基于中西医临床病证特点的围绝经期失眠动物模型分析

Evaluation of animals models with perimenopausal insomnia based on clinical disease and syndrome characteristics of traditional Chinese medicine and Western medicine

关键词:  围绝经期失眠  中西医  动物模型  吻合度  共病

Key words:  perimenopausal insomnia  traditional Chinese and Western medicine  animal model  consistency  comorbidity

摘要:

失眠是围绝经期女性最常见的睡眠障碍，更是加速神经退行性疾病、心血管代谢疾病等老年慢性共病进程的危险因素。通过分析现有围绝经期失眠（PMI）动物模型的特点及不足，以期对PMI病证结合模型提出建议与展望。系统梳理PMI动物模型构建方法，基于中西医诊断标准及模型评价体系，从造模方法（单因素/多因素诱导）、作用机制、评价指标、模型效度及临床吻合度等维度进行综合分析。现有PMI动物模型可分为单因素（药物、手术、应激诱导）和多因素（药物+应激、手术+应激、手术+药物）两类模型体系。其中，去氧乙烯基环己烯（VCD）联合对氯苯丙氨酸（PCPA）诱导模型在中西医临床吻合度方面表现最优，其既符合西医疾病特征，又能较好体现中医证候特点。目前复合共病的动物模型研究较少，且多以疾病模型为主，缺少病症结合模型的研究。未来应着力构建同时满足西医疾病特征与中医证候特点的复合共病模型，这对深化PMI发病机制研究及药效评价具有重要科学价值。

Abstract:

Insomnia is the most common sleep disorder in the period of perimenopause，and it is also an independent risk factor for accelerating the process of chronic co-morbidities in the elderly，such as neurodegenerative diseases and cardiovascular and metabolic diseases. We analyzed the characteristics and deficiencies of the existing animal models of Perimenopausal insomnia，with the aim of proposing suggestions and perspectives for the combined model of PMI. Animal models of PMI were systematically analyzed based on the diagnostic criteria of Chinese and Western medicine and the model evaluation system，in terms of modeling method（unifactorial/multifactorial induction），mechanism of action，evaluation indexes，model validity，and clinical compatibility. Existing models can be categorized into two types of modeling systems：unifactorial（drug，surgery，stress induction） and multifactorial（drug+stress，surgery+stress，surgery+drug）. Among them，the deoxyvinylcyclohexene（4-VCD） combined with p-chlorophenylalanine（PCPA）-induced model showed the best performance in terms of clinical match between Chinese and Western medicine，which was consistent with the characteristics of the disease in Western medicine，and also reflected the characteristics of Chinese medicine. At present，there are fewer studies on animal models of composite diseases，and most of them are disease models，and there is a lack of research on disease-combination models. In the future，efforts should be made to construct a composite model that meets both the disease characteristics of Western medicine and the symptoms of Chinese medicine，which is of great scientific value to deepen the research on the pathogenesis of PMI and the evaluation of pharmacological efficacy.