脾虚、肾虚证及脾肾相关的客观化研究

Objective research on splenic asthenia,nephrasthenia syndrome and correlation between spleen and kidney

目的:了解近年来国内有关脾虚证、肾虚证、脾肾相关方面的现代研究成果,为今后进一步的试验研究提供回顾性文献资料。资料来源:应用计算机检索中国期刊全文数据库1989-07/2006-04期间的相关文章,检索词为“脾虚,肾虚,脾肾相关,实验研究”,并限定文章语言种类为中文。资料选择:对资料进行初筛,并查看每篇文献后的引文。纳入标准:文章所述内容应与脾虚、肾虚或脾肾相关的研究性文献。排除标准:重复研究或Meta分析类文章。资料提炼:共收集到340篇相关文献,48篇文献符合纳入标准,排除的292篇文献为内容陈旧或重复。符合纳入标准的48篇文献中,21篇涉及脾虚证的现代研究,20篇涉及肾虚在神经内分泌免疫网络系统、基因表达等方面的研究,7篇涉及脾肾相关的研究。资料综合:中医证的研究一直是中西医结合证本质研究的重要课题,近年来随着临床病证诊断标准的规范化和实验动物模型的建立,脾虚、肾虚证的研究已经取得了重大的发展。关于脾虚证的实验研究分别从胃肠道功能、免疫和微循环等方面入手,切合中医“脾为后天之本”的理论。肾虚证的研究主要是从下丘脑-垂体轴这一论点入手,似与“肾为先天之本”有所契合,而五脏相关中的脾肾相关仍处于初始阶段,在单一动物造模方面、研究思路方面需要有长足的研究和发展。结论:在现代科学技术和方法更新的前提下,脾虚、肾虚证本质的研究发展迅速,而脾肾相关方面的研究仍处于初始阶段。脾肾相关研究重点要解决的是整体动物模型与病症相结合,从单一动物模型来阐明脾肾的互相关系,这样更符合中医“脾虚及肾”的理论。

OBJECTIVE： To investigate the latest research literatures on splenic as- thenia, nephrasthenia syndrome and correlation with spleen and kidney so as to provide retrospective references for further researches. DATA SOURCES： By using the key terms of＂splenic asthenia, nephrasthenia, correlation with spleen and kidney, trial research＂, a computerbased online search was undertaken to identify relevant articles in Chinese from Chinese Journal Full-Text Database from July 1989 to April 2006. STUDY SELECTION： Primary review of the materials was performed, and every piece of quotation was looked over. Articles about splenic asthenia, nephrasthenia or correlation with spleen and kidney researches were included, and exclusion criteria were repetitive study or Meta analysis. DATA EXTRACTION： Totally 340 interrelated articles were collected, and 48 pieces of them were used in accordance with the inclusion criteria, while other 292 excluded articles were repetitive or old study. Among 48 included articles, 21 were related with modern researches of splenic asthenia, 20 on nephrasthenia syndrome in aspect of neuroendocrine immunity network system and gene expression, and 7 in accordance with correlation with spleen and kidney. DATA SYNTHESIS： It is constantly a important topic in the research of combination of traditional Chinese medicine （TCM） with western medicine symptom-complex nature on study of TCM symptom-complex. With the recent development of diagnostic criteria on clinical disease syndrome and standardized experimental animals model, the study about splenic asthenia and nephrasthenia syndrome already gains a substantial improvement. Modern empirical researches on splenic asthenia syndrome mainly include the gastrointestinal tract function, immune and microcireulation, which gather TCM theory about ＂the spleen being the foundation of acquired constitution＂. With regard to the study of nephrasthenia syndrome, it gets a chief clue from hypothalamus appendices and seems to accord ＂the kidney being the origin of congenital constitution＂. Correlation with spleen and kidney among five solid organs still remains at initial phase, so there is a strong development between making animal norm and study method. CONCLUSION： With the development of modern science technology and method, substance of splenic asthenia and nephrasthenia syndrome gets a rapid improvement, but research on correlation with spleen and kidney only have a first step and emphasize on the integration of animal model into disorder, as so to be illuminated by single animal model, furthermore it benefits to correspond with TCM theory about interrelation of spleen and kidney.