充血性心力衰竭患者中医辨证与甲状腺激素变化的相关性研究

Relationship Between Traditional Chinese Medicine differentiation of syndrome and thyroid hormone variability in patients with congestive heart failure

探讨充血性心力衰竭患者中医辨证与甲状腺激素变化的关系。方法 设立正常对照组 ,采用放射免疫法测定血浆三碘甲状腺原氨酸 (T3)、四碘甲状腺原氨酸 (T4 )、反三碘甲状腺原氨酸 (rT3)及促甲状腺激素 (TSH)的浓度 ,对充血性心力衰竭患者进行中医辨证客观化的研究。结果 充血性心力衰竭患者各证型组T3水平下降程度按气阴两亏证、痰饮阻肺证、心肺虚证、气虚血瘀证、心肾阳虚证、阳虚水泛证的顺序递增 ,rT3水平上升程度按气阴两亏证、痰饮阻肺证、心肺虚证、气虚血瘀证、心肾阳虚证、阳虚水泛证的顺序递增(P <0 .0 5 )。结论 T3下降、rT3水平上升在充血性心力衰竭患者各中医证型间具有差异性 ,可作为中医证候的客观表现之一。临床辨证时可以根据T3下降。

Objective To study the relationship between Traditional Chinese Medicine differentiation of syndrome and thyroid hormone variability in patients with congestive heart failure. Methods 120 patients with congestive heart failure in treatment group were differentiated according to Traditional Chinese Medicine differentiation of syndrome and 15 healthy human in control group were observed on T 3, T 4, rT 3 and TSH. Results T 3 in patients with congestive heart failure was decreased progressively in order of qi-yin deficiency syndrome,phlegm retention and obstructive pulmonary syndrome, heart-lung deficiency syndrome, qi deficiency and blood stasis syndrome, heart and kidney yang-deficiency syndrome and syndrome of edema caused by deficiency of yang. rT 3 in patients with congestive heart failure was increased progressively in order of qi - yin deficiency syndrome,phlegm retention and obstructive pulmonary syndrome ,heart-lung deficiency syndrome, qi deficiency and blood stasis syndrome, heart and kidney yang-deficiency syndrome and syndrome of edema caused by deficiency of yang. Conclusion There were differences in T 3 and rT 3 between various kinds of patients with congestive heart failure by Traditional Chinese Medicine differentiation of syndrome. Level of T 3 and rT 3 can be indicators of Traditional Chinese Medicine differentiation of patients with congestive heart failure.