慢性盆腔疼痛综合征常见中医证型与β内啡肽、血浆p物质的相关性研究

Common TCM syndrome pattern of chronic pelvic pain syndrome relates to plasma substance p and beta endorphin

目的:探讨慢性盆腔疼痛综合征常见中医证型与血浆中β内啡肽、血浆p物质的相关性,从而为中医临床诊断、辨证及治疗慢性盆腔疼痛综合征提供参考数据。方法:本研究共观察慢性盆腔疼痛综合征患者102例,脱落4例,入组患者98例。按中医辨证证候分为湿热下注组32例,瘀血阻络组34例,湿热瘀阻组32例。另选择35例正常中青年男性作为对照组。分别采用放射免疫分析法和酶联免疫分析法检测血浆p物质和β内啡肽含量,并对中医证型与血浆中β内啡肽、血浆p物质的相关性进行分析。结果:3组慢性盆腔疼痛综合征患者血浆中血浆p物质水平从高到低依次为瘀血阻络组[(1 337.84±170.81)pg/ml]、湿热瘀阻组[(1 210.01±162.27)pg/ml]和湿热下注组[(1 135.76±166.45)pg/ml],均显著高于正常对照组[(574.99±113.09)pg/ml](P均<0.01);3组患者血浆中β内啡肽含量从高到低依次为湿热下注组[(212.70±29.49)pg/ml]、湿热瘀阻组[(180.81±20.20)pg/ml]和瘀血阻络组[(157.99±24.01)pg/ml],均显著低于正常对照组[(274.73±27.64)pg/ml](P均<0.01)。结论:慢性盆腔疼痛综合征患者血浆中β内啡肽含量明显降低,而血浆p物质水平明显升高,提示它们可能参与了慢性盆腔疼痛综合征的炎症反应;血浆中β内啡肽、血浆p物质为慢性前列腺炎的中医分型提供了一定的参照数据。

Objective： To investigate the relationship of the common Traditional Chinese Medicine （TCM） syndrome pattern of chronic pelvic pain syndrome （CPPS） with the contents of substance p and beta endorphin in the plasma, and provide reference data for the clinical diagnosis, differentiation and treatment of CPPS by TCM. Methods ： We observed 98 cases of CPPS, which were clas- sified into a lower-part damp-heat invasion group （group A, n = 32）, a blood stasis-indnced collateral obstruction group （group B, n = 34） , and a damp-heat stagnation group （group C, n = 32 ） according to the TCM syndrome differentiation. Another 35 normal healthy young men were enrolled as controls. We measured the contents of substance p and beta endorphin in the plasma by immunoradiometry and ELISA, and analyzed their relationship with the TCM syndrome pattern. Results： The contents of plasma substance p were significantly higher in groups A （ [ 1 135.76 ± 166.45 ] pg/ml）, B （ [ 1 337.84 ± 170.81 ] pg./ml）, and C （ [ 1 210.01 ± 162.27 ] pg/ml） than in the control （ [ 574.99 ± 113.09 ] pg/ml） （ all P 〈 0.01 ）, while the contents of plasma beta endorphin in groups A （ [ 212.70 ± 29.49 ] pg/ml）, B （ [ 157.99 ± 24. 01 ] pg/ml）, and C （ [ 180.81 ± 20.20 ] pg/ml） were remarkably lower than that in the control （ [ 274.73 ± 27.64 ] pg/ml） （ all P 〈 0.01 ）. Conclusion ： In the plasma of CPPS patients, the content of substance p is significantly elevated and that of beta endorphin markedly reduced, which suggests that they may be involved in the in- flammatory reaction of CPPS. The levels of plasma substance p and beta endorphin can be used as valuable reference for the TCM classification of chronic prostatitis.