Li Rui-li (李瑞麗), Fu Jin-ying (傅金英), Deng Ying-ying (鄧迎瑩), Shen Wen-juan (沈文娟), Ma Hong-li (馬紅麗), Li Wei (李威), Wu Xiao-ke (吳效科)

1 Department of Obstetrics and Gynecology, National Key Discipline and Clinical Base, Heilongjiang University of Chinese Medicine, Harbin150040, China

2 Department of Obstetrics & Gynecology, Henan University of Chinese Medicine, Zhengzhou 450008, China

Critical Review

Review of acupuncture treatment for perimenopausal syndrome

Li Rui-li (李瑞麗)1, Fu Jin-ying (傅金英)2, Deng Ying-ying (鄧迎瑩)1, Shen Wen-juan (沈文娟)1, Ma Hong-li (馬紅麗)1, Li Wei (李威)1, Wu Xiao-ke (吳效科)1

1 Department of Obstetrics and Gynecology, National Key Discipline and Clinical Base, Heilongjiang University of Chinese Medicine, Harbin150040, China

2 Department of Obstetrics & Gynecology, Henan University of Chinese Medicine, Zhengzhou 450008, China

Objective:To summarize the mechanism of acupuncture in treating perimenopausal syndrome (PMS) from the aspects of reproductive endocrinology, immune system, neuroendocrine, the metabolism of free radicals and bone, and the effect of lipid.

Methods:The databases including MEDLINE, EMBASE, CNKI, Wanfang, and CQVIP were searched from the launch of each database to June 2014 for relevant papers involving clinical and laboratory researches about PMS treated with acupuncture.Results:Acupuncture is a safe, effective, and scientific method in treating PMS, and the efficacy is significant.Conclusion:Considering the limits of previous studies, future research should use high technologies such as molecular biology and genetic testing, and adopt multicenter randomized controlled study method to evaluate the efficacy of acupuncture in treating female PMS, and to further explore the mechanism of acupuncture in treating PMS.

Acupuncture Therapy; Perimenopause; Climacteric; Women; Review

As an integral part of traditional Chinese medicine (TCM), acupuncture dates back about 3 000 years[1]. It has been accepted as a complementary and alternative medicine therapy in the United States[2]. The history of using acupuncture to treat female reproductive disorders lasts at least 2 000 years. Acupuncture has been known to regulate the nerve-endocrine-immunity network, free radical metabolism, blood lipid and bone metabolism[3-6], with the advantages of convenience, lower cost and safety.

Perimenopausal syndrome (PMS) is a female reproductive disorder, presenting a series of somatic and psychological symptoms, such as menstrual disorders, anxiety, change of blood pressure, hot flashes[7], depression and sweating, and insomnia. Hormone replacement therapy (HRT) is effective in treating PMS[8], but it has many side effects and increases the risks of cancer[9], pulmonary embolism, and cardiovascular disease[10]. That’s why it is not widely accepted by patients, about 10% in America and less than 1% in China[11]. However, it offers a good chance to acupuncture therapy and the efficacy of acupuncture in treating PMS has been confirmed by a large amount of studies. Therefore, researches on acupuncture in treating PMS have become a core issue.

We reviewed the experiments and clinical trials in which acupuncture was adopted to treat PMS by observing reproductive endocrinology, immune system, neuroendocrine, metabolism of free radicals, lipid, and the metabolism of bone.

1 Mechanism of Acupuncture in Treating PMS

1.1 Regulation of reproductive endocrine system

With gradual degradation of ovarian function andfemale hormone level[12], especially serum estradiol (E2), women in perimenopausal period easily suffer from dysfunction of hypothalamic-pituitary-ovarian axis (HPOA) and a series of clinical symptoms. It’s reported that acupuncture has a content effect in regulating HPOA[13-16]. Researchers have found that acupuncture can increase the level of serum E2, decrease the levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH), and improve clinical symptoms, especially hot flashes[17-19].

