老年抑郁症不同证候阶段外周血单胺类神经递质与甲状腺激素的相关性研究

Study on the relativity between peripheral blood monoamine neurotransmitter aand thyroid hormone in senile depression patients with different TCM syndrome stages

目的探讨老年抑郁症患者不同证候阶段外周血神经递质与甲状腺激素的相关性。方法患者组203例,其中实证证候阶段(肝郁气滞证)患者28例,虚实夹杂证候阶段(肝郁脾虚证、肝郁痰阻证)患者74例,虚证证候阶段(心脾两虚证、心肾不交证)患者101例。正常对照组50例。测定2组人群外周血血清总三碘甲状腺原氨酸(T3)、血清总甲状腺素(T4)、血清促甲状腺素(TSH)、5-羟色胺(5-HT)、去甲肾上腺素(NE)及多巴胺(DA)水平。结果虚证证候阶段T3的降低及TSH的升高较正常对照组明显(P<0.05)。5-HT与TSH呈负相关(r=-0.89,P<0.01),5-HT与T3、T4呈正相关(r=0.94,P<0.01)。结论老年抑郁症患者不同证候阶段与单胺类神经递质及甲状腺激素功能密切相关。

Objective To study the relativity of peripheral blood monoamine neurotransmitter with thyroid hormone in senile depression patients with different TCM syndrome stages. Methods Among 203 cases of patients,excess syndrome stage（ syndrome of liver qi stagnation） were seen in 28 cases,syndrome of combination of deficiency and excess syndrome（ syndrome of liver depression and spleen deficiency,syndrome of liver depression and phlegm obstruction） in 74 cases,deficiency syndrome stage（ syndrome of heart and spleen deficiency,disharmony of heart and kidney） in 101 cases. There were 50 cases in normal control group. The levels of peripheral serum triiodothyronine（ T3）, thyroxine（ T4）, thyroid stimulating hormone（ TSH）,5- hydroxytryptamine（ 5-HT）,norepinephrine（ NE） and dopamine（ DA） were detected in two groups. Results T3 was decreased and TSH increased more obviously in deficiency syndrome stage than that of control group（ P〈0. 05）. Negative correlation was seen between 5-HT and TSH（ r =- 0. 89,P〈0. 01） and positive correlation between 5-HT and T3, T4（ r = 0. 94, P〈0. 01）. Conclusion In the elderly patients with depression in different syndrome stage,monoamine neurotransmitters and the thyroid hormone is closely related to each other.