哺乳期重度铅中毒的神经毒理机制及中医辨证分型探析

Study on Neurotoxic Mechanisms and Differentiation of Symptoms and Signs for Classification of Syndrome in Traditional Chinese Medicine of Severe Lead Poisoning in Lactation

发育期铅中毒会导致不可逆的脑损伤,而目前螯合剂只能降低体内的铅含量,不能修复铅致智力下降,更无法用于亚临床铅中毒和血铅水平不很高的儿童铅中毒的治疗。而铅损伤早期智力发育的机理远未阐明,因此深入探讨铅中毒的神经毒理机制及中医病机,可为儿童铅中毒的中医药防治提供依据。我们已证实哺乳期重度铅中毒会导致中枢性甲状腺功能减退,甲减性脑损伤可能是铅中毒致脑损害的原因之一。哺乳期重度铅中毒的中医辨证分型应该是肾精不足证。

Developmental exposure to lead （Pb） can induce irreversible brain damage. The chelating agent cannot repair the impairment of intelligence while decrease the blood Pb levels （BLLs） in vivo at present. Furthermore, they cannot be used to cure the sub-clinical Pb poisoning and the children whose BLLs are not very high. However, the potential mechanisms whereby early-life expo- sure to Pb hinders intelligence development in children are still not fully understood. So, it is important to investigate the mechanisms of Pb poisoning and to explore the pathogenesis of traditional Chinese medicine （TCM） . Meanwhile, these could provide theory evi- dence to prevent and cure the saturnine children by TCM. We have confirmed that the severe Pb poisoning could lead to central hypot- hyroidism in lactation. These results suggest that the brain damage of hypothyroidism may be one mechanism of the impairment of intelli- gence by Pb. The differentiation of symptoms and signs for classification of syndrome in TCM of severe Pb poisoning in lactation may be syndrome of deficiency of kidney-essence.