Shang YJ, et al[20]believe that the combination of Yuan-Primary points and Back-Shu point can effectively regulate the levels of E2, FSH and LH in PMS, and the effect is more significant than that of conventional acupuncture. Jin H, et al[21]designed a clinical study on acupuncture at the Back-Shu points of the five Zang organs in the treatment of PMS, with a group of subjects treated with oral administration of Premarin tablets as the control. The results showed that the therapeutic efficacy of acupuncture at the Back-Shu points is higher than that of Premarin. Moreover, Qin ZY, et al[22]found that electroacupuncture (EA) at Sanyinjiao (SP 6) can modulate the function of reproductive endocrine in PMS patients. Li Y, et al[23]observed the effects of different acupoints combination in treating PMS. Eighty subjects with PMS were recruited and randomly allocated to a Guanyuan (CV 4) group [selecting Guanyuan (CV 4) and Sanyinjiao (SP 6)] and a Neiguan (PC 6) group [selecting Neiguan (PC 6) and Zusanli (ST 36)], and the results showed that the E2level increased in both groups. In 2009, Liu DH[24]discovered that acupuncture and moxibustion plus psychotherapy can produce an ideal therapeutic effect on female PMS without side effects and the efficacy was higher than acupuncture and moxibustion treatment. Other researchers also found this phenomenon[25-30].

In order to explore the specific mechanisms of acupuncture therapy in treating female PMS, Chen BY, et al[31]designed a trial to study from the perspective of HPOA. The results showed that there was a decrease of blood E2and an increase of the expression of estrogen receptor protein and mRNA in the brain of ovariectomized (OVX) rats; while through stimulating the effective acupoints, EA increased the level of blood E2and suppressed the level of estrogen receptor, and consequently normalized the function of hypothalamicpituitary-ovarian axis. Ma S, et al[32]used quantitative real-time reverse transcription PCR (qRT-PCR) to detect the effects of EA on estrogen receptor alpha (ERα) and beta (ERβ) mRNA and protein expression in the hypothalamus of OVX rats. The results demonstrated that EA treatment could restrain the elevated mRNA and protein expression of ERα and ERβ in hypothalamus of the OVX rats, and also inhibited GnRH mRNA level in OVX rats. This should be a crucial mechanism of EA in treating PMS. This phenomenon had also been confirmed by Li XH, et al[33]. Yao X, et al[34]discovered that EA could increase the level of E2and the expression of prolactin-releasing peptide (PrRP) in the medulla oblongata of OVX rats. These results all suggest that EA can improve the reproductive disorders. Other researches[35-36]in China found that EA may increase E2level via promoting aromatase activity and mRNA expression in adipose and liver tissues, and transforming androgen into estrogen.

1.2 Regulation of immune system

Recently, the exploration of the relationship between menopause and immunity has attracted great attention. Wang WJ, et al[37]proved that splenic estrogen receptor (ER) and serum E2levels were generally down in the aging female rats. Therefore, it’s concluded that the function of immune system should be regulated by ER. In the aging rats, decreased serum E2level leads to the fading of ER in immune cells and then results in low immunity. With the arrival of aging, estrogen decreases because ovarian function declines and the immune function of perimenopausal women is consequently impaired. Li J, et al[38]believe that acupuncture can regulate cellular and humoral immune, and different acupoints can selectively activate different immune system. Chen JX, et al[39]discovered that acupuncture can increase the levels of interleukin (IL)-8, E-selectin and L-selectin, which may be one of the mechanisms that acupuncture regulates immune function. Liu HY, et al[40]reported that EA can improve the immunity of menopausal rats. In other reports, it’s found that EA can regulate estrogen receptor expression of immune cells and enhance immunity.

1.3 Regulation of neuroendocrine system

It’s confirmed that the changes of neurotransmitters should be related to menopause. The neurotransmitters include substance P (SP), β-endorphins (β-EP), 5-hydroxytryptamine (HT), dopamine (DA), epinephrine (E) and so on, which are important in regulating the secretion of Gonadotropin-releasing hormone (GnRH) and interacted with estrogen. The GnRH increases with the elevated SP, E and 5-HT; GnRH decreases with the elevated β-EP and DA. β-EP[41]and DA[42]are comparatively low in PMS patients, but SP, 5-HT and E are comparatively high in PMS patients. Researchers suggested that acupuncture can modulate the neurotransmitters in rats[43-44]. Therefore, acupuncture therapy is effective in improving the neurological disorders in PMS. Hao JW, et al[45]discovered that acupuncture can increase DA andγ-amino-butyric acid (GABA) which can inhibit the release of GnRH; while acupuncture also reduced aspartate (Asp), glutamate (Glu) and 5-HT which can promote the release of GnRH. Bao YX, et al[46]also proved that acupuncture can increase DA in brain issues of rats.

