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艾灸對絕經(jīng)前后亞健康狀態(tài)女性的內(nèi)分泌及免疫機制研究

發(fā)布時間:2018-08-01 12:29
【摘要】:目的觀察艾灸不同腧穴對絕經(jīng)前后亞健康狀態(tài)女性的軀體、生活、情志、精力、睡眠狀況以及生存質(zhì)量等方面的影響,探討干預前后不同腧穴對機體內(nèi)分泌、免疫功能的參數(shù)變化及影響,篩選最佳腧穴,為臨床針灸防治絕經(jīng)綜合征提供理論及實驗依據(jù)。方法隨機選擇符合納入標準的絕經(jīng)前后亞健康女性志愿者120名,再隨機分為關(guān)元組、三陰交組、腎俞組和VE組。關(guān)元組、三陰交組和腎俞組分別采用清艾條溫和灸法,每日一次,每次15min,5日為1療程,各療程間休息2天,共干預4個療程;VE組服用天然維生素E軟膠囊(250mg/粒),每日一粒,連續(xù)服用28天。干預前后分別觀察其生存質(zhì)量、軀體、生活、情志、精力以及睡眠狀況等,同時抽取靜脈血5ml檢測血清性激素、抗苗勒管激素、抑制素B以及免疫指標等。結(jié)果艾灸腎俞穴可以顯著改善絕經(jīng)前后亞健康狀態(tài)女性的軀體狀況(P0.05)以及生活狀況(P0.01),療效明顯優(yōu)于關(guān)元組、三陰交組和VE組。然而,四組對情志狀況及精力狀況改善均不明顯(P0.05)。從睡眠狀況上看,艾灸干預絕經(jīng)前后亞健康狀態(tài)女性對其睡眠情況總積分影響不明顯(P0.05),但關(guān)元組和腎俞組對睡眠情況中早醒這一癥狀有顯著改善(P0.05)。從生存質(zhì)量上看,四組干預后生存質(zhì)量簡表中生理領(lǐng)域評分均較干預前明顯改善(P0.05),以腎俞組更為顯著(P0.01)。而腎俞組與VE組干預后生存質(zhì)量簡表總評分均較干預前顯著改善(P0.01),關(guān)元組與三陰交組干預后生存質(zhì)量簡表總積分與干預前相比,有改善但尚無醫(yī)學統(tǒng)計學意義(P0.05)。艾灸關(guān)元、三陰交、腎俞穴均可以顯著提高絕經(jīng)前后亞健康狀態(tài)女性的血清E2水平(P0.05),以腎俞組療效更優(yōu)(P0.01),與VE組相比,具有顯著醫(yī)學統(tǒng)計學意義。但艾灸對FSH、LH以及P的調(diào)整均不明顯(P0.05)。關(guān)元組、三陰交組以及腎俞組分別干預4個療程后,AMH水平都得到顯著提高(P0.01),而VE組干預療程后無顯著差異。艾灸對血清INHB水平無顯著改善(P0.05)。從免疫指標看,艾灸關(guān)元穴明顯提高CD3+(P0.05),降低CD8+水平(P0.01);艾灸三陰交穴可以顯著提高CD3+(P0.05),降低CD8水平+(P0.05),并且CD4+/CD8+比值明顯升高(P0.05);艾灸腎俞穴可以顯著升高血清CD3+(P0.01)、CD4+(P0.05)含量,降低CD8+(P0.05)含量,并且調(diào)整CD4+/CD8+比值(P0.05);VE組干預后可以顯著降低CD8+(P0.05)含量,CD4+/CD8+比值明顯升高(P0.01)。結(jié)論艾灸腎俞穴分別可以有效改善絕經(jīng)前后亞健康狀態(tài)女性的軀體及生活狀況,優(yōu)于三陰交、關(guān)元穴;腎俞、關(guān)元穴艾灸可以在一定程度上改善早醒這一睡眠狀況;艾灸關(guān)元、三陰交、腎俞三穴均可顯著改善生存質(zhì)量中生理領(lǐng)域評分,其中以腎俞穴較優(yōu)。艾灸三穴均可以顯著提高血清E2及AMH水平,以腎俞穴更佳,但對FSH、LH、P及INHB均無明顯調(diào)整作用。艾灸三穴均可以有效的調(diào)節(jié)機體免疫T細胞含量,提高絕經(jīng)前后亞健康狀態(tài)女性的免疫功能。
[Abstract]:Objective to observe the effects of moxibustion at different acupoints on the body, life, mood, energy, sleep and quality of life of women with subhealthy state before and after menopause, and to explore the endocrine effects of different acupoints before and after intervention. The changes and effects of immune function parameters, screening the best acupoints to provide theoretical and experimental basis for clinical acupuncture and moxibustion prevention and treatment of menopausal syndrome. Methods 120 subhealthy female volunteers who met the inclusion criteria were randomly divided into three groups: Guan Yuan group, Sanyinjiao group, Shenshu group and VE group. Guanyuan group, Sanyinjiao group and Shenshu group were treated with Qingai Pao mild moxibustion once a day for 15 minutes, 5 days as a course of treatment, with two days of rest between each course of treatment. The VE group took natural vitamin E soft capsules (250mg/ granules) once a day for 4 courses of intervention. Take it continuously for 28 days. The quality of life, body, life, mood, energy and sleep were observed before and after intervention. Serum sex hormone, anti-mullerian hormone, inhibin B and immune index were detected by 5ml. Results moxibustion at Shenshu point could significantly improve the physical status and living condition of women with subhealthy state before and after menopause (P0.05), and the curative effect was better than that of Guanyuan