急性脑梗死始发状态证候量值与神经内分泌免疫网络功能指标水平的相关性探讨  

Exploration on correlation of traditional Chinese medicine syndromic quantitative volume and levels of functional parameters about neuroendocinoimmunal network in the patients with acute cerebral infarction during initial state

作　　者：谌剑飞[1] 关少侠[1] 马雅玲[1] 丁萍[1] 梁浩荣[1] 

机构地区：[1]广州中医药大学附属珠海市中医院神经内科,广东珠海519015

出　　处：《中国中西医结合急救杂志》2002年第2期81-83,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：广东省珠海市医药卫生科研基金资助项目 (No.19995 410 )

摘　　要：目的 :探讨急性脑梗死 (ACI)始发状态证候量值与神经内分泌免疫网络 (NEIN)功能指标水平的相关关系 ,提出微观辨证量化意见。方法 :对 338例 ACI患者进行了证候量化标准调查 ,测定了 2 6 6例患者血清下丘脑垂体肾上腺皮质 (HPA)轴激素与免疫细胞因子 ,并与健康人 (30名 )作比较。结果 :1风证、火热证、痰湿证、血瘀证评分量值与 NEIN指标促肾上腺皮质激素释放激素 (CRH)、促肾上腺皮质激素 (ACTH )、皮质醇(CS)、肿瘤坏死因子 α(TNFα)、白介素 6 (IL 6 )水平均呈正相关 (r=0 .19～ 0 .81,P均 <0 .0 1) ,其中风证r=0 .2 5～ 0 .81(P均 <0 .0 1) ,火热证 r=0 .35～ 0 .76 (P<0 .0 5或 P<0 .0 1) ,痰湿证 r=0 .31～ 0 .79(P均 <0 .0 1) ,血瘀证 r=0 .19～ 0 .4 3(P均 <0 .0 1) ;2气虚证量值与 CRH、ACTH、CS、TNFα呈正相关 (r=0 .2 1～0 .2 6 ,P<0 .0 5或 P<0 .0 1) ;3阴虚阳亢证评分量值除与 CS(r=0 .35 ,P<0 .0 1)呈正相关外 ,余各项无明显关系 (P>0 .0 5 )。结论 :1HPA轴激素和细胞免疫因子与 ACI的发生、发展有重要关系 ;2 NEIN功能多指标综合分析 ,有助于中医对 ACI始发状态证候的判别 ;3提出微观辨证新指标与量化意见 ,供参考。Objective:To explore the correlation of traditional Chinese medicine(TCM) syndromic quantitative volume and levels of functional parameters about neuroendocrinoimmunal network(NEIN) in the patients with acute cerebral infarction (ACI) during initial state.Methods:The syndromic quantitative dignosis of 338 cases with ACI during initial state were performed.The serum levels of hypothalamuspituitaryadrenalcortex (HPA) axis hormones and immunal cellular factors were determined in 266 cases and compared with 30 health subject (control group).Results:①The quantitative volumes of 4 TCM syndromes were positively related with levels of parameters on NEIN such as corticotropinreleasing hormone(CRH),adrenocorticotropic hormone(ACTH),cortisol(CS),tumor necrosis factorα(TNFα) and interleukin6(IL6)〔 r =0 19-0 81,all P <0 01;wind syndrome (风证): r =0 25-0 81,all P <0 01;firehot syndrome(火热证): r =0 35 -0 76, P <0 05 or P <0 01,phlegmdampness syndrome (痰湿证): r =0 31-0 79,all P <0 01;blood stasis syndrome (血瘀证): r =0 19-0 43,all P <0 01〕.②The quantitative volume of Qideficiency syndrome (气虚症) were positively related with levels of CRH,ACTH,CS and TNFα ( r =0 21-0 26, P <0 05 or P <0 01).③The quantitative volume of hyperactivity of Yang due to Yindeficiency syndrome (阴虚阳亢证) and levels of NEIN parameters showned no correlation ( r =0 11-0 16,all P >0 05) except CS ( r =0 35 , P <0 05).Conclusions:①The hormones of HPA axis and immunal cellular factors are importantly related with the happening and development of ACI.②Comprehensive analysis of NEIN multiple parameters will be helpful to differentiate the TCM syndrome with ACI during initial state.③Put forward new parameters of differential diagnosis with ACI and the quantitative standard for discussion.

关 键 词：脑梗死 始发状态证候 辨证量化标准 神经内分泌免疫网络相关指标 

分 类 号：R277.7[医药卫生—中医学]