1.4 Regulating the metabolism of free radicals and anti-aging

Free radicals are one of the major causes of aging. They can react with substances such as nucleic acids, proteins and lipids in the body and change them into oxide or peroxide, and subsequently damage the body, resulting in aging and death. During the recent years, the relationship between the free radicals and menopause has attracted the attention of the medical researchers. With the decline of ovarian function and disorders of sex hormone in perimenopausal women, lipid peroxidation increases and the activity of free radical scavenging enzymes decreases[47]. It has been proven that acupuncture can postpone the aging process of cells by eliminating the free radicals and enhancing the activities of anti-oxidases[48].

Li M, et al[49]observed the effects of EA at Yongquan (KI 1) acupoint on the expression of p53 and bcl-2 in the aging rats. The results showed that the p53 gene expression in aging rats was suppressed by EA at Yongquan (KI 1). Cong SY, et al[50]adopted EA to stimulate Zusanli (ST 6) and Guanyuan (CV4) acupoints in the aged female rats, and the results indicated that acupuncture can enhance the level of nitric oxide (NO) and the activity of superoxide dismutase (SOD), and decrease the level of malondialdehyde (MDA) in the rats’ brain, and there was a significant difference compared with the control group. The results were then confirmed by Bai W, et al[51].

1.5 The effects on lipid metabolism

With the decline of ovarian function, the estrogen level also drops in the perimenopausal women. Korljan B, et al[52]believe that the decline of estrogen concentration should be associated with a number of changes in perimenopause: increase of total cholesterol (TC), triglycerides, and low density lipoprotein cholesterol (LDL-C). Therefore, menopause is a process closely related to cardiovascular risk factors[53]. Cai H, et al[54]observed the effect of acupuncture on serum NO content and activity of myeloperoidase in rats with hyperlipoidemia. They concluded that acupuncture can reduce blood lipid, and the mechanism may be related to the inhibition of oxidative state. Li CJ, et al[55]found that acupuncture at Fenglong (ST 40) effectively stopped the increase of blood lipids. Other studies also obtained similar results[56-57]. Another interesting experiment performed in China by Xu TS[58]discovered that acupuncture could decrease the level of TC and LDL-C, and increase the level of high-density lipoprotein cholesterol (HDL-C) in patients with PMS.

1.6 Effects on bone metabolism

Postmenopausal osteoporosis stems from estrogen deficiency, which is because estrogen insufficiency stimulates the formation of both osteoblasts and osteoclasts[59-60]. When osteoblasts become active, osteoblasts will secrete a large amount of alkaline phosphatase (ALP) and deoxypyridinoline (DPD), which is an important part of type I bone collagen matrix. When the bone matrix is dissolved, bone collagen protein will hydrolyze to be DPD, which will then come into blood. DPD can be also discharged directly from the kidney in the form of prototype, which reflects the situation of bone resorption. One experiment was done by Li J, et al[61], showing that acupuncture improves the level of serum ALP and reduces the level of DPD in the osteoporosis rats, consequently promoting bone formation and inhibiting bone resorption, thus preventing the occurrence of osteoporosis in ovariectomized rats. Other researchers in China[62]had also achieved the similar results.

2 Summary and Future Directions

Recent clinical and experimental studies have confirmed that acupuncture therapy is effective in treating PMS by improving clinical symptoms such as menstrual disorders, hot flashes, sweating, insomnia, and mood disorders. The mechanism of acupuncture in treating PMS includes the following aspects: regulation of reproductive endocrine system, i.e. increasing the level of estrogen, decreasing the levels of FSH and LH, increasing the expression of estrogen receptor protein, inhibiting the release of GnRH, and transforming androgen into estrogen; regulation of immune system, i.e. increasing the levels of E-selectin and L-selectin, regulating estrogen receptor expression in immune cells; regulation of neuroendocrine system, i.e. increasing DA and GABA, decreasing Asp and Glu; modulation of free radicals, i.e. enhancing the content of NO and the activity of SOD; modulation of blood lipids, i.e. suppressing oxidative stress state of organism; regulation of bone metabolism, i.e. increasing the level of serum ALP and reducing the level of DPD. Therefore, acupuncture now has been widely accepted as an effective treatment for PMS by many countries.

