利用脑电超慢涨落图技术对神经症不同证型患者脑内神经递质的分析

Analysis of Intracerebral Neurotransmitters in Patients with Neurosis of Different Syndromes Using Encephalofluctuogram

目的:探讨神经症患者不同证型间脑内神经递质的差异。方法:将符合诊断的130名患者根据中医证型分组,另设31名健康人作为对照组,采用脑电超慢涨落分析仪,对各组患者及对照组进行检测,分析不同证型间γ-氨基丁酸(GABA)、谷氨酸(Glu)、乙酰胆碱受体(AchR)、5-羟色胺(5-HT)、乙酰胆碱(Ach)、强兴奋介质(EXC)、去甲肾上腺素(NE)、多巴胺(DA)、深抑制介质(INH)9种神经递质及相关递质比值的差异。结果:肝郁化火、肝郁脾虚GABA值显著低于正常组(P<0.05);肝郁脾虚、脾肾阳虚、其他组Glu值显著低于正常组(P<0.05);肝肾阴虚AchR值显著低于正常组(P<0.05);心脾两虚5-HT值显著高于肝肾阴虚(P<0.05);脾肾阳虚NE值显著高于肝郁化火、肝郁脾虚、心脾两虚、其他、正常组(P<0.05);肝郁化火DA值显著高于心脾两虚(P<0.05);心脾两虚、肝肾阴虚、脾肾阳虚、其他组DA值显著低于正常组(均P<0.05);肝郁化火INH值显著低于肝郁脾虚及正常组(均P<0.05)。相关神经递质的比值中,脾肾阳虚组GABA/Glu值显著高于肝郁化火、肝郁脾虚、心脾两虚、肝肾阴虚及正常组(均P<0.05);肝郁脾虚5-HT/DA值、NE/DA值显著高于正常组(均P<0.05)。结论:脑内神经递质及其相关比值的差异可为神经症中医辨证分型提供客观依据,有助于临床进一步辨证施治。

Objective：To analyze the intracerebral neurotransmitters in the patients with neurosis of different syndromes. Methods：One hundred and thirty hospitalized patients with neurosis were divided into different groups according to the traditional Chinese medicine（TCM） syndrome,and 31 healthy people were as the control group. Encephalofluctuogram was applied to test the patients and the control. Also gamma-aminobutyric acid（GABA）,glutamate（Glu）,aeetylcholine receptor（AchR）,5-hydroxytryplamine（5-HT）,aeetylcholine（Ach）, excitatory transmitter （EXC）, norepinephrine （NE）, dopamine （DA）, and inhibitory transmitter （INH）, 9 neurotransmitters,were tested and the ratio between each neurotransmitter ratio was calculated. Results：In the groups of fire due to liver stagnation and liver fire with spleen deficiency,the value of GABA was significantly lower than that in the group（P〈0.05）;in the group of liver stagnation with spleen deficieney,yang deficiency of spleen and kidney ,and others ,the value of Glu was significantly lower than that in the control （P〈0.05）;in the groups of yin deficiency of liver and kidney,the value of AchR was significantly lower than that in the control;in the group of the deficiency of heart and spleen,5-HT was significantly higher than that in the group of yin of liver and kidney ;in the group of yang deficiency of spleen and kidney,the value of NE was significantly higher than that in the groups of fire due to liver stagnation ,liver stagnation with spleen deficiency ,deficiency of heart and spleen ,other and the control ;in the group of fire due to liver stagnation ,DA was significantly higher than that in the group of deficiency of spleen and heart;in the group of deficiency of spleen and heart deficieney,yin deficiency of liver and kidney,yang deficiency of spleen and kidney and other,DA was lower than that in the control（P〈0.05）;in the group of fire due to liver stagnation,INH was significantly lower than that in the groups of liver stagnation with spleen deficiency and others （P〈0.05）. On the ratio of related neurotransmit- ters,in the groups of yang deficiency of spleen and kidney,GABA/Glu was higher than that in the groups of fire due to liver stagnation,liver stagnation and spleen deficiency,deficiency of heart and spleen,yin deficiency of liver and kidney,and the control（P〈0.05）. In the group of liver stagnation and spleen deficiency 5-HT/DA and NE/DA were higher than these in the control （P〈0.05）. Conclusion：The difference intracerebral neurotransmitterts and the ratio can provide an objective basis for TCM syndrome differentiation of neurosis,and could guide clinical treatment.