group, Sanyinjiao group and VE group. However, the four groups of emotional status and energy status improvement were not significant (P0.05). In terms of sleep status, the effect of moxibustion intervention on the total score of subhealthy women before and after menopause was not significant (P0.05), but Guanyuan group and Shenshu group significantly improved the symptoms of early waking up during sleep (P0.05). From the point of view of quality of life, the scores of physiological field in the summary table of quality of life of the four groups were significantly improved compared with those before intervention (P0.05), especially in Shenshu group (P0.01). The total score of quality of life in Shenshu group and VE group was significantly improved compared with that before intervention (P0.01). The total score of quality of life in Guanyuan group and Sanyinjiao group after intervention was better than that before intervention, but there was no medical statistical significance (P0.05). Moxibustion at Guanyuan, Sanyinjiao and Shenshu could significantly increase the serum E _ 2 level of women with sub-healthy state before and after menopause (P0.05), especially in Shenshu group (P0.01). Compared with VE group, it had significant medical statistical significance. But moxibustion on FSHL LH and P adjustment were not significant (P0.05). The levels of AMH in Guanyuan group, Sanyinjiao group and Shenshu group were significantly increased after 4 courses of intervention (P0.01), but there was no significant difference after intervention in VE group. Moxibustion had no significant improvement on serum INHB level (P0.05). From the point of immune index, moxibustion at Guanyuan point significantly increased CD3 (P0.05), decreased CD8 level (P0.01); moxibustion at Sanyinjiao point significantly increased CD3 (P0.05), decreased CD8 level (P0.05), and CD4 / CD8 ratio increased significantly (P0.05); moxibustion at Shenshu point significantly increased serum CD3 (P0.01) CD4 (P0.05) content, Decrease the content of CD8 (P0.05), and adjust the ratio of CD4 / CD8 (P0.05). After intervention, the content of CD8 (P0.05) and the ratio of CD4 / CD8 were significantly increased in VE group (P0.01). Conclusion moxibustion at Shenshu point can effectively improve the body and life status of women with subhealthy state before and after menopause, which is superior to Sanyinjiao and Guanyuan points, Shenshu and Guanyuan points moxibustion can improve the sleep state of early waking up to a certain extent, moxibustion can improve the sleep state of Guanyuan. Three points of Sanyinjiao and Shenshu could significantly improve the score of physiological field in the quality of life, among which Shenshu was the best. Moxibustion at three points could significantly increase serum E 2 and AMH levels, especially at Shenshu point, but had no significant effect on FSH LHN P and INHB. Moxibustion three points can effectively regulate the content of immune T cells and improve the immune function of subhealthy women before and after menopause.
【學位授予單位】:南京中醫(yī)藥大學
【學位級別】:博士
【學位授予年份】:2017
【分類號】:R246.3

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