摘要
目的本研究旨在通过观察耳尖刺血对去卵巢拟阴虚内热大鼠神经内分泌的影响,来探讨耳尖刺血对围绝经期潮热的疗效及部分机理,为临床应用提供依据和指导。
方法雌性Wistar大鼠60只(180~250g),随机分为5组:正常组、假手术组、模型对照组、雌激素对照组、耳尖刺血组。模型对照组、雌激素对照组、耳尖刺血组行双侧卵巢摘除术,假手术组行同样操作,只是不摘除卵巢。手术后第10天,模型组、雌激素对照组、耳尖刺血组采用50%的附子干姜液灌胃造模,正常组、假手术组则灌服等容积蒸馏水。用去卵巢加灌服热性中药的方法复制人工绝经的拟阴虚内热大鼠模型,以己烯雌酚为阳性对照药物,采取耳尖刺血为干预措施,其余组均采用灌服等容积蒸馏水进行对照。用电脑数字式体温计测定大鼠肛温;光镜下观察大鼠阴道脱落上皮细胞角化情况;摘取大鼠子宫,精密测量重量并计算子宫指数;采用放射免疫法测定血清E2(雌二醇)、FSH(促卵泡生成激素)、LH(促黄体生成激素);采用高效液相色谱-电化学检测器测定下丘脑NE(去甲肾上腺素)、5-HT(五羟色胺)、5-HIAA(五羟吲哚乙酸)。比较分析各组观测指标差异性。
结果1.大鼠肛温的变化模型组大鼠肛温有上升趋势,在治疗第6天相对正常组、假手术组、雌激素素大鼠肛温显著上升(p<0.05)。雌激素组大鼠肛温在前3次测量中均显著低于模型组(p<0.05)。耳尖刺血组肛温与模型组无明显差异。2.大鼠阴道角化细胞情况正常组、假手术组、雌激素组大鼠涂片均可见大量上皮细胞、角化上皮细胞,模型组与耳尖刺血组则基本以大量白细胞、多核白细胞为主。模型组相对正常组、假手术组阴道上皮细胞角化程度明显下降。雌激素组阴道上皮细胞角化程度高。耳尖刺血组与模型组大鼠阴道上皮细胞角化程度无差异性。3.大鼠子宫重量指数的变化模型组大鼠子宫重量指数与正常组、假手术组相比下降极显著(p<0.001)。雌激素组与模型组相比升高极显著(p<0.001);耳尖刺血组与模型组相比有升高趋势。4.大鼠血清性激素的变化模型组较正常组、假手术组血清E2下降极显著(p<0.01),FSH上升极显著(p<0.01),LH有上升趋势。雌激素组与模型组相比E2有升高趋势,FSH显著下降(p<0.05),LH有下降趋势。耳尖刺血组与模型组相比E2有升高趋势,FSH显著下降(p<0.05),LH有下降趋势。5.大鼠下丘脑神经递质的变化模型组与正常组相比NE显著升高(p<0.05),5-HT、5-HIAA有下降趋势,5-HT/NE比值显著下降(p<0.05)。雌激素组与模型组相比,NE显著降低(p<0.05),5-HT下降极显著(p<0.01),5-HT/NE比值显著下降(p<0.05),5-HIAA/5-HT比值显著上升(p<0.05)。耳尖刺血组与模型组相比,NE显著降低(p<0.05),5-HT下降极显著(p<0.01),5-HIAA上升显著(p<0.05),5-HT/NE比值显著下降(p<0.05),5-HIAA/5-HT比值上升极显著(p<0.01)。
结论耳尖刺血有降低肛温、LH的趋势,升高E2的趋势,降低FSH、NE、5-HT的含量,降低5-HT/NE的比值,提高5-HIAA/5-HT比值。耳尖刺血法能够调节去卵巢拟阴虚内热大鼠的神经内分泌功能,对围绝经期潮热有一定的治疗作用。
Objective: Through observation of the effects on the neuroendocrine functions of climacteric rat model with interior heat syndrome due to deficiency of yin by ear-apex bloodletting method to investigate its therapeutic effects and mechanism on hot flush and support for the clinical practice.
Method: 60 female Wistar rats (180~250g) were randomly divided into 5 groups of normal group, sham-operated group, model group, Diethylstibestrol (DES) group and ear-apex bloodletting(EAB) group. Rats in model group, DES group and EAB group were removed with the ovaries while the sham-operated group with the same operations but without removal of the ovaries. On the tenth day of post-operation, rats in the model group, DES group and EAB group were manipulated with lavage of 50% Fuzi Ganjiang Decoction (Prepared Common Monkshood Daughter Root & Dried Ginger) to prepare interior heat syndrome while the normal group and sham-operated group with lavage of distilled water as contrast. Climacteric rat model with interior heat syndrome due to yin deficiency by method of removal of ovaries and lavage of 50% Fuzi Ganjiang Decoction, were treated with different methods of ear-apex bloodletting, lavage of DES while the control groups with lavage of distilled water. Rat rectal temperature was measured by digital themometor; Rat desquamated Vagina Epithelial Cell was observed under light microscope; Rat uterus was precisely measured after removal and then for calculation of uterus weight index; Rat serum Estradiol (E2), Follicle-stimulating Hormone (FSH) and Luteinizing Hormone (LH) were measured by radio-immunity method; Rat hypothalamus NE, 5-HT and 5-HIAA were measured by High performance Liquid Chromatography with Electrochemical Detection (HPLC-ECD).