These trials are the bases for further researches on the mechanism and action pathways of acupuncture therapy in treating PMS. They also offer an innovative treatment approach for perimenopausal women rather than using herbal medicine or Western medicine alone. However, to improve the quality of acupuncture researches, future clinical and experimental studies should have a rigorous and standard design, such as increasing the sample size, employing the methods of blinding (i.e. blinding to observer and patient), paying attention to the details of acupuncture, and the training of acupuncturists.

Conflict of Interest

There was no conflict of interest in this article.

[1] Ng EH, So WS, Gao J, Wong YY, Ho PC. The role of acupuncture in the management of subfertility. Fertile Steil, 2008, 90(1): 1-13.

[2] Chou W, Bringhurst JC. Neuroendocrine mechanisms of acupuncture in the treatment of hypertension. Evid Based Complement Alternat Med, 2012: ID878673.

[3] Zhang XZ, Peng YM, Yu JC, Liu CZ, Han JX. Effects of acupuncture on expression of OPG and BMP-2 in SAMP6 mouse with osteoporosis. Zhonghua Zhongyiyao Zazhi, 2008, 23(8): 672-675.

[4] Xie JP, Nong Y, Jia JJ, Li W, Zhang LF, Chen X, Li XH, Gao Y. Efficacy comparison of needling Fenglong (ST 40) and coordinated acupoints for regulating blood lipid level in rats with hyperlipemia. Beijing Zhongyiyao Daxue Xuebao, 2008, 31(2): 141-144.

[5] Yu JS, Zeng BY, Hsieh CL. Acupuncture stimulation and neuroendocrine regulation. Int Rev Neurobiol, 2013, 111: 125-140.

[6] Eshkevari L, Permaul E, Mulroney SE. Acupuncture blocks cold stress induced increases in the hypothalamuspituitary-adrenal axis in the rat. J Endocrinol, 2013, 217(1): 95-104.

[7] Cooper GS, Baird DD, Darden FR. Measures of menopausal status in relation to demographic, reproductive, and behavioral characteristics in a population-based study of women aged 35-49 years. Am J Epidemiol, 2001, 153: 1159-1165.

[8] Xu L. Scientific analysis of the merits and demerits of HRT. Zhonghua Fuchanke Zazhi, 2002, 37(10): 577-579.

[9] Gompel A. Micronized progesterone and its impact on the endometrium and breast versus progestogens. Climacteric, 2012, 15(1): 18-25.

[10] Mueck AO. Postmenopausal hormone replacement therapy and cardiovascular disease: the value of transdermal estradiol and micronized progesterone. Climacteric, 2012, 5(1): 11-17.

[11] Lu HB, Yang XZ. The status of epidemiological studies on perimenopausal syndrome. Guangxi Yixue, 2001, 23(5): 1131-1134.

[12] Kakkar V, Kaur D, Chopra K, Kaur A, Kaur IP. Assessment of the variation in menopausal symptoms with age, education and working/non-working status in north-Indian sub population using menopause rating scale (MRS). Maturitas, 2007, 57(3): 306-314.

[13] Chen BY. Acupuncture normalizes dysfunction of hypothalamic-pituitary-ovarian axis. Acupunct Electrother Res, 1997, 22(2): 97-108.

[14] Zhao H, Tian ZZ, Chen BY. Electroacupuncture stimulates hypothalamic aromatization. Brain Res, 2005, 1037(1-2): 164-170.

[15] Cheng K, Tian SL. Effects of preventiveelectroacupuncture of “Guanyuan” (CV 4) and “Sanyinjiao”(SP 6) on hypothalamus-pituitary-ovary axis in ovariectomized rats. Zhen Ci Yan Jiu, 2012, 37(1): 15-19.

[16] Hu L, Wang HL, Gao XZ, Shen XM, Jin R, Zhu QC, He ZB. Comparison of regulative effects of electroacupuncture at “Guanyuan” (CV 4) and “Sanyinjiao” (SP 6) on sex hormones and hypothalamic β-endorphin in perimenopausal model rats. Zhongguo Zhen Jiu, 2004, 24(9): 649-651.

[17] Tian HZ, Zhang CY, Duan SM. The combined use of acupuncture and Chinese medicines for treatment of menopausal syndrome: a clinical report of 63 cases. Zhongyi Zazhi, 2008, 28(1): 3-4.

