本文選題：針刺 + 抑郁癥�。� 參考：《廣州中醫(yī)藥大學(xué)》2016年博士論文

【摘要】：目的：通過觀察針刺“四神聰”、“內(nèi)關(guān)”、“三陰交”穴對慢性不可預(yù)見性輕度應(yīng)激抑郁模型(CUMS)大鼠體重、飲食以及行為學(xué)的影響,并通過觀察實(shí)驗(yàn)大鼠海馬腦區(qū)GLU及GABA含量變化、外周血神經(jīng)遞質(zhì)(DA和5-TH)水平、谷氨酸脫羧酶(GAD65,GAD67)、谷氨酸轉(zhuǎn)運(yùn)體(EAAT3)、GABA轉(zhuǎn)運(yùn)體1(GAT1)、NMDA受體亞單位NR2B、GABAA受體的蛋白表達(dá)的變化,初步研究針刺抗抑郁的作用原理,并試圖探討其機(jī)制。方法：SD大鼠50只,SPF級,雌雄各占一半,體重180-230g,置于模擬日夜的實(shí)驗(yàn)室中(白天7：00-19：00,夜晚19：00-7：00),并隨機(jī)分為空白組、模型組、西藥組(氟西汀)、穴位組和非穴組,每組10只。飼養(yǎng)1周后,應(yīng)用慢性不可預(yù)見性輕度應(yīng)激措施,建立抑郁模型(CUMS),應(yīng)激措施主要有：禁食、禁水、顛倒晝夜、束縛活動、夾尾、搖晃、足底電擊、冰水游泳。除空白對照組外,其余各組大鼠均進(jìn)行抑郁造模,每天隨機(jī)選取一種措施進(jìn)行刺激,每天刺激2次。從入組第1天開始對各組大鼠進(jìn)行治療,每日1次,治療至入組第21天。從入組第1天至第21天,穴位組選取“四神聰”、“內(nèi)關(guān)”、“三陰交”穴進(jìn)行針刺,每次留針30min,每日1次。非穴組在上述三穴位旁邊的非穴位點(diǎn)進(jìn)行針刺(根據(jù)國內(nèi)外通用非穴位取穴方法,相近兩條經(jīng)絡(luò)連線中點(diǎn)取為非穴位點(diǎn)),余治療方法同穴位組。西藥組給予氟西汀1.8mg/kg體重,溶于2m1純凈水中灌胃,1次/天。每組動物于入組第1天、第7天、第14天和第21天分別稱量體重,記錄進(jìn)食量以及open-field實(shí)驗(yàn),實(shí)驗(yàn)結(jié)束檢測海馬腦區(qū)GLU及GABA含量、外周血神經(jīng)遞質(zhì)(DA和5-TH)含量、谷氨酸脫羧酶(GAD65, GAD67)、谷氨酸轉(zhuǎn)運(yùn)體(EAAT3)、GABA轉(zhuǎn)運(yùn)體1(GAT1)、NMDA受體亞單位NR2B、GABAA受體的蛋白表達(dá)。結(jié)果：1、隨著造模時間的延長,空白對照組大鼠的體重增加明顯,其次為西藥組、穴位組體重明顯增加；穴位組在后期治療中增加幅度較西藥組較大,但相互之間無明顯差異(P0.05)；非穴組體重有所增加,但增加緩慢,增加量也明顯比其他各治療組大鼠少,與模型組之間無明顯差異(P0.05)；與空白組相比,各治療組在治療21天后體重逐漸接近正常組體重水平,但尚有一定差異(P0.05),與模型組及非穴組相比,差異明顯(P0.05),各組蔗糖消耗量及飼料消耗量與體重變化呈正相關(guān)。在行為學(xué)調(diào)節(jié)方面：模型組動物與正常組比較,水平運(yùn)動次數(shù)與垂直運(yùn)動次數(shù)均明顯減少,差異顯著(P0.05)；穴位組、西藥組治療組的水平運(yùn)動和垂直運(yùn)動得分同模型組比較,均有顯著性(P0.05～0.01),而與正常組相比,則無顯著性差異(P0.05)；非穴位組與模型組之間差異不明顯(P0.05)；各治療組間的得分相比無顯著差異(P0.05)2、CUMS大鼠模型海馬腦區(qū)GLU含量明顯降低(P0.05),而GABA含量明顯升高(P0.05),經(jīng)過針刺穴位干預(yù),使慢性應(yīng)激抑郁大鼠模型海馬腦區(qū)GLU含量明顯升高(P0.01),GABA含量明顯降低(P0.01)。3、CUMS大鼠模型外周血DA含量較正常組顯著降低(P0.05),西藥組、穴位組跟模型組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.01)。各組大鼠外周血5-HT含量空白組與模型組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)；西藥組、穴位組跟模型組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.01)4、CUMS大鼠模型GAD65蛋白表達(dá)較正常對照組水平顯著升高(P0.01),EAAT3蛋白表達(dá)水平顯著降低(P0.05),GAT1蛋白表達(dá)水平顯著升高(P0.05),NR2B蛋白表達(dá)水平顯著降低(P0.01)；與模型組比較,氟西汀和針刺穴位組GAD65蛋白表達(dá)水平顯著降低(P0.05),EAAT3蛋白表達(dá)水平顯著升高(P0.01,P0.05),GAT1蛋白表達(dá)水平顯著降低(P0.01,P0.05),NR2B蛋白表達(dá)水平顯著升高(P0.05),而針刺非穴組均無顯著差異(P0.05)。結(jié)論：1、通過針刺干預(yù),抑郁大鼠蔗糖消耗量、飼料消耗量增加以及體重均增加,同時運(yùn)動活力增多,由此推斷,針刺可緩解抑郁癥的軀體及心理功能紊亂。2、針刺的抗抑郁機(jī)制與調(diào)節(jié)多巴胺(DA)、5-TH含量以及興奮性氨基酸谷氨酸及其受體的表達(dá)有關(guān)。3、針刺干預(yù)抗抑郁作用具有腧穴特異性。
[Abstract]:Objective: To observe the effects of "Si Shen Cong", "Neiguan" and "Sanyinjiao" on the weight, diet and behavior of rats with chronic unpredictable mild stress depression (CUMS), and to observe the changes in the content of GLU and GABA in the hippocampus of rats, the level of peripheral blood neurotransmitters (DA and 5-TH), and glutamic acid decarboxylase (G) (GAD65, G). AD67), glutamate transporter (EAAT3), GABA transporter 1 (GAT1), NMDA receptor subunit NR2B, and the protein expression of GABAA receptor, preliminary study the mechanism of acupuncture antidepressant, and try to explore its mechanism. Methods: 50 SD rats, SPF, female and male, and weight 180-230g, are placed in the Laboratory of day and night (7:00-19:00 in the daytime). At night 19:00-7:00), and randomly divided into blank group, model group, western medicine group (Fu Xiting), acupoint group and non acupoint group, 10 in each group. After 1 weeks of feeding, the chronic unpredictable mild stress measures were used to establish the depression model (CUMS). The stress measures mainly include fasting, water prohibition, reversing day and night, binding activity, tailing, wobble, foot shock, ice water travel In addition to the blank control group, the rest of the rats were all depressive models. Each day was randomly selected to stimulate 2 times a day. From the first days of entering the group, the rats were treated, 1 times a day, and the treatment to the group twenty-first days. From the entry group first to twenty-first days, the point group selected "four Shen Cong", "Neiguan", "Three Yin Jiao". Acupoints were needled with acupuncture at 30min each time, 1 times a day. Non acupoint groups were acupuncturing at the non acupoint points next to the above three acupoints. (according to the common non acupoint acupoint extraction methods at home and abroad, non acupoint points in the middle point of two meridians and collaterals), the residual treatment method was the same as the acupoint group. The western medicine group was given the fluoxetine 1.8mg/kg weight, dissolved in the pure water in 2M1 and 1 times. Each group of animals