Result: 1. Rat Rectal Temperature: Rectal temperature in model group had an increasing tendency and obviously increased higher than those in normal group, sham-operated group and DES group (p<0.05). Rat rectal temperature in DES group obviously decreased lower than those in model group (p<0.05). There were no obvious difference between ear-apex bloodletting group and model group. 2. Rat Vagina Epithelial Cell: Vaginal smear results showed a lot of epithelial cells and cuticular epithelial cells in normal group, sham-operated group and DES group while in model group and ear-apex bloodletting group with a lot of leucocytes and polycytes. The extent of cuticularization of the vaginal epithelial cells was obviously lower than that in normal group and sham-operated group while the DES group with higher extent. There were no difference between the EAB group and model group. 3. Rat Uterus Weight Index: Uterus weight index in model group descended extremely remarkable in contrast with normal group and sham-operated group (p<0.001). Index in DES group ascended extremely remarkable in contrast with that of model group (p<0.001). Index in EAB group had an increasing tendency in comparison with that of model group. 4. Rat Serum Hormones: E2 in model group descended obviously than those of normal group and sham-operated group (p<0.01), FSH ascended obviously (p<0.01) and LH had an increasing tendency. In contrast with model group, E2 in DES group and EAB group had an increasing tendency, FSH descended obviously (p<0.05) & LH had a decreasing tendency. 5. Rat Hypothalamus Neurotransmitters: In contrast with normal group, NE in model group obviously increased (p<0.05), ratio of 5-HT/ NE obviously descended (p<0.05) and 5-HT and 5-HIAA had a descending tendency. In contrast with model group, NE and ratio of 5-HT/NE in DES group obviously descended (p<0.05), 5-HT descended significantly (p<0.01) and 5-HIAA/5-HT ascended obviously (p<0.05). In comparison with model group, NE and ratio of 5-HT/NE in EAB group obviously descended (p<0.05), 5-HT descended significantly (p<0.01), 5-HIAA increased obviously (p<0.05) and 5-HIAA/5-HT ascended significantly (p<0.01).
Conclusion: Ear-apex bloodletting has functions of lowering rat rectal temperature, LH, FSH, NE, 5-HT & ratio of 5-HT/NE and improving E2 and ratio of 5-HIAA/5-HT. Ear-apex bloodletting method can effect on the neuroendocrine functions of climacteric rat model and has certain effect on treating climacteric syndrome.
引文
[1] 曹泽毅.中华妇产科学(第 2 版).人民卫生出版社,2004:2535~25
[2] 张玉珍.新编中医妇科学.中国中医药出版社,2003 :168~169
[3] Overlie I, M15oen MH, Holte A. et al. Androgens and estrogens in relation to hot flashes during the menopausal transition[J] . Maturitus 2002 , 41 (1) :69 ~ 77
