ET、NO与绝经后骨质疏松症中医证型关系的临床初探

The Primary Clinical Study on Endothelins、Nitrogen Monoxide to Postmenopausal Osteoporosis Syndrome Types of Traditional Chinese Medicine

目的 :分析 ET、NO在 PMOP不同证型间变化的内在联系。方法 :在 1 3 0例 PMOP患者中 ,根据中医辨证分型的原则分为肾阳虚、肝肾阴虚、脾肾阳虚、气滞血瘀四种不同证型。应用酶联免疫法测定患者 E2 、ET,硝酸还原酶法测量 NO的含量 ,应用方差分析方法分析 PMOP患者 ET-1、NO、BMD、E2 在不同证型间的关系。结果 :ET-1、NO、BMD、E2 在气滞血瘀组与肾阳虚衰组中均存在着显著的差异 ;气滞血瘀组 ET-1与其余三组比较明显增高 ,且均具有显著差异。结论 :“肾阳虚损 ,瘀血阻滞”病机转变可能是 PMOP病理演变的一个重要环节 ,肾阳虚衰型绝经后骨质疏松症多发生在绝经后骨质疏松症早期阶段 ,程度较轻 ,而气滞血瘀型绝经后骨质疏松症则多发生在晚期阶段 ,程度相对严重。 ET可作为区别气滞血瘀型 PMOP与其它三型的客观物质指标 ,因此在进行对绝经后骨质疏松症辨证分型过程中 ,可把 ET-1作为气滞血瘀证的微观的检测指标。

Objective:To analyze the variable inherent relationship of ET?NO in the different syndrome types of PMOP patients.Methods:In the 130 cases of PMOP, according to the principle of the differentiation of syndromes,they were divided into four syndrome types ,namely deficiency of Kidney-yang,Yin-deficiency of both the Liver and Kidney, yang- deficiency of both the Spleen and Kidney and blood stasis due to Stagnancy of Qi. The titer of plasma level of ET and serum level of E2 was detected by the competitive binding enzyme linked immunoassay format, and the titer of serum NO level by colorimeteric, the variable inherent relationship of ET?NO in the different syndrome types of PMOP patients were analyzed with analysis of variance.Results:The differences of ET-1?NO?BMD?E2 between deficiency of Kidney-yang group and blood stasis due to Stagnancy of Qi group were all significant; the content of plasma level of ET-1 in blood stasis due to Stagnancy of Qi group was higher than the rest groups,and the differences were all significant.Conclusions:'Kidney-yang is deficient and damaging,and blood stasis will accumulate ', which transformation of pathological mechanism is the important link of pathological mechanism development of PMOP, PMOP of deficiency of Kidney-yang mostly occurs the early stage,and the degree is rather light;however PMOP of blood stasis due to Stagnancy of Qi mostly occurs in the later period,the degree is rather serious relatively. The titer of plasma level of ET may be regarded as the objective examinational index of distinction between blood stasis due to Stagnancy of Qi types and the rest syndrome types of PMOP. For this reason, ET-1 can be considered as the microcosmic material index of blood stasis due to Stagnancy of Qi in the course of PMOP's typing according to syndrome differentiation.