[18] Zhou J, Qin ZY, Li WL, Zhang CP, Tian LY, Zhang YJ, Hu L. Clinical observation on therapeutic effect of electroacupuncture at Sanyinjiao (SP 6) on peri-menopausal syndrome. Zhongguo Zhen Jiu, 2006, 26(9): 617-620.

[19] Zhou K, Jiang J, Wu J, Liu Z. Electroacupuncture modulates reproductive hormone levels in patients with primary ovarian insufficiency: results from a prospective observational study. Evid Based Complement Alternat Med, 2013: ID657234.

[20] Shang YJ, Bhang Y, Kong LL, Wang YY, Wang DS, Li J. Clinical observation on combination of source point and Back-Shu point for treatment of perimenopausal syndrome. Zhongguo Zhen Jiu, 2009, 29(6): 444-448.

[21] Jin H, Liu TT, Wang R. Clinical observation on acupuncture at the five-zangshu for treatment of perimenopausal syndrome. Zhongguo Zhen Jiu, 2007, 27(8): 572-574.

[22] Qin ZY, Ling H, Xia XH, Meng L, Wu ZJ. Effects of electroacupuncture of Sanyinjiao (SP 6) on genitoendocrine in patients with perimenopausal syndrome. Zhen Ci Yan Jiu, 2007, 32(4): 255-259.

[23] Li Y, Xia Y, Liu SM, Ju ZY, Shi XL, Chen MG, Cheng L, He JS. Effect of electroacupuncture on serum sex hormones in patients with perimenopausal syndrome. Shanghai Zhenjiu Zazhi, 2010, 29(4): 199-201.

[24] Liu DH. Observations on the efficacy of acupuncture and moxibustion plus psychotherapy in treating female climacteric syndrome. Shanghai Zhenjiu Zazhi, 2009, 28(7): 373-374.

[25] Wei XC, Zhang XX, Chen DY, Xie XL. Observation and nursing of 60 cases of perimenopausal syndrome treated with abdominal acupuncture. Dangdai Huli, 2012, 4(4): 105-107.

[26] Chen XL, Luo RH. Clinical observation of electroacupuncture treatment for menopausal syndrome. Zhenjiu Linchuang Zazhi, 2013, 29(8): 35-37.

[27] Xia XH, Hu L, Qin ZY, Zhou J, Li M, Li WL, Tian LY, Zhang YJ. Multicentral randomized controlled clinical trials about treatment of perimenopausal syndrome with electroacupuncture of Sanyinjiao (SP 6). Zhen Ci Yan Jiu, 2008, 33(4): 262-266.

[28] Sunay D, Ozdiken M, Arslan H, Seven A, Aral Y. The effect of acupuncture on postmenopausal symptoms and reproductive hormones: a sham controlled clinical trial. Acupunct Med, 2011, 29(1): 27-31.

[29] Su CM, Jiang LJ, Yu LJ. Clinical observation on perimenopausal syndrome treated by acupuncture. Dalian Yike Daxue Xuebao, 2007, 29(4): 380-381.

[30] He JS, Liao JQ, An XY, Xu JM, Wang J. Analysis of the clinical effect of electroacupuncture on peri-climacteric syndrome. Shanghai Zhenjiu Zazhi, 2005, 24(12): 3-5.

[31] Chen BY, Cheng LH, Gao H, Ji SZ. Effects of electroacupuncture on the expression of estrogen receptor protein and mRNA in rat brain. Shengli Xuebao, 1998, 50(5): 495-500.

[32] Ma S, Wu J, Feng Y, Chen B. Elevated estrogen receptorexpression in hypothalamic preoptic area decreased by electroacupuncture in ovariectomized rats. Neurosci Lett, 2011, 492(2): 109-113.

[33] Li XH, Zheng L, Xie JP, Zhang LF, Zhai JH, Zhou J, Tian YC, Zhou DF, He YW, Qu LM. Experimental study on changes of expressions of ER-alpha and ER-alpha mRNA in different hypothalamic nuclei and the affect of“preventive acupuncture and moxibustion” in ovariectomy rats. Zhongguo Zhen Jiu, 2008, 28(12): 918-922.

[34] Yao X, Wang XQ, Ma SL, Chen BY. Electroacupuncture stimulates the expression of prolactin-releasing peptide (PrRP) in the medulla oblongata of ovariectomized rats. Neurosci Lett, 2006, 411(3): 243-248.