[4] 林凤仪,刘丹,黄金凤.尼尔雌醇治疗更年期综合征 40 例疗效观察[J].国际医药卫生导报,2004, 10(20):65~66
[5]Colacurci N, et al. Effects of soy isoflavones on menopausal neurovegetative symptoms [J] Minerva Ginecol. 2004 Oct:56(5):407~12
[6] Freeman EW, Sammel MD , Grisso JA , et al. Hot flashes in the late reproductive years: Risk factors for African American and Caucasian women [J]. J Wom Health Gender~Based Med 2001 ,10 (1) : 67 ~ 76
[7] Hammar ML, Hammar-Henriksson MB, Frisk J, et al. Few oligoamenorrheic athletes have vasomotor symptoms[J ] . Maturitas 2000,34 (3) :219~225
[8] Kronenberg F. Hot flashes: Epidemiology and physiology [J]. AnnNY Acad Sci 1990, 592 (86):123~133
[9] Caper RF. Menopausal flushes: a neuroendocrine link with pulsatile luteinizing hormone secretion. Science,1979,205:823~825
[10] Kronenberg F, Downey JA. Thermoregulatory physiology of menopausal hot flashes: a review. Can J Physiol Pharmacal,1987,65: 1312~1324
[11] Overlie I, Moen MH, Holte A.et al. Androgens and estrogens in relation to hot flashes during the menopausal transition [J]. Maturitus 2002,41(1): 69~77
[12] Guthrie JR, Dennerstein L, Hopper JL.et al. Hot flushes, menstrual status, and hormone levels in a population-based sample of midlife women [J]. Obstet Gynecol 1996,88(3): 437~472
[13] Burger HG. The endocrinology of the menopause[J]. Maturitas 1996,23(2):129~136
[14] Sheard MH, Aghajanian GK. Neural release of brain serotonin and body temperature. Nature 216:495~6
[15] Werner J, Bienek A. The significance of nucleus raphe dorsalis and centralis for thermoafferent signal transmission to the preoptic area of the rat. Exp. Brain Res 1985,59:543~554
[16] Lin MT, Tsay HJ, Su WH, et al. Change in extracellular aerotonin in rat hypothalamus affect thermoregulatory function. Am J Physiol 1998,274(5):1260~7
[17] Loprinzi CL, Sloan JA, Perez EA, et al. Phase III evaluation of fluoxetine for treatment of hot flashes. J Clin Oncol 2002, 20(6): 1578~83
[18] Loprinzi CL, Kugler JW, Sloan JA, et al. Venlafaxine in management of hot flashes in survivors of breast cancer: a randomized controlled trial. Lancet 2000, 356(9247): 2059~63
[19] Berendsen HH. The role of serotonin in hot flashes. Matuitas 2000, 36(3): 155~64
[20] Gonzales GF, Carillo C. Blood serotonin levels in postmenopausal women: effects of age and serum estradiol levels. Maturitas 1993, 17(1): 23~9
[21] Blum I, Vered Y, Lifahitx A, et al. The effect of estrogen replacement therapy on plasma serotonin and catecholamines of postmenopausal women. Isr J Med Sci 1996, 32(12): 1158~62
[22] 陈亚琼,吕肖峰.绝经后潮热妇女血浆 5-羟色胺前体及代谢产物水平的变化[J].中华妇产科杂志,2002,37(12):726~728
[23] 罗晓梅,陈亚琼,辛晓燕等.雌激素对去卵巢大鼠中缝核簇 5-羟色胺能神经元的影响[J].中国临床康复,2005,9(3):174~177
