艾灸对绝经前后亚健康状态女性的内分泌及免疫机制研究
发布时间：2018-08-01 12:29
【摘要】：目的观察艾灸不同腧穴对绝经前后亚健康状态女性的躯体、生活、情志、精力、睡眠状况以及生存质量等方面的影响,探讨干预前后不同腧穴对机体内分泌、免疫功能的参数变化及影响,筛选最佳腧穴,为临床针灸防治绝经综合征提供理论及实验依据。方法随机选择符合纳入标准的绝经前后亚健康女性志愿者120名,再随机分为关元组、三阴交组、肾俞组和VE组。关元组、三阴交组和肾俞组分别采用清艾条温和灸法,每日一次,每次15min,5日为1疗程,各疗程间休息2天,共干预4个疗程;VE组服用天然维生素E软胶囊(250mg/粒),每日一粒,连续服用28天。干预前后分别观察其生存质量、躯体、生活、情志、精力以及睡眠状况等,同时抽取静脉血5ml检测血清性激素、抗苗勒管激素、抑制素B以及免疫指标等。结果艾灸肾俞穴可以显著改善绝经前后亚健康状态女性的躯体状况(P0.05)以及生活状况(P0.01),疗效明显优于关元组、三阴交组和VE组。然而,四组对情志状况及精力状况改善均不明显(P0.05)。从睡眠状况上看,艾灸干预绝经前后亚健康状态女性对其睡眠情况总积分影响不明显(P0.05),但关元组和肾俞组对睡眠情况中早醒这一症状有显著改善(P0.05)。从生存质量上看,四组干预后生存质量简表中生理领域评分均较干预前明显改善(P0.05),以肾俞组更为显著(P0.01)。而肾俞组与VE组干预后生存质量简表总评分均较干预前显著改善(P0.01),关元组与三阴交组干预后生存质量简表总积分与干预前相比,有改善但尚无医学统计学意义(P0.05)。艾灸关元、三阴交、肾俞穴均可以显著提高绝经前后亚健康状态女性的血清E2水平(P0.05),以肾俞组疗效更优(P0.01),与VE组相比,具有显著医学统计学意义。但艾灸对FSH、LH以及P的调整均不明显(P0.05)。关元组、三阴交组以及肾俞组分别干预4个疗程后,AMH水平都得到显著提高(P0.01),而VE组干预疗程后无显著差异。艾灸对血清INHB水平无显著改善(P0.05)。从免疫指标看,艾灸关元穴明显提高CD3+(P0.05),降低CD8+水平(P0.01);艾灸三阴交穴可以显著提高CD3+(P0.05),降低CD8水平+(P0.05),并且CD4+/CD8+比值明显升高(P0.05);艾灸肾俞穴可以显著升高血清CD3+(P0.01)、CD4+(P0.05)含量,降低CD8+(P0.05)含量,并且调整CD4+/CD8+比值(P0.05);VE组干预后可以显著降低CD8+(P0.05)含量,CD4+/CD8+比值明显升高(P0.01)。结论艾灸肾俞穴分别可以有效改善绝经前后亚健康状态女性的躯体及生活状况,优于三阴交、关元穴;肾俞、关元穴艾灸可以在一定程度上改善早醒这一睡眠状况;艾灸关元、三阴交、肾俞三穴均可显著改善生存质量中生理领域评分,其中以肾俞穴较优。艾灸三穴均可以显著提高血清E2及AMH水平,以肾俞穴更佳,但对FSH、LH、P及INHB均无明显调整作用。艾灸三穴均可以有效的调节机体免疫T细胞含量,提高绝经前后亚健康状态女性的免疫功能。
[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.
【学位授予单位】：南京中医药大学
【学位级别】：博士
【学位授予年份】：2017
【分类号】：R246.3
本文编号：2157583
[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.
【学位授予单位】：南京中医药大学
【学位级别】：博士
【学位授予年份】：2017
【分类号】：R246.3
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