联合疗法治疗绝经后骨质疏松症的概述

笔者总结了近7年来中西医联合、运动联合西药以及运动联合中药对绝经后骨质疏松症进行治疗的基础研究与临床研究概况。3种联合疗法均能取得较好的疗效，且联合疗法均优于单一疗法，但目前中西医联合、运动联合西药以及运动联合中药治疗绝经后骨质疏松症的基础研究还不够深入，与临床研究存在一定程度的脱节。中西医联合疗法及运动联合西药疗法都不可能完全去除西药的毒副作用，而运动联合中药治疗绝经后骨质疏松症不仅有较好的疗效，而且安全无副作用，存在着疗效好、价格低、可长期坚持等优势。因而进一步深入探讨运动联合中药治疗绝经后骨质疏松症的机理，观察以运动锻炼来巩固加强中药对于绝经后骨质疏松症的疗效应会成为研究的热点。     

Effects of exercise on behavior and peripheral blood lymphocyte apoptosis in a rat model of chronic fatigue syndrome

This study examined the effects of exercise on behavior and peripheral blood leukocyte apoptosis in a rat model of chronic fatigue syndrome （CFS）. Thirty-six healthy male Sprague-Dawley rats were equally randomized into 3 groups： the control group, CFS model group and the exercise group in terms of body weight. A total of 25 rats entered the final statistical analysis due to 11 deaths during the study. CFS model was established by subjecting the rats in CFS model group and exercise group to electric shock, chronic restraint stress and cold water swim. Besides, rats in the exercise group took rtmning wheel exercise. After a week of conditioning feeding, model construction and running wheel exercise were performed simultaneously, and lasted for 23 consecutive days. The behavior experiments, including running wheel exercise, open-field test, tail suspension test and Morris water maze test, were conducted, either before or after the model establishment. Rats were sacrificed and peripheral blood was obtained for the assessment of lymphocyte apoptosis index by flow cytometry （FCM）. It was found that as compared with those in the control group, the weight of the rats was decreased obviously （P〈0.01）, the mobility time in the open-field and the tail suspension tests was shortened significantly （P〈0.01）, the time to locate the platform was enhanced （P〈0.01） and the cell apoptosis index was increased substantially （P〈0.01） in the CSF model group. Meanwhile, in comparison to the model group, the behavior in the open-field and the tail suspension tests was improved significantly （P〈0.05）, and the apoptosis index decreased remarkably （P〈0.01） in the exercise group. It is concluded that sport intervention can prevent lymphocyte apoptosis and improve animal behavior rather than the memory.     

运动配合中药及艾灸对慢性疲劳综合症大鼠行为及外周血淋巴细胞凋亡的影响

目的 探讨慢性疲劳综合症(GFS)造模对SD大鼠行为及外周血淋巴细胞凋亡的影响,并观察运动配合中药及艾灸作用效果.方法 用48只Sprague - Dawley 大鼠,按体质量分4组即对照组(CG)、CFS模型组(CFSG)、运动加中药组(ETCMG)和艾灸组(MG),每组12只.试验共进行3次旷场与悬尾行为测试,最后进行水迷宫实验和取外周血,流式细胞仪测定淋巴细胞凋亡指数.结果 CFSG 、ETCMG、MG参与造模的3组体质量的增长受到严重抑制;旷场行为CFSG行为指数明显降低,ETCMG和MG旷场行为指数比CFSG显著升高;悬尾行为CFSG显著降低,ETCMG比CFSG显著升高,MG悬尾与CFSG无差异;水迷宫可视平台组间无差异,探索第2象限参与造模3组的时间比CG延长;细胞凋亡指数CFSG比CG显著升高,ETCMG比CFSG显著降低,且与CG无差异,MG与CFSG无差异.结论 CFS造模抑制大鼠体重增长,行为表现抑郁,外周血淋巴凋亡细胞增多;运动加中药方法有效缓解大鼠行为症状,降低凋亡细胞指数;艾灸方法可缓解大鼠行为症状,但对细胞凋亡未见影响;两种干预方法对记忆行为未见影响.     

散打运动员赛前与冬训期间视觉事件相关电位P300的比较

目的:探讨散打运动员赛前与冬训期间两个时期视觉事件相关电位P300变化。方法:分别在全国锦标赛前一周及冬训期间对18名散打运动员(健将10名,非健将8名)进行心境状态量表(POMS)问卷调查及视觉事件相关电位测试。事件相关电位测试采用视觉的Oddball范式,以红色大圆形为标准刺激(概率为80%),红色小圆形为靶刺激(概率为20%),要求被试者对靶刺激进行按键反应,比较赛前和冬训期间P300在额区、中央区、顶区和枕区的振幅和潜伏期。结果:健将级和非健将级散打运动员赛前和冬训期间相比,心境状态量表得分均有显著性差异,健将级运动员冰山剖面图峰值无差异,非健将级运动员冰山剖面图峰值差异明显;健将、非健将级运动员的视觉事件相关电位P300潜伏期赛前和冬训期间相比无明显变化,健将运动员视觉事件相关电位P300振幅赛前和冬训期间相比变化不明显,非健将运动员在多点有显著性差异。结论:散打运动员在赛前与冬训期间心境状态量表得分有所不同,非健将级散打运动员冬训期间冰山剖面图峰值高于赛前,且其赛前视觉事件相关电位P300振幅与冬训期间比较有差异。     

运动配合左归丸对去卵巢大鼠骨质疏松的偶联信号IL-1、IL-6及COX-2传递的影响

目的通过观察运动配合左归丸对去卵巢大鼠骨质疏松的偶联信号因子骨髓基质细胞IL-1,成骨细胞IL-6、COX-2的影响,探讨该方法治疗骨质疏松症的作用机理。方法随机分为正常对照组、假手术组、模型组、己烯雌酚组、运动组、左归丸组、运动配合服用左归丸组。采用免疫组化的方法观察胫骨中白细胞介素1(IL-1β)、白细胞介素6(IL-6)和环加氧酶2(COX-2)3种细胞因子的蛋白表达,并运用ELISA技术测定血清中雌二醇(E2)、降钙素(CT)、骨钙素(BGP)、甲状旁腺激素(PTH)含量。结果大鼠造模后,胫骨IL-1、IL-6、COX-2蛋白表达显著增高,血清中CT、E2显著性降低,BGP、PTH显著性升高。运动配合服用左归丸可以对升高的IL-1、IL-6、COX-2产生明显的抑制作用,且运动配合服用左归丸组与运动组相比IL-1β、IL-6有显著性差异,与左归丸组相比IL-1β、COX-2有显著性差异。与模型组相比,运动配合左归丸组CT、E2升高,BGP、PTH均降低,且运动配合左归丸组血清E2较左归丸组及运动组有显著性升高。结论运动配合左归丸可使去卵巢大鼠体内雌激素分泌增加,进而抑制骨质疏松偶联信号因子IL-1β、IL-6、COX-2分泌,间接地抑制骨吸收,调节骨吸收与骨形成的动态平衡,达到治疗绝经后骨质疏松症的目的。