were weighed on first days, seventh days, fourteenth days and twenty-first days respectively. The content of GLU and GABA in the hippocampus of the hippocampus, the content of neurotransmitters (DA and 5-TH), glutamic acid decarboxylase (GAD67), glutamic acid transporter (EAAT3), GABA transporter 1 (GAT1), NMDA receptor subunit in the hippocampus were measured at the end of the experiment. NR2B, GABAA receptor protein expression. Results: 1, with the prolongation of the molding time, the weight of the blank control group increased significantly, followed by the western medicine group, the acupoint group increased significantly, the acupoint group increased in the later treatment than the western medicine group, but there was no significant difference (P0.05), but the weight of the non acupoint group increased, but increased, but increased, but increased, but increased, but increased, but increased, but increased, but increased, but increased, but increased, but increased, but increased There was no significant difference between the model group and the other treatment group (P0.05). Compared with the blank group, the weight gradually approached the normal weight level in the treatment group after 21 days of treatment, but there was a certain difference (P0.05), and the difference was obvious (P0.05) compared with the model group and the non acupoint group, and the consumption of sucrose and the feeding of each group were significantly different. There was a positive correlation between the amount of material consumption and the change of body weight. In the aspect of behavioral regulation, the number of horizontal movement times and the number of vertical movements in the model group were significantly reduced, and the difference was significant (P0.05). The scores of horizontal and vertical movement in the acupoint group and the western medicine group were significantly higher than those in the model group (P0.05 to 0.01). There was no significant difference in the normal group (P0.05), and there was no significant difference between the non acupoint group and the model group (P0.05); there was no significant difference in the scores between the treatment groups (P0.05) 2, the GLU content in the hippocampus of the CUMS rat model decreased significantly (P0.05), while the GABA content increased significantly (P0.05), and the chronic stress was depressed in the rats through acupuncture point intervention. The content of GLU in the hippocampus of the model was significantly increased (P0.01), the content of GABA decreased significantly (P0.01).3, and the content of DA in the peripheral blood of CUMS rats was significantly lower than that of the normal group (P0.05). The difference was statistically significant (P0.01) compared with the model group (P0.01). The difference was statistically significant (P) in the blank group of peripheral blood 5-HT content in each group (P). 0.05): compared with the model group, the difference between the western medicine group and the model group was statistically significant (P0.01) 4. The expression of GAD65 protein in the CUMS rat model was significantly higher than that in the normal control group (P0.01), the expression level of EAAT3 protein was significantly decreased (P0.05), the expression level of GAT1 protein increased significantly (P0.05), and the expression level of NR2B protein was significantly decreased (P0.01). The expression level of GAD65 protein in fluoxetine and acupuncture point group was significantly decreased (P0.05), the expression level of EAAT3 protein was significantly increased (P0.01, P0.05), the expression level of GAT1 protein was significantly decreased (P0.01, P0.05), the expression level of NR2B protein was significantly increased (P0.05), but there was no significant difference in acupuncture non acupoint group (P0.05). Conclusion: 1, through acupuncture intervention, depression is big. The consumption of sucrose, the increase of feed consumption, the increase of weight and the increase of exercise activity, it is concluded that acupuncture can relieve the physical and psychological dysfunction of depression.2. The antidepressant mechanism of acupuncture is related to the regulation of dopamine (DA), the content of 5-TH and the expression of glutamic acid and its receptors of excitatory amino acids,.3, and acupuncture intervention for antidepressant. The effect has acupoint specificity.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2016
【分類號】：R245;R-332

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