[24] Halbreich U, Rojansky N, Palter S, et al. Estrogen augments serotogergic activity in postmenopausal women. Biol Psychia, 1995, 37(7), 434~441
[25] Stearns V, Ullmer, Lopez JF, et al. Hot flushes. Lancet, 2002, 360(9348): 1851~1861
[26] Lomax P. The pathophysiology of postmenopausal hot flushes. Reproduction, 1982, 6(2): 93~99
[27] 李连香,陈亚琼,吕葆真等.GnRH 受体和 5-HT 受体与更年期大鼠潮热的关系[J].解剖学杂志,2004,27(4):380~382
[28] Sherwin BB, Gelfand MM. A prospective one-year study of estrogen and progestin in postmenopausal women: effects on clinical symptoms and lipoprotein lipids. Obstet Gynecol, 1989, 73:759~766
[29] Mulley G. Hot flushes after hypophysectomy. BMJ, 1977,2: 1062
[30] Tataryn LV. Objective techniques for the assessment of postmenopausal hot flashes. Obstet Gynecol, 1981,57: 340~344
[31] Chakravarti S, Colline WP, Newton JR, et al. Endocrine changes and symptomatology after oophorectomy in premenopausal women. Br J Obstet Gynaecol, 1977, 84: 769~755
[32] Wehrenbery WB, Wardlaw SL, Frantz AG, et al. ?-EP in hypophyseal poral blood: variations throughout the menstrual cycle. Endocrinology, 1982,111: 879
[33] Tomimatsu N, et al. Effects of oestrogen on hypothalamic beta-endorphin ovarietomized and old rats [J]. Maturitas, 1993, 17(1): 5~16
[34] Simpkins JW, et al. Similarities between morphine withdrawal in the rat and the menopausal hot flush. J Life sci. 1983,32(17): 1957~66
[35] 王跃清,李俊霞,刘文枝.β-内啡肽对更年期妇女潮热的影响[J].实用妇产科杂志,1999,15(6):321)
[36] Schurs B, Wimmer-Greinecher G, Metka M, et al. ?-EP levels during the climacteric period, Maturitas, 1998, 10:45
[37] Kuljis RO, Advis JP. Immunocytochemical and physiological evidence of a synapse between dopamine and GnRH-containing neurons in the ewe median eminence. J. Endocinology, 1989,124: 1574~1581
[38] Contijoch AM, Gonzalez C, Singh HN, et al. Dopaminergic regulation of luteinizing hormone~releasing hormone release at the median eminence level: Immunocytochemical and physiological evidence in hem. J. Neuroendocrinology, 1992,55: 290~300
[39] 沈卫斌.儿茶酚胺神经递质对促性腺激素释放激素分泌的影响[J].生理科学进展,1996,27(4):368~370)
[40] Freedman RR,李晓梅摘.绝经期潮热的生化、代谢和血管机理[J].国外医学妇产科学分册,1999,26(4):245~246
[41] Cignareli M, et al. Biophysical and endocrine-metabolic changes during menopausal hot flashes: increase in plasma free acid and norepinephrine levels. J Gynecol Obstet Invest. 1989, 27(1):34~7
[42] Abe T, et al. The correlation between climacteric symptoms and plasma levels of catecholamines. J. Nippon Naibunpu Gakkai Zasshi. 1980,56(7):993~9
[43] David A, et al. Veralipride: alternative antidopaminergic treatment for menopausal symptoms. J.Am J Obstet Gynecol, 1988, 158(5): 1107~15
[44] Melis GB, et al. Effects of the dopamine antagonist veralipride on hot flushes and luteinizing hormone secretion in postmenopausal women. J. Obstet Gynecol, 1988, 72(5): 688~92
