围绝经期综合征肝郁兼杂与单胺类神经递质的相关性研究

Correlative study on monoamine neurotransmitters and stagnation of liver qi syndrome and mix syndrome of perimenopausal period syndrome

目的:观察围绝经期综合征(PPS)妇女肝郁及其兼杂特征与单胺类神经递质的关系,探讨PPS肝郁及其兼杂特征的部分生物学机制。方法:以证素辨证判定189例PPS患者的肝郁及兼杂特点,应用ELISA等方法检测血液中的单胺类神经递质。比较PPS肝郁组(128例)和非肝郁组(61例)神经递质差异,比较肝郁不同兼杂神经递质差异。结果:肝郁组的DA和NE较非肝郁组为低(P<0.05)。肝郁病位兼肾者DA和5-HT显著低于单纯肝郁者(P<0.01);肝郁兼痰者DA和5-HT显著低于无痰者(P<0.01,P<0.05);肝郁兼湿者5-HT显著低于无湿者(P<0.01);肝郁兼热者5-HT显著低于无热者(P<0.01);肝郁兼气虚者5-HT显著低于无气虚者(P<0.01);肝郁兼血虚者DA和5-HT均显著低于无血虚者(P<0.01);肝郁兼阴虚者DA和5-HT均低于无阴虚者(P<0.05)。结论:PPS患者DA和NE的降低可能是肝郁发生的生物学基础。PPS单胺类神经递质的变化与肝郁兼杂特点密切相关。

Objective： The correlation of monoamine neurotransmitters and perimenopausal period syndrome （PPS） with syndrome of stagnation of liver qi was investigated to explore the potential biological mechanism underlying PPS. Methods： Syndrome characteristics of 189 patients with PPS were determined by syndrome differentiation of syndrome elements. EL1SA and other methods were used to detected monoamine neurotransmitters level in blood to compare the differences between stagnation of liver qi group （128 caces） and non-stagnation of liver qi group （61 caces） as well as the differences between different mixed syndromes. Results： DA and NE level in stagnation of liver qi group were lower than those in the non-stagnation of liver qi group （P〈0.05）. DA and 5-HT level of patients with stagnation of liver qi combining with disease location in kidney were significantly lower than those in patients with stagnation of liver qi （P〈0.01）; DA and 5-HT level in patients with stagnation of liver qi combining phlegm were significantly lower than those without phlegm （P〈0.01, P〈0.05）; 5-HT level in patients with stagnation of liver qi combining dampness were significantly lower than those without dampness （P〈0.01）; 5-HT level in patients with stagnation of liver qi combining heat were significantly lower than those without heat （P〈0.01）; 5-HT level in patients with stagnation of liver qi combining qi deficiency were significantly lower than those without qi deficiency （P〈0.01）; DA and 5-HT level in patients with stagnation of liver qi combining blood deficiency were significantly lower than those without blood deficiency （P〈o.ol）; DA and 5-HT level in patients with stagnation of liver qi combining yin deficiency were significantly lower than those without yin deficiency （P〈0,05）. Conclusion： Reduced DA and NE may be the biological mechanism of PPS patients with stagnation of liver qi syndrome. The changes of monoamine neurotransmitter closely associated with the characteristics of stagnation of liver qi syndrome and mix syndromes.