滋肾阴、温肾阳中药拮抗短程地塞米松反馈抑制作用的临床观察

Observation on the Role of Nourishing Shen Yin and Warming Shen Yang Drugs in Resistance to the Suppression of the Activity of HPA Axis Aroused by Short-Term Administration of Dexamethasone

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中文关键词: 地塞米松抑制试验血浆皮质醇抑制作用温补肾阳临床观察治疗效应中药滋阴泻火昼夜节律温肾阳

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基金项目:

作者	单位
沈自尹	上海第一医学院华山医院脏象研究室
张玲娟	上海第一医学院华山医院脏象研究室
陈素珍	上海第一医学院华山医院脏象研究室
张新民	上海第一医学院华山医院脏象研究室
吴波水	上海第一医学院华山医院脏象研究室
涂灏	上海市康定路地段医院
黄杰	上海市康定路地段医院

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中文摘要:

我们在探寻某些中药与激素同用时,能减少激素的反馈抑制作用,而又不减弱其治疗效应的过程中,曾采用地塞米松(Dex)对血11羟昼夜节律的抑制试验,发现滋阴泻火药与温补肾阳药均有一定的对抗地塞米松对清晨皮质醇分泌高峰的抑制作用。现进一步采用短程(5天)接近于临床治疗剂量的地塞米松抑制试

英文摘要:

A suppressive test to HPA axis was made,in which,short-term(5 days)Dexamethasone approximate to the clinical dosage was used.1.5mg of Dexamethasone were taken orally by 11 normal volunteers twice a day,5 days consecutively,and the values,of the plasma corticosteroids of these volunteers were measured at 8AM every other day.A diagram of inhibitory curve was obtained,in which the level of plasma corticosteroids measured on the third and fifth day was remarkably inhibited and dropped,and on the seventh day the level of plasma corticosteroids ascended gradually. Various groups of TCM drugs(Group of Tab.Warming Yang,Group of Rehmannia Root plus Anemarrhena Rhizome,Group of Rehmannia Root and Group of Anemarrhena Rhizome)were used in the tests to find their resistance to the suppression of the activity of HPA axis.The levels of plasma corticosteroids appeared:(1)Anemarrhena Rhizome had remarkable action resistant to the suppression of the activity of HPA axis,which was aroused by the administration of Dexamethasone;and on the third or the fifth day,its action was the most effective in all groups.(2)Tab.Warming Yang had remarkable action resistant to the suppression of the activity of HPA axis on the fifth day;and on the seventh day,i.e.the second day after the withdrawal of Dexamethasone,the level of plasma corticosteroids,which had been inhibited by the administration of Dexamethasone,was significantly promoted,and returned earlierthan in all other groups. Clinically and in animal experiments,it was proved that drugs of nourishing Shen Yin and warming Shen Yang did not weaken the pharmacological or curative effect of corticosteroids when they were coordinated with the administration of corticosteroids. This series suggested that Anemarrhena Rhizome should be coordinated with while short-term large dose of corticosteroids was used clinically,whereas the drugs of warming Yang should be taken to coordinate with long-term medium or small dose of corticosteroids in order to protect HPA axis function from the suppressive activity caused by the administration of extra source glucocorticosteroids.

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