[45] Tataryn LV. Objective techniques for the assessment of postmenopausal hot flashes. J. Obste Gynecol,1981, 57: 340~344
[46] Chakravarti S, Colline WP, Newton JR, et al. Endocrine changes and symptomatology after oophorectomy in premenopausal women. Br J Obstet Gynaecol, 1977, 84: 769~775
[47] Sherwin BB, Gelfand MM. A prospective one-year study of estrogen and progestin in postmenopausal women: effects on clinical symptoms and lipoprotein lipids. Obstet Gynecol, 1989, 73: 759~766
[48] Valentini A, Petraglia F, et al. Changes of plasma calcitonin gene-related peptide levels in postmenopausal women. Am J Obstet Gynecol. 1996, 175(3 Pt 1): 638~42
[49] Freedman RR Hot flashes revisited J Menopause 2000, 7(1): 3~4
[50] Robertson DM, Burger HG. Reproductive hormones: Ageing and the perimenopause J Acta Obstet Gynecol Scand 2002, 81(7): 612~16
[51] Ballinger CB. Psychiatric aspects of the menopause. Br J Psychiatry 1990, 156: 773~787
[52] Lobo RA. Treatment of the postmenopausal woman: basic and clinical aspects. New York: Raven Press, 1994: 97~117
[53] 谢长莲.三黄烘热汤治疗妇女更年期烘热症[J].四川中医,2003,21(8):64
[54] 郑红.滋肾清降汤配合耳穴贴压治疗女性更年期综合征 51 例[J].河北中医,2003,25(2):95
[55] 王健康.蒿芩清胆汤治疗妇女更年期头面烘热症 30 例[J].光明中医,2001,16(93):36
[56] 崔振波,杨太银.桂枝汤加味治疗更年期烘热症 40 例[J].安徽中医临床杂志,2003,15(6):478
[57] 张盛之.中药敷脐治疗妇女更年期潮热汗出[J].中医外治杂志,2001,10(3):41
[58] 李义方,熊超.从肾虚挟瘀论治更年期综合征[J].吉林中医药,1998,3:29
[59] 姚石安.补肾化瘀法治疗更年期综合征的理论与实践依据是什么[J].中杂志,1994,35(4):245
[60] 张昱,李勇生.肾虚血瘀是妇女更年期综合征的病理基础[J].陕西中医,1999,20(5):239
[61] 刘晓伟,邓虹珠.更年期综合征中医辨治研究进展[J].现代中西医结合杂志,2001,10(8):792
[62] 叶燕萍.更年期综合征辨证分型的研究[J].新中医,2000,32(9):36
[63] 张桂珍.陈慧侬教授治疗妇科经验撷菁[J].广西中医药,2002,25(1):39~40
[64] 张大英.更年期综合征 55 临床分析[J]. 天津中医,1994,11(3):7
[65] 张桂玲,申宏.从肝论治更年期综合征[J].甘肃中医学院学报,2000,17(2):32
[66] 程化奇.女性更年期综合征阴虚阳亢证与肝郁气滞证宏观辨证与微观辨证研究[J]. 新中医,1997,29(1):36
[67] 陆启滨.更年期综合征病因病机探源[J].中医药学刊,2001,19(2):139
[68] 余庆.脾胃阴火与更年期综合征[J].福建中医学院学报,1999,9(3):34
[69] 李庆生.治疗妇女更年期综合征应重视柔肝疏肝、气阴双调[J].云南中医中药杂志,1997,18(3):4
[1] 管建红,马逢升,吴帆等.针刺治疗更年期综合征 38 例[J].上海针灸杂志,2002,19(4):26
[2] 李淑荣,都亚娟,张淑杰.针刺背腧穴为主治疗女性更年期综合征 200 例[J].针灸临床杂志,2005,21(11):39~40
[3] 陈园秀,赵晓峰,武连仲.针刺治疗更年期综合征 300 例临床研究[J].天津中医学院学报,2002,21(2):20
[4] 朴联友,孙彩霞,张国瑞.灵龟八法治疗更年期综合征 60 例小结[J].北京中医药大学学报,1997,20(3):44
[5] 袁志太.五脏俞加膈俞针刺治疗更年期综合征[J].上海针灸杂志,1999,18(6):19
[6] 孙远征,崔淑子,郭淑颖等.俞募配穴为主治疗更年期综合征[J].中国针灸,2004,24(2):85~87
[7] 孙冬梅,吴富东,单秋华.耳穴贴压治疗女性更年期综合征的临床观察[J].针灸临床杂志,2003,19(12):32~34
[8] 骆晓金,李亚伟.耳穴埋针治疗更年期综合征 12 例[J].辽宁中医学院学报,6(4):329
[9] 王新宇,杨柳.耳穴贴压疗法对女性更年期综合征患者神经内分泌功能的影响[J].中国临床康复,2004,8(27):5909
[10] 潘红玲,许天兵.穴位注射治疗更年期综合临床观察[J].针灸临床杂志,1998,14(11):14
[11] 张官印.针刺配合穴位注射治疗更年期综合征 35 例[J].山东中医杂志,2003,22(8):476~477
[12] 李芳莉.灸脐治疗女性更年期综合征的临床观察[J].中国针灸,2004,24(10):689~690