[35] Cheng LN, Du GZ, Chen BY. The biochemical mechanism of electroacupunctrue regulation of dysfunctional hypothalamic-pituitary-ovarian axis in ovariectomized rats. Shanghai Zhenjiu Zazhi, 2001, 20(6): 32-34.

[36] Horvath TL, Roa-Pena L, Jakab RL, Simpson ER, Naftolin F. Aromatase in axonal processes of early postnatal hypothalamic and limbic areas including the cingulate cortex. J Steroid Biochem Mol Biol, 1997, 61(3-6): 349-357.

[37] Wang WJ, Yu J, Li DJ, Bu SZ. Observation on the changes of splenic ER, IL-2and TNF levels in aging female rats. Zhonghua Neifenmi Daixie Zazhi, 1999, 15(4): 225-228.

[38] Li J, Cui JM, Bao JT, Jia YS, Yao RM. Explore the relationship between acupuncture effect and modern immune. Shizhen Guoyi Guoyao, 2010, 21(8): 2058-2060.

[39] Chen JX, Liu YY, Guo Y, Chen SB, Guo YM. Experimental study of acupuncture Zusanli (ST 36) on the effect of the concentration of partial immune substances in healthy rats. The 2nd Conference on Pricking Cupping of China Association of Acupuncture-moxibustion, 2012: 78.

[40] Liu HY, Wang B. Effect of electrical acupuncture on neuroendocrine of rats during climacteric period. Jiangsu Zhongyiyao, 2003, 24(1): 49-51.

[41] Brown ER, Harlan RE, Krause LE. Gonadal steroid regulation of substance P (SP) and SP-encoding messenger ribonucleic acids in the rat anterior pituitary and hypothalamus. Endocrinology, 1990, 126(1): 330-334.

[42] Yan LJ, Wang XQ, Guo SZ. Opioid peptide with its receptor and female reproductive endocrinology. Shanxi Yike Daxue Xuebao, 2003, 34(4): 374-376.

[43] Yu JS, Zeng BY, Hsieh CL. Acupuncture stimulation and neuroendocrine regulation. Int Rev Neurobiol, 2013, 111: 125-140.

[44] Guan F, Ma SL, Chen BY. Effects of electro-acupuncture on signal transduction pathway of hypothalamic neuroendocrine system in ovariectomized rats. Zhongxiyi Jiehe Xuebao, 2009, 7(6): 563-568.

[45] Hao JW, Ma SL, Jiang JW, Chen BY. A study of in vitro effects by nucleus microinjection of acupuncture push-pull perfusion fluid from preoptic area of ovariectomized rats. Shanghai Zhenjiu Zazhi, 2006, 25(9): 46-50.

[46] Bao YX, Lü GH. Effect of acupuncture on dysmnesia and monoamine neurotransmitter of dementia mice. Shanghai Zhenjiu Zazhi, 2003, 22(7): 23-25.

[47] Fang YR, Wang LJ, Zhou X. The changes of serum sex hormone levels, free radicals, and lipid content in perimenopausal women. Shiyong Fuchanke Zazhi, 2004, 20(3): 151-152.

[48] Lin SR. Effect of acupuncture “Shenshu” (BL 23) and“Guanyuan” (CV 4) on the activity of renal tissue antioxidant enzyme in aging rats. Zhongyiyao Xuekan, 2005, 23(3): 538.

[49] Li M, Wang G, Zhang W, Wang MQ, Zhang YZ. Effects of electroacupuncture of yongquan acupoint on the expression of p53 and bcl-2 in aging model rats. Zhongguo Linchuang Kangfu, 2004, 8(9): 1788-1790.

[50] Cong SY, Li YD, Li JN, Wu HC. The experimental research on influence of the content of the NO, SOD and MDA by needling “Zusanli” and “Guanyuan” point of brain tissues of the old pantheress big rats. Zhenjiu Linchuang Zazhi, 2006, 22(9): 47-48.

[51] Bai W, Jiang GH, Xu Q, Zhang FL. Effect of acupuncture“Zusanli” (ST 36) and “Guanyuan” (CV 4) on the content of NO, SOD and MDA in menopausal female rats. Zhongyiyao Xuebao, 2009, 37(6): 90-91.

