肝肾阴虚型多发性硬化患者下丘脑-垂体-肾上腺轴功能改变的研究  

Changes of HPAA function in multiple sclerosis patients with syndrome of yin deficiency of liver and kidney

作　　者：樊永平[1] 胡蕊[2] 王苏[3] 

机构地区：[1]首都医科大学附属北京天坛医院,北京100050 [2]北京市和平里医院,北京100013 [3]北京中医药大学东直门医院,北京100700

出　　处：《中华中医药杂志》2014年第11期3412-3415,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：北京市卫生系统高层次卫生技术人才培养计划项目(No.2011-2-09);国家自然科学基金项目(No.81173237);北京市自然科学基金项目(No.7142053)~~

摘　　要：目的:观察多发性硬化(MS)患者肝肾阴虚型、非肝肾阴虚型和正常组有关指标差异,揭示肝肾阴虚型MS与下丘脑-垂体-肾上腺轴(HPAA)功能变化的关系。方法:用酶联免疫吸附法(ELISA)检测30例肝肾阴虚型多发性硬化受试者与30例非肝肾阴虚型多发性硬化受试者上午8:00血清皮质醇(CORT)、促肾上腺皮质激素(ACTH)、促肾上腺皮质激素释放激素(CRH)水平,采用同期在北京天坛医院门诊体检的30名健康自愿者作为对照。结果:肝肾阴虚型MS患者复发次数显著高于非肝肾阴虚型MS患者(P<0.05);与正常组比较,MS患者血清CORT水平显著升高,血清ACTH水平显著降低(P<0.05,P<0.01),血清CRH水平无显著性差异;MS患者血清CORT水平肝肾阴虚型高于非肝肾阴虚型,有显著性差异(P<0.05)。MS患者上午8:00血清CORT水平与性别、年龄、病程、复发次数、EDSS评分、西医分型均无显著相关性,与中医分型相关(P<0.05)。结论:MS患者存在HPAA功能紊乱,CORT、ACTH及CRH分泌紊乱在MS的发病中起重要作用。MS中医证型的CORT浓度水平存在差异,肝肾阴虚型MS患者CORT表达水平明显升高,组间比较存在显著性的差异,相关分析也证实了CORT水平与MS肝肾阴虚的证型存在相关性,MS不同的证型可能与肾上腺皮质激素水平分泌差异有关。Objective： To observe the index differences among multiple sclerosis （MS） patients with syndrome of yin deficiency of liver and kidney and with non-syndrome of yin deficiency of liver and kidney, and healthy people, in order to reveal the relationship between the changes of hypothalamo-pituitary-adrenal axis （HPAA） function and MS patients with syndrome of yin deficiency of liver and kidney. Methods： Elisa was used to test the levels of cortisol （CORT）, adrenocorticotropin （ACTH） and corticotropin releasing hormone （CRH） in patients＇ serum, in comparison to 30 healthy volunteers. Results： The recurrence rate of MS patients with syndrome of yin deficiency of liver and kidney was significantly higher than that of MS patients with non-syndrome of yin deficiency of liver and kidney （P〈0.05）. Compared with healthy people, the CORT level in patients＇ serum was increased significantly, and ACTH level was decreased significantly （P〈0.05, P〈0.01）, but the differences of serum CRH level between the two groups were not significant. CORT level in serum of MS patients with syndrome of yin deficiency of liver and kidney was significantly higher than that of MS patients with non-syndrome of yin deficiency of liver and kidney （P〈0.05）. There was no significant correlation between CORT level and sex, age, disease course, recurrence rate, EDSS score and western sub-type medium, and there was significant correlation between CORT level and traditional Chinese medicine syndrome types （P〈0.05）. Conclusion： The HPAA dysfunction in multiple sclerosis patients. The secretion disorder of CORT, ACTH and CRHplayed an important role in the pathogenesis of MS. The CORT level was different in MS patients with different syndromes, and J!t was increased significantly in MS patients with syndrome of yin deficiency of liver and kidney, which confirmed that CORT level correlated with MS with syndrome of yin deficiency of liver and kidney. The different syndromes of MS might be related to the

关 键 词：多发性硬化 下丘脑-垂体-肾上腺轴 肝肾阴虚 

分 类 号：R277.7[医药卫生—中医学]