[13] 张道武,郑秀芝,王秋景.针灸治疗更年期综合征临床研究[J].上海针灸杂志,1999,18(4):20~21
[14] 艾正海.梅花针叩击足部反射区治疗更年期综合征 60 例[J].云南中医中药杂志,1997,18(142):27
[15] 孙敬青.走罐疗法治疗更年期综合征 50 例临床观察[J].针灸临床杂志,1999,15(7):31~32
[16] 姜守信.穴位埋线治疗妇女更年期 60 例临床观察[J].针灸临床杂志,2000,16(7):46~47
[17]霍则军, 张文兵.针灸治疗更年期汗证 51 例[J].上海针灸杂志,2002,21(4):33
[18] 潘文宇,林国华.针刺加火针治疗更年期综合征 103 例[J].上海针灸杂志,2002,21(4):33
[19] 高建忠,朱桂玲.针药并用治疗更年期综合征 31 例[J].上海针灸临床杂志,2004,23(10):12
[20] 张皓.针刺干预后更年期综合征患者临床症状及β-内啡肽的改变[J].中国临床康复,2006,10(31):1~3
[21] 马晓芃.针刺治疗女性更年期综合征研究[J].山东中医药大学学报,1999,23(1):34
[22] 朱江,郑格林,张水清等.耳穴贴压治疗女性更年期综合征 59 例[J].上海针灸杂志,1996,15(4):10
[23] 李沛,黄攸玉,徐文清.针刺对女性生殖内分泌影响的实验研究[J].针刺研究,2002,27(4):277~280
[24] 单秋华,孙冬梅,吴富东.耳穴贴压对女性更年期综合征患者血清内分泌素及β-内啡肽的影响[J].中国针灸,2003,23(11):676~678
[25] 李平.耳穴贴压对女性更年期症状及血清内分泌激素的影响[J].中医康复研究,2005,9(15):140~142
[26] 王新宇,杨柳.耳穴贴压对女性更年期综合征患者神经内分泌功能的影响[J].中医临床康复,2004,8(27):5909
[27] 余晓星,吴群英,黄俊.电针对老年雌性大鼠血清睾酮、雌二醇和孕酮浓度的影响[J].上海针灸杂志,2005,24(9):37~40
[28] 刘宏艳,吴高媛,王滨等.针刺治疗更年期综合征的实验研究[J].天津中医学院学报,2002,21(1):45
[29] 刘宏艳,王滨.电针对更年期大鼠神经内分泌免疫网络的影响[J].江苏中医药,2003,24(1):49
[30] 汪惠丽,胡玲,高忻.电针“关元”、“三阴交”对围绝经期模型大鼠神经内分泌的调整作用[J].针刺研究,2003,28(2):124~127
[31] 祖英秋,杨志国,田淑君.电针对更年期雌性大鼠雌激素水平及垂体 ERαmRNA 表达的影响[J].哈尔滨医科大学学报,2005,39(2):127~130
[32] 杨志国,田淑君,尹岭.电针对更年期大鼠血中性激素水平和下丘脑 P 物质 mRNA 表达的影响[J].生殖与避孕,2005,25(4):205~210
[33] 田淑君,尹岭,孙锦平.针刺对去卵巢大鼠脑内胆碱乙酰转移酶基因表达的影响[J].生理学报,2004,56(4):498~502
[34] 李耀功,杨茹,高慧等.针刺对雌性大鼠垂体雌激素受体 mRNA 表达和血雌二醇水平影响的研究[J].针刺研究,1998,1:28~32
[35] 陈伯英,程立海,高慧等.电针对脑内雌激素受体蛋白及其 mRNA 表达的影响[J].生理学报,1998,50(5):498~500
[36] 姚晓,马淑兰,陈伯英.电针及去卵巢术对大鼠脑内催乳素释放肽的影响[J].针刺研究,2004,29(2):135~140
[37] 冯异,马淑兰,陈伯英.脑内催乳素释放肽参与电针对围绝经期综合征大鼠下丘脑-垂体-卵巢轴异常功能的调整[J].针刺研究,2006,31(4):195~202
[38] 安晓飞,马淑兰,冯异等.下丘脑孤啡肽参与电针对去卵巢大鼠 LH 释放的影响[J].针刺研究,2005,30(3):138~233
[39] 赵宏,田占庄,陈伯英.电针对去卵巢大鼠下丘脑 GnRH 系统影响的分子机制[J].上海针灸杂志,2003,22(1):3~6
[40] 程丽娜,杜挂珍,陈伯英.电针调整去卵巢大鼠下丘脑-垂体-卵巢轴异常功能的生化机制[J].上海针灸杂志,2001,20(6):32~34
[41] 崔大鹏,吴群英,李磊.针刺对去卵巢大鼠脑内芳香化酶基因表达的影响[J].针灸临床杂志,2006,22(12):60~63
[42] 沈晓明,李梦,朴泰虎等.调神益肾针法对更年期大鼠雌激素效应器官的作用[J].安徽中医学院学报,2002,21(1):27~30
[43] 沈晓明,杜元灏,胡玲.调神益肾针法对更年期大鼠卵巢、肾上腺皮质中 3β-羟类固醇脱氢酶的影响[J].中医杂志,2006,47(10):747~750
[44] 沈晓明,杜元灏,朴泰虎等.调神益肾针法对更年期大鼠下丘脑-垂体-卵巢功能的影响[J].中国针灸,2002,22(10):693
[45] 沈晓明,阿艳芸.调神益肾针法对更年期大鼠下丘脑阿片促黑素皮质素原 mRNA 表达的影响[J].安徽中医学院学报,2002,21(4):31
[46] 沈晓明,杜元灏,李谈.调神益肾针法对更年期大鼠中脑 5-羟色胺神经元形态功能的影响[J].针刺研究,2004,29(1):35~40
[47] 沈晓明.卵巢老化相关基因筛选及针刺“肾俞”的干预作用[J].安徽中医学院学报,2006,25(2):18~23
[48] 杨廉,路暾,刘媛媛等.温针“肾俞”穴对老年雌鼠子宫、卵巢及性激素作用的研究[J].针刺研究,2000,25(3):207—210
[49] 杨廉,路暾,刘媛媛等.温针灸“肾俞”穴对老年雌鼠性激素的影响[J].针刺研究,2000,25(3):172—173
[50] 李晓泓,解秸萍,张露芬等,预先艾灸对随后不同阶段更年期大鼠促性激素释放激素、卵泡刺激素和黄体生成素的干预作用[J].中国临床康复,2006,10(31):99~101
[51] 翟景慧,李晓泓,张露芬等,“逆 针”与“逆灸”对去卵巢大鼠血脂水平的影响[J].针刺研究,2005,30(2):80~82
[52]张露芬,李晓泓,张慧等.逆针关元穴对自然更年期大鼠血脂的调节作用[J].中国临床康复,2005,9(23):132~133
[53] 张慧,张露芬,李晓泓.逆针关元穴对自然更年期大鼠超氧化物歧化酶和一氧化氮合酶活性的调节[J].中国临床康复,9(31):147~149
