通元针法联合隔药盐灸神阙对产后抑郁症模型大鼠下丘脑-垂体-性腺轴的影响

Influence of Tongyuan Acupuncture Combined with Herbal-Salt Partitioned Moxibustion on Shenque to HPGA in Rats with PPD

目的:通过观察通元针法联合隔药盐灸神阙穴对产后抑郁症模型大鼠下丘脑-垂体-性腺轴相关激素水平的影响,分析针灸治疗产后抑郁症的疗效作用机制。方法:雌性SD大鼠120只,随机分为空白组20只、假手术组20只、造模组80只;空白组不予干预,假手术组实施不摘除卵巢的假手术,造模组确认造模成功后,造模大鼠随机分为模型组、药物组、常规针刺组、实验组,每组20只;模型组大鼠不予治疗,药物组大鼠采用盐酸氟西汀灌胃治疗,常规针刺组大鼠电针百会穴和太冲穴,实验组大鼠采用通元针法联合隔药盐灸神阙进行治疗。在干预后的第2周末、第4周末每组各随机选取大鼠10只,检测行为学指标后处死,再检测血清GnRH、FSH、LH、E2、P水平。结果:与空白组大鼠比较,模型组大鼠的旷场实验水平评分、垂直活动评分、糖水消耗量评分显著降低(P<0.05),强迫游泳实验不动时间显著延长(P<0.05);与模型组大鼠比较,干预后药物组、常规针刺组和实验组大鼠的旷场实验水平评分、垂直活动评分、糖水消耗量显著增高(P<0.05),强迫游泳实验不动时间显著缩短(P<0.05)。干预后的第2周、第4周,空白组和假手术组大鼠血清GnRH、LH、FSH、E2、P水平无显著差异(P>0.05);与模型组大鼠比较,药物组、常规针刺组和实验组大鼠血清GnRH、E2水平显著增高(P<0.05),LH、FSH、P水平显著降低(P<0.05)。干预后的第4周,实验组大鼠血清GnRH、E2水平与空白组大鼠差异无统计学意义(P>0.05),显著高于药物组和常规针刺组大鼠(P<0.05);实验组大鼠血清FSH水平与药物组和空白组大鼠无统计学意义(P>0.05),显著低于常规针刺组大鼠(P<0.05);实验组大鼠血清LH、P水平与药物组、常规针刺组和空白组大鼠无统计学意义(P>0.05)。结论:通元针法联合隔药盐灸神阙能有效改善产后抑郁症模型大鼠的抑郁症状,作用机制可能与调节下丘脑-垂体-性腺轴相关激素水平有关。

Objective:To observe the influence of Tongyuan acupuncture combined with medicine-salt partitioned moxibustion on Shenque to the levels of hormones related to hypothalamus-pituitary-gonad axis(HPGA)in rats with postpartum depression(PPD),and to explore the therapeutic mechanism of acupuncture and moxibustion for postpartum depression.Methods:120 female SD rats were randomly divided into the blank group(n=20),the sham-operated group(n=20)and the modeling group(n=80).The blank group had no intervention,the sham-operated group had no ovariectomy sham operation,and the modeling group was established the model of PPD according to reference literature.After successful modeling,the model rats were randomly divided into the model group(n=20),the medication group(n=20),the routine acupuncture group(n=20)and the study group(n=20).The medication group was treated with Fluoxetine Hydrochloride;the routine acupuncture group was treated with electro-needling Baihui(DU20)and Taichong(LR3);the study group was treated with Tongyuan acupuncture combined with herbal-salt partitioned moxibustion on Shenque(CV8).At the 2nd and 4th week of intervention,10 rats were randomly selected from each group for examination.The behavioral indicators were observed,and the serum levels of GnRH,FSH,LH,E2 and P were measured in each group.Results:Compared to the blank group,the sugar and water consumption,the scores of open-field horizontal and vertical activity were lower in the model group(P<0.05);the immobility time of forced swimming was longer in the model group(P<0.05).After the treatment,the sugar and water consumption,the scores of open-field horizontal and vertical activity were increased(P<0.05),and the immobility time of forced swimming was shortened in the medication group,the routine acupuncture group and the study group than those in the model group(P<0.05).The serum levels of GnRH,LH,FSH,E2 and P showed no significant change in the blank group and in the sham-operated group after 2w and 4w of intervention(P>0.05).The serum levels of GnRH and E2 were significantly higher(P<0.05),and the serum levels of LH,FSH and P were significantly lower in the medication group,the routine acupuncture group and the study group than those in the model group(P<0.05).After 4w of intervention,there were no statistical differences in serum GnRH and E2 between the study group and the blank group(P>0.05),which were significantly higher than those in the medication group and the routine acupuncture group(P<0.05).There was no statistical difference in serum FSH among the study group,the medication group and the blank group(P>0.05),which was significantly lower than that of the routine acupuncture group(P<0.05).There were no statistical differences in serum levels of LH and P amonge the study group,the medication group,the routine acupuncture group and the blank group(P>0.05).Conclusion:Tongyuan acupuncture combined with herb-salt partitioned moxibustion on CV8 can effectively improve the depressive symptoms of the rats with PPD.The mechanism may be related to the regulation of HPGA related hormones.