地中海贫血患者肾虚三证与NEI网络关系的临床研究  

Clinical Studies of the Relationship of Thalassemia with Three Types of Kidney Deficiency and NEI Network

作　　者：褚娜利[1] 吴志奎[1] 张新华[2] 王文娟[3] 程艳玲[1] 方素萍[1] 

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]中国人民解放军第303医院,北京100053 [3]首都医科大学,北京100053

出　　处：《辽宁中医杂志》2015年第6期1187-1191,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家重点基础研究发展计划"973"计划资助项目(2010CB530406);国家自然科学基金资助项目(81173167);国家科技重大专项资助项目(2009ZX09301-005)

摘　　要：目的:通过对肾阳虚、肾阴虚、肾精不足证地中海贫血与神经内分泌免疫相关性研究,初步了解地中海贫血患者及3种证型之间神经内分泌免疫系统的功能,并探讨地贫患者血红蛋白水平和中医证候积分严重程度与神经内分泌免疫指标的相关性。方法:收集符合西医诊断标准的地中海贫血患者36例,按照中医辨证分型标准分为肾精不足证组(13例),肾阳虚组(9例),肾阴虚组(14例)。正常人7例。对36例地中海贫血患者进行中医证候量化评分并检测主要血液参数血红蛋白(Hb)水平。检测36例地中海贫血患者和7例正常人的神经内分泌免疫等指标,分析地贫3种证型Hb水平和中医证候量化评分与神经内分泌指标的相关性。结果:36例地中海贫血患者和正常人比较,睾酮、5-HT、DA、CA、γ-干扰素水平显著降低(P<0.01或P<0.05)。TSH、皮质醇、ACTH的水平与正常人相比降低。肾阴虚证的地中海贫血患者TSH水平高于正常人、肾阴虚证者、肾精不足证者(P<0.05)。3种证型的地中海贫血患者睾酮、5-HT水平均低于正常人(P<0.05)。肾阴虚证和肾精不足证患者γ-INF水平低于正常人(P<0.05)。36例地中海贫血患者Hb水平与NA、Ach、IL-1的水平呈负相关(P<0.05);13例肾精不足证的地中海贫血患者ACTH、5-HT、DA的水平与Hb水平呈正相关(P<0.01或P<0.05),与Ach水平呈负相关。9例肾阳虚证的地中海贫血患者Hb水平与睾酮水平呈正相关(P<0.01)。肾精不足证的地中海贫血患者中医证候总积分与TSH、Ach、NA、IL-1、IL-2水平呈正相关(P<0.05或P<0.01),肾阳虚证的地中海贫血患者中医证候总积分与皮质醇水平呈正相关(P<0.05)。地中海贫血患者的16个神经内分泌免疫指标之间呈显著、极显著相关的对子有40个,说明地中海贫血患者神经内分泌免疫之间呈现复杂的相关性。结论:地中海贫血患者神经内分泌免疫网络的调节作用是一个多成�Objective:Through the correlation research between three types of kidney deficiency with thalassemia and neuroendocrine immune system,we would preliminary had an understanding of the funtions of neuroendocrine immune system between three types of kidney deficiency,and wanted to explore the correlation between Hb levels and the quantity score of TCM syndrome with the index of neuroendocrine immune system. Methods:36 patients with thalassemia who met the western medicine diagnosis standard were divided into 13 cases of kidney essence deficiency,14 cases of kidney- yin deficiency and 9 cases of kidney- yang deficiency. 7 cases of normal persons were included in the clinical study. Detecting the hemoglobin( Hb) level,the quantitative score of TCM syndromes and the indicators of neuroendocrine immune system,we analyzed the relevance between Hb level and the quantitative score of TCM syndromes with neuroendocrine immune indicators. Results:Compared to normal people,the levels on the patients with thalassemia of testosterone,5- HT,DA,CA,γ- INF were significantly lower( P < 0. 01 or P < 0. 05). The levels of TSH on the patients of kidney- yin deficiency were higher than that of the patients of kidney- yang deficiency,the patients of kidney essence deficiency and the normal people( P < 0. 05),the levels of testosterone and 5- HT on three types of patients were lower than that of the normal people( P < 0. 05). The levels of γ- INF on the kidney essence deficiency and kidney- yin deficiency patients. The levels of Hb of 36 patients were negatively correlated with the levels of IL- 1,NA,Ach( P < 0. 05);the levels of Hb of 13 patients with kidney essence deficiency were positively correlated with ACTH,5- HT,DA( P < 0. 01 or P <0. 05) and negatively correlated with the level of Ach. The levels of total quantitive score of TCM syndrome on patients of kidney essence deficiency were positively correlated with the levels of TSH,Ach,NA,IL- 1and IL- 2( P < 0. 05 or P < 0. 01). The levels of total quantitive score of TCM syndrome o

关 键 词：地中海贫血 肾阳虚证 肾阴虚证 肾精不足证 神经内分泌免疫 

分 类 号：R556.61[医药卫生—血液循环系统疾病]