消化性溃疡的寒热辨证和治疗观察

作者	单位
庞宁海	北京医科大学第一医院中医科
谢竹藩	北京医科大学第一医院中医科
钮淑兰	北京医科大学第一医院中医科
马剑鸣	北京医科大学第一医院中医科
马澜	北京医科大学第一医院中医科
马玉凤	北京医科大学第一医院中医科
张淑娥	北京医科大学第一医院中医科

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中文摘要:

本文报告消化性溃疡62例,按辨证分为寒证组、热证组和无明显寒热证候组。分别测定尿中儿茶酚胺排出量,寒证组降低,热证组增加,无明显寒热证候组与对照组相近。儿茶酚胺的增减,表示交感—肾上腺系统机能活动增强或减弱,可能是溃疡病寒证、热证的物质基础。用自拟中药方治疗后,复查尿中儿茶酚胺,寒证组增加,热证组减少,其作用机理,可能是通过交感—肾上腺系统和副交感神经系统的调节。

英文摘要:

For investigating the nature of"cold"and"heat"syndromes,62 cases of peptic ulcer with or without hemorrhage were studied.According to TCM these 62 cases were classified into 3 categories: "heat"syndrome(23 cases),"cold"syndrome(16 cases)and inapparent"heat or cold"syndrome(23 cases).A urine catecholamines(UC,Epinephrine,norepinephrine and dopamine)were determined in these cases and 26 healthy persons.The UC were increased in"heat"syndrome,while in the"cold" syndrome,on the contrary.UC were decreased and there was no difference of the UC changes in inapparent"heat or cold"syndrome in comparison with healthy persons.After treating with traditional prescriptions(Astragalus meebranaceus,Alpinea officinale,Salvia miltiorrhiza.Saussurea lappa and Glycyrrhiza uralensis)UC were decreased in"heat"syndrome and increased in"cold" syndrome.Thus,these changes can be considered as the characteristic features of"cold"and"heat" syndrome,showing hyperfunctioning of the sympathetico-adrenal medulla system in the cases of "heat"syndrome in contrast with hypofunctioning of sympathetic system and hyperfunctioning of the parasympathetic system in"cold"syndrome,It can be concluded that the dysfunctional state of the sympathetico-adrenal system is one of the fundamental changes upon which the differentiation of"cold"and"heat"syndromes is founded,and the regulation or correction of this disordered state seems to be one of the principles in the treatment with TCM.

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