基于代谢组学的隔药灸脐法治疗原发性痛经的机理研究  

Metabonomics-based Mechanism Study on Herb-partitioned Moxibustion at Umbilicus for Primary Dysmenorrhea

作　　者：杨星月[1] 马玉侠[1] 杜冬青[2] 高树中[1] 

机构地区：[1]山东中医药大学,济南250014 [2]济南市中医医院,济南250012

出　　处：《上海针灸杂志》2015年第8期707-710,共4页Shanghai Journal of Acupuncture and Moxibustion

基　　金：国家重点基础研究发展计划项目(2007CB512703);国家自然科学基金面上项目(30973789)

摘　　要：目的从代谢组学的角度探讨隔药灸脐法治疗原发性痛经的机制。方法将20例原发性痛经患者随机分成隔药灸脐组和艾条灸脐组,治疗3个月经周期后,采用VAS评价腹痛程度以及用LC-MS联用的代谢组学方法检测治疗前后的血浆代谢产物变化。结果经治疗后,两组VAS值随治疗周期逐渐降低,隔药灸脐组VAS读数的下降幅度大于艾条灸脐组(P<0.05);隔药灸脐法可升高血浆中20α-二氢黄体酮、孕烯醇酮、前列腺素E2、γ-氨基丁酸的含量,降低雌酮、前列腺H2的含量,艾条灸脐法可降低5’-磷酸吡哆醛的含量。结论两种疗法均可改善患者的腹痛症状,但是隔药灸脐法治疗原发性痛经的疗效优于艾条灸脐法,其可能是通过调节雌酮、孕酮以及前列腺素等激素水平从而发挥治疗痛经的作用。Objective To explore the mechanism of herb-partitioned moxibustion at umbilicus in treating primary dysmenorrhea based on metabonomics. Method Twenty patients with primary dysmenorrhea were randomized into two groups to respectively receive herb-partitioned moxibustion at umbilicus and moxa-stick moxibustion at umbilicus. After treatment for 3 menstrual cycles, Visual Analogue Scale（VAS） was used to evaluate abdominal pain, and LC-MS-based metabonomics analysis was adopted to detect the change of plasma metabolites. Result After intervention, the VAS scores decreased with the menstrual cycles in both groups. The decrease of VAS score in herb-partitioned moxibustion group was more significant than that in moxa-stick moxibustion group（P〈0.05）; herb-partitioned moxibustion at umbilicus up-regulated the contents of 20α-dihydroprogesterone, pregnenolone, prostaglandin E2 and γ-propalanine, and down-regulated the contents of estrone and prostaglandin H2 in plasma; moxa-stick moxibustion decreased the content of 5＇-pyridoxal phosphate. Conclusion The two methods both can improve abdominal pain in primary dysmenorrhea, while herb-partitioned moxibustion can produce a more significant efficacy than moxa-stick moxibustion, and its effect is possibly realized via regulating estrone, progesterone, and prostaglandin.

关 键 词：痛经 间接灸 代谢组学 隔药灸 穴 神阙 艾条灸 

分 类 号：R246.3[医药卫生—针灸推拿学]