[52] Korljan B, Bagatin J, Kokic S, Berovic Matulic N, Barsic Ostojic S, Dekovic A. The impact of hormone replacement therapy on metabolic syndrome components in perimenopausal women. Med Hypotheses, 2010, 74(1): 162-163.

[53] Eshtiaghi R, Esteghamati A, Nakhjavani M. Menopause is an independent predictor of metabolic syndrome in Iranian women. Maturitas, 2010, 65(3): 262-266.

[54] Cai H, Yuan AH. Effect of acupuncture on NO contents of serum and activity of myeloperoxidase in rat with hyperlipoidemia. Hebei Zhongyi, 2010, 32(9): 1404-1406.

[55] Li CJ, Cheng XS, Li CY, Cui MZ, Sun ZR. Regulative effects of acupuncture at Fenglong (ST 40) acupoints on the blood lipids of normal rats and those with hyperlipemia. Zhongguo Linchuang Kangfu, 2005, 9(27): 86-87.

[56] Rerksuppaphol L, Rerksuppaphol S. A randomized controlled trial of electroacupuncture at body acupoints and Fenglong for regulating serum lipids in dyslipidemic patients in Thailand. Complement Ther Clin Pract, 2014, 20(1): 26-31.

[57] Xie JP, Li XH, Zhang LF, Chen K. Experimental study on the effects of puncturing different points on blood lipid in rats with hyperlipemia. Beijing Zhongyiyao Daxue Xuebao, 2003, 26(5): 80-83.

[58] Xu TS. Research on auricular acupuncture combined with body acupuncture for menopausal syndrome. Xiandai Zhongxiyi Jiehe Zazhi, 2004, 13(17): 2269-2270.

[59] DeSlem CJ, Takahata Y, Warren J, Chappel JC, Khan T, Li X, Liu C, Choi Y, Kim YF, Zou W, Teitelbaum SL. IL-17 mediates estrogen-deficient osteoporosis in an Act1-dependent manner. J Cell Biochem, 2012, 113(9): 2895-2902.

[60] Lukefahr AL, Frye JB, Wright LE, Marion SL, Hoyer PB, Funk JL. Decreased bone mineral density in rats rendered follicle-deplete by an ovotoxic chemical correlates with changes in follicle-stimulating hormone and inhibin A. Calcif Tissue Int, 2012, 90(3): 239-249.

[61] Li J, Wang Y, Li P. Biochemical research on effect of acupuncture and moxibustion on bone metabolism in castrated rats. Tianjin Zhongyiyao, 2008, 25(1): 26-28.

[62] Ma J, Hu YG, Zhang DH. Effects of acupuncture on bone metabolism and serum estradiol level in ovariectomyinduced osteoporosis rats. Zhen Ci Yan Jiu, 2008, 33(4): 235-239.

針刺治療圍絕經(jīng)期綜合征的研究進(jìn)展

目的：從生殖內(nèi)分泌、免疫系統(tǒng)、神經(jīng)內(nèi)分泌、自由基和骨的新陳代謝、血脂改變的角度，總結(jié)針刺治療圍絕經(jīng)期綜合征的機(jī)制。方法：檢索了截止到2014年6月發(fā)表的臨床和實(shí)驗(yàn)的針刺治療圍絕經(jīng)期的研究，檢索數(shù)據(jù)庫(kù)包括MEDLINE，EMBASE，CNKI，萬(wàn)方和重慶維普。結(jié)果：針刺治療圍絕經(jīng)期綜合征是安全的、有效的、科學(xué)的，療效是顯著的。結(jié)論：以前的研究存在一定的局限性，以后再開(kāi)展研究時(shí)，應(yīng)采用諸如分子生物學(xué)、基因檢測(cè)等高科技，也應(yīng)開(kāi)展更多的隨機(jī)對(duì)照臨床試驗(yàn)來(lái)評(píng)估針刺治療圍絕經(jīng)期綜合征的療效，進(jìn)一步探討針刺治療圍絕經(jīng)期綜合征的機(jī)制。

針刺療法; 圍絕經(jīng)期; 更年期; 婦女; 綜述

R246.3 【

】A

27 August 2014/Accepted: 15 October 2014

Author: Li Rui-li, M.D. candidate

Wu Xiao-ke, professor.

E-mail: Email:xiaokewu2002@vip.sina.com