主 办:北 京 中 医 药 大 学
ISSN 1006-2157 CN 11-3574/R

北京中医药大学学报 ›› 2015, Vol. 38 ›› Issue (5): 351-355.doi: 10.3969/j.issn.1006-2157.2015.05.013

• 临床研究 • 上一篇    下一篇

肝炎肝硬化患者促肾上腺皮质激素、糖皮质激素水平与中医证候要素的相关性探讨*

赵丰润1,赵丽红1,王天芳1#,薛晓琳1,吴秀艳1,李永纲2,李宁1,王思颖1,杨慧银2, 江宇泳3,刘燕玲4,陈盛铎5,张秋云6,李秀惠7,毛德文8,张厂9,刘汶10   

  1. 1 北京中医药大学 北京 100029;
    2 解放军第302医院;
    3 首都医科大学附属北京地坛医院;
    4 中国中医科学院西苑医院;
    5 湖北省中医院;
    6 首都医科大学;
    7 首都医科大学附属北京佑安医院;
    8 广西中医药大学第一附属医院;
    9 北京中医药大学东方医院;
    10 首都医科大学附属北京中医医院
  • 收稿日期:2015-01-12 出版日期:2015-05-15 发布日期:2015-05-15
  • 通讯作者: 王天芳,女,博士,教授,博士生导师,主要研究方向:诊法与辨证的规范化、标准化研究,E-mail:tianfangwang2000@163.com
  • 作者简介:赵丰润,男,在读硕士生
  • 基金资助:
    *国家重点基础研究发展计划(973计划)项目(No.2011CB505105),北京中医药大学科研创新团队项目(No.2011CXTD08)

ACTH and GC levels in patients with hepatitis cirrhosis at two stages and their correlation with TCM pattern elements*

ZHAO Feng-run 1, ZHAO Li-hong 1, WANG Tian-fang1#, XUE Xiao-lin 1, WU Xiu-yan 1, LI Yong-gang 2, LI Ning 1, WANG Si-ying 1, YANG Hui-yin 2, JIANG Yu-yong 3, LIU YAN-ling 4, CHEN Sheng-duo 5, ZHANG Qiu-yun 6, LI Xiu-hui 7, MAO De-wen 8, ZHANG Chang 9, LIU Wen 10   

  1. 1 Beijing University of Chinese Medicine, Beijing 100029;
    2 People’s Liberation Army 302 hospital;
    3 Beijing Ditan Hospital, Capital Medical University;
    4 Xiyuan Hospital, China Academy of Chinese Medical Sciences;
    5 The Hubei Provincial Traditional Chinese Medical Hospital;
    6 Capital Medical University;
    7 Beijing Youan Hospital, Capital Medical University;
    8 The First Affiliated Hospital, Guangxi University of Traditional Chinese Medicine;
    9 Dongfang Hospital, Beijing University of Chinese Medicine;
    10 Beijing Chinese Medicine Hospital, Capital Medical University
  • Received:2015-01-12 Online:2015-05-15 Published:2015-05-15

摘要: 目的 比较代偿期与失代偿期肝炎肝硬化患者血清促肾上腺皮质激素(Adrenocorticotropic hormone,ACTH)、糖皮质激素(Glucocorticoid,GC)的水平,探讨其与中医常见病性类证候要素的相关性。方法 研究制定《肝炎肝硬化临床信息采集表》,进行全国多中心的横断面流行病学调查,收集患者的一般情况、症状等信息,采集血液标本并统一检测指标;参照以往制定和发布的肝硬化诊疗共识和原则,结合文献回顾和临床调查结果,并经过专家两轮论证,形成《肝炎肝硬化常见证候要素辨识标准》,根据该标准,判定患者的常见病性类证候要素;分别分析代偿期与失代偿期患者间血清ACTH、GC水平的差异,以及代偿期和失代偿期血瘀、阴虚、湿热、气滞、气虚、阳虚、水停诸病性类证候要素的判定组与非判定组患者间ACTH、GC水平的差异。结果 与代偿期比较,失代偿期患者的ACTH和GC水平均升高,其中GC差异有统计学意义(P<0.05);在代偿期患者中,只有阳虚判定组患者的ACTH水平显著低于非判定组(P<0.05);在失代偿期患者中,只有血瘀判定组患者的ACTH水平显著高于非判定组(P<0.05);诸证候要素(除水停)判定组患者的GC水平显著高于非判定组(P<0.05)。结论 肝炎肝硬化患者的血清ACTH与GC水平反映了疾病的轻重,且初步提示与中医常见病性类证侯要素之间有一定相关性。

关键词: 肝炎肝硬化, 代偿期, 失代偿期, 证候要素, 肾上腺皮质激素, 糖皮质激素

Abstract: Objective To compare the levels of serum adrencortical hormone (Adrenocorticotropic hormone, ACTH), and glucocorticoid (Glucocorticoid, GC) between patients of hepatitis cirrhosis at compensated and decompensated stages, and to evaluate their correlation with common TCM pattern elements. Methods Using a unified “hepatitis cirrhosis clinical information collection list”, which is formulated by this team, we conducted a national multi-center cross-sectional epidemiological survey, to collect the general condition of patients, their symptoms and other information. We also collected their blood samples for standardized laboratory tests. Previously published consensus and guidelines on diagnosis and treatment of hepatic cirrhosis were reviewed. With reference to literature review of clinical investigation, and finally we came up with a“common pattern element identification standard for hepatitis cirrhosis” after two rounds of expert consensus verification process. According to this standard, we can analyze the pattern elements and compare the differences between serum ACTH and GC levels during compensated and decompensated stages, as well as those between the pattern elements of blood stasis, yin deficiency, damp heat, qi stagnation, Qi deficiency, Yang deficiency, and water retention. ResultsCompared with patients at compensated stage, ACTH and GC levels in patients at decompensated stage were elevated, with significant difference in GC levels (P<0.05). In patients at decompensated stage, levels of ACTH in patients with Yang deficiency group was significantly lower than those in groups without it (P<0.05); In patients with blood stasis at decompensated stage, the level of ACTH was significantly higher than those in groups without it (P<0.05), but GC was higher than that of the other groups (P<0.05) in terms of pattern elements (except water retention). Conclusion ACTH and GC levels in patients with hepatitis cirrhosis could reflect the severity of disease, and may suggest a certain correlation with TCM pattern elements of class of common diseases.

Key words: liver cirrhosis, compensated and decompensated stages, pattern elements, ACTH, GC

中图分类号: 

  • R259.75