神经甾体及神经递质与肝气逆证和肝气郁证经前期综合征发病的相关性  

Correlation between Neurotransmitters and Neurosteroids and Premenstrual Syndrome Patients of Gan-yang Ascending Syndrome and Gan-qi Stagnation Syndrome

作　　者：高慧[1] 夏天[2] 乔明琦[3] 张惠云[3] 马月香[3] 

机构地区：[1]承德医学院附属医院中医科,河北承德067000 [2]天津中医药大学一附院妇科,天津300193 [3]山东中医药大学基础医学院,济南250355

出　　处：《中国中西医结合杂志》2012年第11期1503-1507,共5页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金面上项目(No.81072833);山东省博士后创新项目专项资金资助项目(No.200701003);河北省中医药管理局中医药科研计划课题资助项目(No.2009068)

摘　　要：目的检测肝气逆证及肝气郁证经前期综合征(premenstrual syndrome,PMS)的神经-生殖激素,探讨PMS的病因病机和愤怒、郁怒与肝气逆证、肝气郁证PMS发病的相关性,为临床制定规范的PMS证类诊断标准提供理论依据。方法采用HPLC、HPLC-MC、ELISA、放射免疫等技术手段,检测肝气逆证(30例)及肝气郁证(30例)PMS患者卵泡期及黄体期的血清性激素(促卵泡激素、促黄体激素、雌二醇、孕酮、睾酮、催乳素)、血浆神经递质(γ-氨基丁酸、β-内啡肽、谷氨酸、多巴胺、5-羟色胺、肾上腺素、去甲肾上腺素)、神经甾体(别孕烯醇酮、孕烯醇酮、脱氢表雄酮)水平,并与健康对照组(30名)作比较。结果卵泡期所有检测指标各组比较差异无统计学意义。黄体期PMS肝气逆证组与健康对照组比较睾酮有增高趋势(P>0.05);肝气逆证组多巴胺、5-羟色胺高于健康对照组(P<0.05),γ-氨基丁酸低于健康对照组(P<0.05);肝气逆证组及肝气郁证组肾上腺素、去甲肾上腺素高于健康对照组(P<0.05)。肝气逆证组及肝气郁证组孕烯醇酮与别孕烯醇酮低于健康对照组,脱氢表雄酮高于健康对照组(P<0.05);肝气逆证组及肝气郁证组脱氢表雄酮/别孕烯醇酮和脱氢表雄酮/孕烯醇酮2个比值均高于健康对照组,且肝气逆证组高于肝气郁证组(P<0.05)。结论黄体期孕烯醇酮与别孕烯醇酮的降低、脱氢表雄酮的增高、脱氢表雄酮/别孕烯醇酮和脱氢表雄酮/孕烯醇酮比值升高可能是肝气逆证及肝气郁证PMS患者愤怒和郁怒的生物学因素之一。Objective To explore the pathogenesis of premenstrual syndrome （PMS）, and the correlation between anger and depression and PMS of Gan-yang ascending syndrome （GYAS） and Gan-qi stagnation syndrome （GQSS） by detecting the neuro-reproductive hormones of PMS patients of GYAS and GQSS, thus providing theoretical reliance for diagnostic standards for clinical normative PMS. Methods Using techniques such as HPLC, HPLC-MC, ELISA, and radioimmunoassay （RIA）, levels of serum sex hormones （follicle stimulating hormone, luteinizing hormone, estradiol, progesterone, testosterone, and prolactin）, plasma neurotransmitters （γ-aminobutyric acid, β-endorphin, glutamic acid, dopamine, 5-HT, adrenaline, and noradrenaline）, neurosteroids （allopregnenolone, pregnenolone, and dehydroepiandrosterone） in the follicular phase and the luteal phase of PMS patients of GYAS （30 cases） and GQSS （30 cases） were detected, and compared with the healthy control group （30 cases）. Results There was no statistical difference in either index of the follicular phase among the 3 groups. Compared with the healthy control group, the testosterone level in PMS patients of GYAS in the luteal phase showed increasing tendency （P0.05）. The levels of dopamine and 5-HT of PMS patients of GYAS in the luteal phase were higher and the γ-aminobutyric acid level was lower than those of the healthy control group （all P0.05）.The levels of adrenaline and noradrenaline of PMS patients of GYAS and GQSS in the luteal phase were higher than those of the healthy control group （all P0.05）. The levels of allopregnenolone and pregnenolone of PMS patients of GYAS and GQSS in the luteal phase were lower, and the dehydroepiandrosterone level was higher than those of the healthy control group （all P0.05）. The ratios of dehydroepiandrosterone/allopregnenolone and dehydroepiandrosterone/pregnenolone of PMS patients of GYAS and GQSS in the luteal phase were higher than those of the healthy control group （P0.05）. Conclusion

关 键 词：经前期综合征 肝气逆证 肝气郁证 神经递质 神经甾体 性激素水平 

分 类 号：R271.1[医药卫生—中医妇科学]