CAJ | 학술논문

[目的]观察手术创伤应激反应对术后认知功能的影响，探讨电针对术后认知功能障碍(postoperation cognitive dysfunction，POCD)干预效应的下丘脑-垂体-肾上腺轴（Hypothalamic-pituitary-adrenocortical Axis，HPA轴）调节机制。[方法]将100只雌性中老龄SD大鼠随机分为正常组、模型组、电针组和药物组，后三组又分为1d、3d、7d三个亚组,每组10只。采用酶联免疫吸附法测定大鼠血清肾上腺皮质激素释放激素（CRH）、促肾上腺皮质激素(ACTH)和皮质酮(CORT)水平，利用morris水迷宫检测电针对大鼠认知功能的改善作用。[结果] POCD模型组动物血清中ACTH、CORT和CRH水平较正常组有显著升高(P<0.05或P<0.01)；与模型组相比电针组和药物组血清中ACTH、CORT和CRH水平显著下降(P<0.05或P<0.01),电针组和药物组大鼠在原平台象限停留时间较之模型组均有显著升高（P<0.05或P<0.01）。[结论]手术引起的创伤性应激反应可能是POCD诱发机制之一，电针可通过调节HPA轴对POCD产生治疗作用。
[목적]관찰수술창상응격반응대술후인지공능적영향，탐토전침대술후인지공능장애(postoperation cognitive dysfunction，POCD)간예효응적하구뇌-수체-신상선축（Hypothalamic-pituitary-adrenocortical Axis，HPA축）조절궤제。[방법]장100지자성중노령SD대서수궤분위정상조、모형조、전침조화약물조，후삼조우분위1d、3d、7d삼개아조,매조10지。채용매련면역흡부법측정대서혈청신상선피질격소석방격소（CRH）、촉신상선피질격소(ACTH)화피질동(CORT)수평，이용morris수미궁검측전침대대서인지공능적개선작용。[결과] POCD모형조동물혈청중ACTH、CORT화CRH수평교정상조유현저승고(P<0.05혹P<0.01)；여모형조상비전침조화약물조혈청중ACTH、CORT화CRH수평현저하강(P<0.05혹P<0.01),전침조화약물조대서재원평태상한정류시간교지모형조균유현저승고（P<0.05혹P<0.01）。[결론]수술인기적창상성응격반응가능시POCD유발궤제지일，전침가통과조절HPA축대POCD산생치료작용。
Objective The purpose of this study is to investigate the effect of electroacupuncture of Baihui and Dazhui points on POCD rats ’HPA axis and cognitive function. Furthermore, we want to explore the mechanism of electroacupuncture therapy with hypothalamic-pituitary-adrenal axis in POCD. [Methods]100 famale SD rats were randomly divided into control group, model group, electroacupuncture group and drug group. The model, electroacupuncture and drug groups were furtherly divided into 1 day group, 3 days group and 7 days group. The level of ACTH, CORT and CRH in blood serum was measured by enzyme linked immunoadsorbent assay. The improvement of cognitive function in rats was detected by morris water maze. [Results]Compared with control group, the level of ACTH, CORT and CRH in blood serum of POCD model group, P<0.05 or P<0.01; Compared with model group, the level of ACTH, CORT and CRH of electroacupuncture and drug group decreased( P<0.05 or P<0.01). Electroacupuncture and drug group can make the time of rats staying platform quadrant increaseing( P<0.05 or P<0.01). [Conclution]Stress from surgical trauma may be one of inducing mechanisms of POCD.The electroacupuncture can produce a therapeutic effect on POCD by regulating the sthentic HPA axis.