中医热证实质研究

Heat Syndrome of Traditional Chinese Medicine

目的本文对我们以往热证实质研究课题的临床及实验研究成果进行了初步汇总,以期为中医热证本质研究、热证虚实辨证及热证动物模型研究提供更加充分的理论及实验依据。方法本研究从物质及能量代谢角度出发,重点考察热证不同状态(实热证、虚热证)下,甲状腺激素水平、甲状腺超微结构、肝细胞超微结构、肝细胞线粒体立体形态计量以及肝细胞线粒体琥珀酸脱氢酶活性,同时进行了中药疗效观察。结果虚热证的产生可能与甲状腺激素有关,而实热证可能与之无关。实热证、虚热证模型大鼠机体能量代谢都比较旺盛,机体产能和耗能增加,但实热证不如虚热证变化显著,且二者病理基础不同。清热解毒、滋阴清热中药对热证状态下大鼠的各项病理改变具有一定保护作用。结论根据研究结果推断血清T3、T4r、T3、TSH和甲状腺超微结构改变可作为中医热证虚、实辨证的有效指标。热证与机体能量代谢变化趋势呈正相关。

Objective To offer the theory and experimental basis more fully for studies on the heat syndrome of Traditional Chinese medicine. In this paper, we summarized our past outcomes of clinical and experimental research on the physiopathology of the heat syndrome. Methods Material and energy metabolism from the point of view, we detected thyroid hormone levels in serum of patients and rats with heat syndrome, observed thyroid ultrastructure, hepatocytes uhrastructure, morphometry of mitochondria in liver cells, and measured succinate dehydrogenase activity in hepatocytes mitochondria of the heat syndrome rat models in different states of the heat syndrome （excess heat syndrome EHS; deficiency heat syndrome DHS）. And at the same time, we treated the heat syndrome rat models with traditional Chinese herbs （ clearing away heat and dispelling toxic substances for EHS,and nourishing yin and clearing away heat for DHS） and observed the therapeutic effect. Results The results showed that the heat syndrome of deficiency type may be related to the thyroid function and （or） thyroxin, but the heat syndrome of excess type has nothing to do with them. The body energy metabolism of both EHS rat model and DHS rat model were active, but it was not significant in EHS than that in DHS, and the pathological basis of the two types were different. Treatment with traditional Chinese herbs showed that it could benefit the restoration, and had some protective effect to the pathological changes. Conclusion We inferred that based on the findings, thyroid hormone （T3 ,T4 ,rT3 ,TSH） levels in serum and thyroid ultrastructure could be served as index to differentiate EHS and DHS. There is a positive correlation between heat syndrome and the energy metabolism in the body.