基于病证结合模式探讨缺血性中风急性期证候演变与生物学指标表达水平的相关性  

Correlation between progression of the TCM syndromes and expression of the biomarkers in acute phase of ischemic stroke: based on the theory combining disease and syndrome

作　　者：唐璐[1] 高颖[1] 孙塑伦[1] TANG Lu;GAO Ying;SUN Sulun(Department of Neurology,Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine,Beijing100700,China)

机构地区：[1]北京中医药大学东直门医院神经内科,100700

出　　处：《环球中医药》2018年第12期1892-1896,共5页Global Traditional Chinese Medicine

基　　金："十二五"国家科技支撑计划(2014BAI10B05)

摘　　要：目的通过探讨缺血性中风急性期证候与生物学指标的相关性,为完善精准辨证论治提供临床依据。方法采用ELISA法测定急性期缺血性中风病患者起病后72小时内、第7、14天热休克蛋白70(HSP70)、细胞间黏附分子1(ICAM-1)表达水平的变化,采用放免法测定相应时点促肾上腺皮质激素(ACTH)、皮质醇(COR)表达水平的变化,并动态采集四诊信息判断其证候要素,以方差齐性检验和组间比较的统计学方法进行数据分析。结果发病72小时内COR表达水平高或ACTH表达水平低的患者,痰热证持续时间长(P <0. 05);发病72小时内HSP70或ICAM-1表达水平高的患者气虚证持续时间长(P <0. 05)。结论发病72小时内COR表达水平高或ACTH表达水平低的患者,临床中医药干预时应适时延长清热化痰法的治疗时间;发病72小时内HSP70或ICAM-1表达水平高的患者气虚证持续时间长,临床中医药干预时应配合延长补气法的治疗时间。Objective To provide clinical evidences for accurate treatment based on syndrome differentiation by exploring the correlation between the traditional Chinese medicine(TCM)syndromes and biomarkers in acute phase of ischemic stroke.Methods ELISA was used to detect the changes in the expression of heat shock protein70(HSP70)intercellular adhesion molecule-1(ICAM-1)within72h and on the7th day and14th day following disease onset in patients in acute phase of ischemic stroke.Radioimmunoassay was used to detect the changes in the expression of ACTH and COR at the same time points;the syndrome elements were assessed based on the data dynamically collected with the Four TCM Diagnostic Techniques.Statistical analyses including homogeneity of variance test and comparison between groups were performed.Results Within72h of onset,those patients with higher COR expression or lower ACTH expression had longer duration of phlegm-heat syndrome with statistically significant differences;within72h of onset,those patients with higher HSP70or ICAM-1expression had longer duration of the syndrome of qi deficiency with statistically significant differences.Conclusion For those patients with higher COR expression or lower ACTH expression within72h of onset,therapy for clearing heat and eliminating phlegm should be extended appropriately when giving TCM intervention;For those patients those patients with higher SP72or ICAM-1expression within72h of onset,who would have longer duration of the syndrome of qi deficiency,and qi supplementing therapy should be extended appropriately when giving TCM intervention.

关 键 词：病证结合 证候要素 缺血性中风 生物学指标 

分 类 号：R255.2[医药卫生—中医内科学]