解郁方对卒中后抑郁大鼠海马CB1R/CB2R及CRF表达水平的影响  

Clinical study on tonifying kidney,reducing phlegm and removing blood stasis method combined with physical exercise in treatment of overweight/obese polycystic ovary syndrome

作　　者：程潇 陆逸莹 吴春岚 刘笑迎 王长德 CHENG Xiao;LU Yiying;WU Chunlan;LIU Xiaoying;WANG Changde(Shanghai Traditional Chinese Medicine Integrated Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200082,China)

机构地区：[1]上海中医药大学附属上海市中西医结合医院,上海200082

出　　处：《上海中医药大学学报》2024年第6期65-74,共10页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：上海市自然科学基金项目(16ZR1433700);上海市进一步加快中医药事业发展三年行动计划项目(ZY[2018-2020]-ZYBZ-30);上海市虹口区“国医强优”三年行动计划项目(HGY-YSZK-2018-10)。

摘　　要：目的:探讨解郁方(JYF)治疗卒中后抑郁的相关生物学机制。方法:将健康雄性SPF级SD大鼠60只进行行为学评分,随机分为假手术组、卒中组(MCAO组)、卒中后抑郁组(PSD组)、JYF低剂量组、JYF高剂量组和氟西汀组,其中MCAO组采用大脑中动脉栓塞法(MCAO)造模,PSD组、JYF低剂量组、JYF高剂量组和氟西汀组采用MCAO-慢性不可预知性温和应激法(CUMS)-孤养法进行卒中后抑郁造模。分别于0、3、5、7周时进行体质量测定和行为学测试;7周后,采用免疫组化方法检测各组大鼠海马大麻素受体1(CB1R)/大麻素受体2(CB2R)、促肾上腺皮质激素释放因子(CRF)表达情况。结果:体质量测试结果显示:给药前,与假手术组相比,PSD组、JYF高剂量组、JYF低剂量组、氟西汀组的体质量明显减轻(P<0.05);给药后,与PSD组相比,JYF高剂量组和氟西汀组的体质量明显增加(P<0.05)。强迫游泳实验结果显示:给药前,与假手术组相比,PSD组、JYF高剂量组、JYF低剂量组、氟西汀组的强迫游泳不动时间明显升高(P<0.05),强迫游泳挣扎时间明显降低(P<0.05);给药后,与PSD组相比,JYF低剂量组、JYF高剂量组和氟西汀组的强迫游泳不动时间显著降低(P<0.05),强迫游泳挣扎时间显著升高(P<0.05)。糖水偏好实验结果显示:给药前,与假手术组相比,PSD组、JYF高剂量组、JYF低剂量组、氟西汀组的蔗糖偏好度明显降低(P<0.05);给药后,与PSD组相比,JYF低剂量组、JYF高剂量组和氟西汀组的蔗糖偏好度显著升高(P<0.05)。免疫组化结果显示:与假手术组相比,PSD组海马CB1R、CB2R表达在海马亚区(CA1、CA3、DG)的表达均明显降低(P<0.05),PSD组、MCAO组的海马CRF表达在CA1、CA3、DG区域表达均明显升高(P<0.05)。与PSD组相比,JYF低剂量组、JYF高剂量组和氟西汀组的CB1R在CA1、CA3、DG区域的表达均明显升高(P<0.05),JYF高剂量组和氟西汀组的CB2R表达在CA1、CA3、DG区域均明显升高(P<0.05),Objective:To observe the clinical efficacy of tonifying kidney,reducing phlegm and removing blood stasis method combined with physical exercise in the treatment of overweight/obese polycystic ovary syndrome(PCOS).Methods:A total of 72 patients with overweight/obese PCOS were included and randomly divided into the treatment group and control group,36 cases in each group.The patients in the treatment group were treated with tonifying kidney,reducing phlegm and removing blood stasis formula combined with physical exercise,and the patients in the control group were treated with tonifying kidney,reducing phlegm and removing blood stasis formula,with a course of 3 months.The clinical efficacy was compared between the two groups.Before and after intervention,the menstrual condition scores,Ferriman-Gallwey hirsutism scores,acne grading scores,acanthosis nigricans scores,and Self-Rating Anxiety Scale(SAS)scores of both groups were evaluated and compared.Before and after intervention,the levels of sex hormones[including luteinizing hormone(LH),follicle-stimulating hormone(FSH),testosterone(T),anti-Müllerian hormone(AMH),and LH/FSH ratio],glucose and lipid metabolism indicators[including fasting plasma glucose(FPG),fasting insulin(FINS),total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),and insulin resistance index(HOMA-IR)],and serum leptin were detected.Before and after intervention,the ovarian area of patients in both groups was measured by ultrasound.Results:(1)After intervention,the total clinical effective rate was 83.34%in the treatment group and 50.00%in the control group.The efficacy of the treatment group was better than that of the control group(P<0.05).(2)After intervention,the scores of menstrual condition,hirsutism,and acne,and SAS scores in both groups were significantly decreased compared with those before intervention(P<0.05,P<0.01),and the scores of menstrual condition and hirsutism,and SAS score in the treatment group were signif

关 键 词：卒中后抑郁 解郁方 大麻素受体 促肾上腺皮质激素释放因子 

分 类 号：R285.5[医药卫生—中药学]