[54] 李晓泓,解秸萍,张露芬.逆灸关元穴对自然更年期大鼠下丘脑雌激素受体 α 和促肾上腺激素释放激素及血浆促肾上腺激素的调节[J].中国临床康复,10(7):118~120
[55] 李晓泓,解秸萍,张露芬等.逆灸关元穴对不同月龄更年期大鼠肿瘤坏死因子 α 及脾脏雌激素受体 α 的影响[J].中国临床康复,2006,10(43):171~174
[1] 陈侬.敦煌遗书中的耳穴与耳孔灸法[J].中华医史杂志,1995, 25(3):156
[2] 黄丽春.耳穴诊断学(M).科学技术文献出版社,2004:95
[3] 张阿娜,杜雪莉.耳尖放血治疗麦粒肿 78 例[J].实用中医药杂志,1999,15(10):34
[4] 孙跃进.耳尖放血治疗早期睑腺炎[J].中国中医急症,2001,10(3):177
[5] 何琦.耳尖穴点刺放血治疗麦粒肿[J].贵阳中医学院学报,1992, 14(3):39
[6] 戴秀萍,陈芬萍,郑梅英等.耳尖放血的眼科应用[J].中国针灸,1996,11:52
[7] 马元等.耳尖施灸治疗胬肉攀睛[J].上海针灸杂志,1994,13(5):238
[8] 裴良才.耳尖放血对预防流行性出血性结膜炎的观察[J].中国中医眼科杂志,1995,3:179
[9] 熊银松,田建群.火柴灸耳尖穴治疗流行性腮腺炎 100 例[J].中级医刊,1995,30(10):47
[10] 李思康,张传宝.耳尖点刺放血治疗流行性腮腺炎 89 例[J].辽宁中医杂志,1998,1:37
[11] 薛继岚.耳尖放血治疗高血压[J].中国针灸,1991,(1):32
[12] 吴广伟,林矛,陈志斌.耳尖放血治疗高血压 306 例[J].上海针灸杂志,1997, 16(2):21
[13] 陈华德.针刺配合耳尖放血治疗肝阳上亢证 34 例[J].湖南中医药导报,2001, 7(2):68
[14] Dieterich.针刺加耳尖放血治疗高血压[J].上海针灸杂志,2000,19(2):9
[15] 陈华德,王翀敏,方针.耳尖放血对高血压肝阳上亢证大鼠 NO 的影响[J].中医药学刊,2004,22(5):817
[16] 王翀敏,陈华德.耳尖放血法与耳尖电刺激法即时降压效应的比较研究[J].中医药学刊,2004,22(7):1207
[17] 陈华德,方针,王翀敏.耳尖放血疗法治疗高血压病肝阳上亢证的实验研究[J].中西医结合心脑血管病杂志,2003,1(9):521
[18] 陈华德,方针,王翀敏.耳尖放血治疗高血压病肝阳上亢证疗效观察[J].中国针灸,2004,24(4):229
[19] 罗建昌,陈华德.耳尖放血治疗高血压即时疗效观察[J].上海针灸杂志,2004, 23(4):26
[20] 徐凤洲,刘学荣,刘忠荣等.电针耳尖穴对窒息家兔血压和呼吸作用实验及临床研究[J].针刺研究,1992,(1):36
[21] 董兵,凌显凤,陈静操等,电针高血压病人耳尖穴与降压点穴作用的比较[J].针灸学报,1990,(4):15
[22] 刘忠荣,徐凤洲,陆忠鸣.电针自然呼吸和窒息家兔耳尖穴对膈神经放电的影响[J].泸州医学院学报,1991,14(3):186
[23] 刘忠荣,徐凤洲,陆忠鸣.电针自然呼吸和窒息家兔耳尖穴对膈神经放电的影响[J].针灸学报,1991,(4):17
[24] 王彦华.耳尖放血辅助治疗外感发热 50 例[J].中国中医药科技,2003,10(4):240
[25] 袁远芬.耳尖穴刺络放血治疗高热 35 例治疗观察[J].贵阳中医学院学报,2005, 27(1):47
[26] 郭焱,杨建新,张翠莲.三棱针点刺用于癌症高热患者的疗效观察[J].北京中医药大学学报,2002,25(2):74
[27] 钱云,赵连珠.耳尖放血退热的实验观察[J].北京中医药大学学报(中医临床版),1994,1:20
[28] 尤佳.耳尖放血治疗急性卡他性扁桃体炎 85 例[J].医学理论与实践,2002,15(9):1047
[29] 乔玉玲,田丰.耳尖放血并耳穴贴苏子治疗牙痛 57 例临床观察[J].中国社区医师,2005,21(16):32
[30] 邓炳海,王桂梅,迟振等.冷光紫外线照射并耳尖放血治疗口腔溃疡 56 例[J].中华物理医学与康复杂志,2003,25(1):45
[31] 常虹.耳尖放血合耳穴压丸治疗过敏性鼻炎 38 例[J].中国民间疗法,2000,8(9):16
[32] 宋宇.耳尖配合大椎点刺放血治疗痤疮 85 例[J].上海针灸杂志,2002,21(1):29
[33] 赵广琼,张信江,李均.斯奇康注射液结合耳尖穴放血治疗扁平疣临床疗效分析[J].遵义医学院学报,2001,24(5):407
[34] 黄文珍.穴注耳尖血治疗头痛 60 例[J].中国针灸增刊,1994:197
[35] 曾卫峰.耳尖放血治疗为主治疗失眠 57 例[J].中国针灸,1989,(3):7
[36] 赵瑞雪.眼针配合耳尖放血治疗失眠 32 例疗效观察[J].中国针灸,1997,17(2):120
[37] 徐爱华,李衍杭.耳穴压豆配合耳尖放血治疗周围性面瘫[J].山东中医杂志,1995,14(4):178)
[38] 李玮,赵玉霞.耳尖穴针刺放血治疗脑梗死临床疗效观察及对血浆内皮素的影响[J].泰山医学院学报,2005,26(1):51
[39] 李春阳.耳尖放血治疗肛周脓肿 155 例[J].中国民间疗法,2005,13(1):19
[40] 何玲,刘智斌.耳穴贴压更年期烘热汗出 32 例[J].陕西中医,2002,23(11):1022
[41] 相永梅,董威.耳尖放血加耳穴贴压治疗更年期综合征 106 例观察[J].中国针灸,2000,20:207-208
[1] 刘星,王欢.中医刺血术发展史述略[J].山西中医学院学报, 2001,2(3):14
[2] 岳旭东.略述中医刺血术发展史[J].针灸临床杂志,2003,19(6):2
[3] 王秀珍.刺血疗法[J].安徽科技出版社,1984:123
[4] 杨医亚.针灸金方(M).河北科技出版社,1988:243
[5] 崔景胜.陕西中医,1984,(7):13
[6] 鞠颖.中国自然疗法(M).四川科技出版社,1982:177
[7] 关玲等.刺血疗法治疗重症视疲劳 14 例[J].中国民间疗法,2001,9(12):24
