失眠患者血清甲状腺激素及多巴胺水平与中医证型的关系

作者	单位
钟静瑜	福建省中医药研究院
曾雪爱	福建省中医药研究院
刘芳	福建省中医药研究院
黄俊山	福建省中医药研究院
樊建锋	福建省中医药研究院

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中文摘要:

目的通过检测失眠患者血清甲状腺激素(TH)、多巴胺(DA)的含量,分析TH、DA的变化与中医证型之间的相关规律性,探讨中医证型的客观化指标。方法根据失眠患者表现,将其分为肝郁化火型、痰热内扰型、阴虚火旺型、心脾两虚型4组,加上健康对照组共5组,每组30例。采用荧光分光光度计测定血清DA含量;采用放射免疫法(RIA)测定血清三碘甲腺原氨酸(T3)、四碘甲腺原氨酸(T4)含量。结果各组间DA、TH水平均有不同程度的差异。DA水平从高到低依次为:对照组>肝郁化火组>阴虚火旺组>痰热内扰组>心脾两虚组;TH水平从高到低依次为:阴虚火旺组>肝郁化火组>痰热内扰组>对照组>心脾两虚组。结论失眠患者血清DA水平高低与病程由短到长,证型从实到虚的动态变化过程相一致;血清DA是构成实证虚证的病理因素之一,可作为失眠症中医虚实辨证的客观指标之一。

英文摘要:

Objective To analyze the correlation between changes of thyroid hormone(TH),dopamine(DA) and Chinese medicine syndrome types by detecting contents of serum TH and DA in insomnia,thus to explore objective indices of Chinese medicine syndrome types.Methods Insomnia patients were assigned to four Chinese medicine syndrome types groups,covering depressed Gan transforming into fire,internal disturbance by phlegm-heat,excessive fire due to yin deficiency,and Xin-Pi deficiency.One healthy control group was set up.Each group consisted of 30 patients or subjects.Serum DA content was determined using spectrophotofluorimetry.Serum levels of 3,5,3’-triiodothyronine(T3) and tetraiodothyronine(T4) were detected using radioimmunoassay(RIA).Results The serum leuels of DA and TH showed difference among groups at various levels.The serum DA level was sequenced from high to low as the control group>the depressed Gan transforming into fire group>the excessive fire due to yin deficiency group>the internal disturbance by phlegm-heat group>the Xin-Pi deficiency group.The serum TH level was sequenced from high to low as the excessive fire due to yin deficiency group>the depressed Gan transforming into fire group>the internal disturbance by phlegm-heat group>the control group>the Xin-Pi deficiency group.Conclusions Serum DA levels in insomnia patients were in line with the disease course and the dynamic change from sthenia to asthenia in Chinese syndrome types.Serum DA levels,as one of pathological factors constituting the sthenia syndrome or the asthenia syndrome,may be taken as an objective indicator in Chinese medicine syndrome typing.

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