[8] 赵雪梅.龈交穴刺血治疗遗尿症 105 例体会[J].青海医药杂志中医药专辑,1999,29(11):48
[9] 姜玉华.肩穴刺血治疗慢性疲劳综合征 56 例[J].实用中医内科杂志,2005,19(2):181
[10] 杨骏,张庆萍.虚证刺络论[J].上海针灸杂志,1996,15(1):26
[11] 洪恩四.刺络放血对实验性发热家兔的体温免疫功能的影响[J].中国针灸,1993,(1):30
[12] 文琛.对经络实质的讨论[J].1983,(2):23
[13] 王海泉.刺络疗法与微循环[J].山东中医杂志,1996,15(2):73
[14] 徐斌.刺络放血疗法的血管生物学基础[J].中国临床康复 2004,8(24):5126-5127)
[1] 曹泽毅.中华妇产科学第 2 版(M).人民卫生出版社,2004:2535~2536
[2] 罗晓梅,陈亚琼.围绝经期潮热的非激素治疗[J].国外医学妇幼保健分册,2004,16(2):107-9
[3] 杨安峰,王平.大鼠的解剖和组织(M).科学出版社,1985:101
[4] 乐杰,《妇产科学》第六版(M).人民卫生出版社,2005:395
[5] 陈主初,吴端生.实验动物学(M).湖南科学技术出版社,2001:81
[6] 马堃,李连达.中医药治疗更年期综合征药效学试验的基本要求[J].中药新药与临床药理,2005,16(3):214
[7] 曲显俊,崔淑香,李凤琴等.骨维素注射液对 X 线致大鼠更年期综合征模型的治疗作用观察[J].山东医药工业,1998,17(4):1-3
[8] 胡随瑜,尤劲松,向群辉等.地贞颗粒对“更年期”拟阴虚内热证模型大鼠的影响[J].中药新药与临床药理,2000,11(3):143-145
[9] 尤劲松,胡随瑜,向群辉.地贞颗粒对更年期拟阴虚内热证大鼠儿茶酚胺递质及促性腺激素水平的影响[J].湖南医科大学学报,2001,26(1):33-36
[10] 徐亚香,师海波.妇乐颗粒对去卵巢拟阴虚内热大鼠的影响[J].中草药,2004,36(1):1161-1163
[11] 谢长莲.三黄烘热汤治疗妇女更年期烘热症[J].四川中医,2003,21(8):64
[12] 郑红.滋肾清降汤配合耳穴贴压治疗女性更年期综合征 51 例[J].河北中医,2003,25(2):95
[13] 王健康.蒿芩清胆汤治疗妇女更年期头面烘热症 30 例[J].光明中医,2001,16(93):36
[14] 崔振波,杨太银.桂枝汤加味治疗更年期烘热症 40 例[J].安徽中医临床杂志,2003,15(6):478
[15] 李义方,熊超.从肾虚挟瘀论治更年期综合征[J].吉林中医药,1998,3:29
[16] 张昱,李勇生.肾虚血瘀是妇女更年期综合征的病理基础[J].陕西中医,1999,20(5):239
[17] 刘晓伟,邓虹珠.更年期综合征中医辨治研究进展[J].现代中西医结合杂志,2001,10(8):792
[18] 叶燕萍.更年期综合征辨证分型的研究[J].新中医,2000,32(9):36
[19] 张桂珍.陈慧侬教授治疗妇科经验撷菁[J].广西中医药,2002,25(1):39~40
[20] 张桂玲,申宏.从肝论治更年期综合征[J].甘肃中医学院学报,2000,17(2):32
[21] 程化奇.女性更年期综合征阴虚阳亢证与肝郁气滞证宏观辨证与微观辨证研究[J].新中医,1997,29(1):36
[22] 张大英.更年期综合征 55 临床分析[J].天津中医,1994,11(3):7
[23] 陆启滨.更年期综合征病因病机探源[J].中医药学刊,2001,19(2):139
[24] 余庆.脾胃阴火与更年期综合征[J].福建中医学院学报,1999,9(3):34
[25] 李庆生.治疗妇女更年期综合征应重视柔肝疏肝、气阴双调[J].云南中医中药杂志,1997,18(3):4
[26] 高惠合,Heine H,Dtsch Zschr.耳穴的形态学结构[J].国外医学中医中药分册,1994,16(5):51
[27] 叶林书.血管内皮细胞功能紊乱研究进展[J].疑难病杂志,2004,3(4):247
[28] 相永梅,董威.耳尖放血加耳穴贴压治疗更年期综合征 106 例观察[J].中国针灸,2000,20:207-208
[29] 何玲,刘智斌.耳穴贴压更年期烘热汗出 32 例[J].陕西中医,2002,23(11):1022
[30] 骆晓金,李亚伟.耳穴埋针治疗更年期综合征 12 例[J].辽宁中医学院学报,2004,6(4):329
[31] 陈玲.耳穴贴压治疗更年期妇女高血压病[J].空军医高专学报,1998,20(3):25-26
[32] 武君丽.耳穴贴压治疗更年期综合征 38 例[J].中国民间疗法,1999,6(6):13
[33] 李忠仁.实验针灸学(M).中国中医药出版社,2003:327
[34] 汪廉.现代医学实验方法(M).人民卫生出版社,1997:1059
[35] 苗明三.实验动物和动物实验技术(M).中国中医药出版社,1997:167,336,97
[36] 徐叔云,卞如廉,陈修.药理实验方法学(M).人民卫生出版社,1982:1184
[37] 陈良儿.不同性别的大鼠日间体温变化规律[J].九江医学,2003,18(1):38~39
[38] 乐杰.妇产科学(M)第五版.北京:人民卫生出版社,2001,382~384
[39] 李继俊.妇产科内分泌治疗学(M).人民军医出版社,2005,9,1:293-296
[40] 张绍芬,陆湘云.绝经—内分泌与临床(M).人民卫生出版社,2005:111
[41] 卫生部继续教育医学教育委员会组编,女性生殖内分泌性激素补充疗法(M).北京医科大学中国协和医科大学联合出版社,1999:26~30
[42] Ortega E, Cuadros JL, Gonzalez AR, et al. Effects of estrogen-progestin replacement therapy on plasma beta-endorphin levels in menopausal women. Biochem Mol Biol Int.1993, 29(5):831)
[43] 郭建生,贺海波,王小娟等.更年安神胶囊对去势雌性大鼠神经内分泌的影响[J].中医药学刊,2003,21(2):262-264