基于重复测量设计的甲基苯丙胺男性戒断者不同时点的脉图特点及其与HPA轴关系

The characteristics and mechanism of male methamphetamine abstainers' pulse parameters at different points intime: A prospective repeated measures design

目的 基于重复测量设计总结甲基苯丙胺(methamphetamine, MA)戒断期脉图变化及机制。方法 观测戒断急性、亚急性和慢性期脉图、下丘脑-垂体-肾上腺轴(hypothalamic-pituitary-adrenal axis, HPA)激素水平。结果 急性期脉图参数t5/t4、h3/h1降低,h1、h5、t1/t、h2、As升高,皮质醇(cortisol, COR)、内皮素1(endothelin 1, ET-1)升高;亚急性期h1、hr、h4/h1、t3降低,t1、t2、t5、t、h5、h2、As升高,ET-1升高,多巴胺(dopamine, DA)降低;慢性期W1/t、t4、hr、h4/h1、t3降低,h1、h3、t1、t2、t5、t、h2、As升高,促肾上腺皮质激素(adrenocorticotropic hormone, ACTH)降低。COR与t3、t4、h3/h1、t1/t, DA与hr, ACTH与t1/t, ET-1与t2正相关,DA与h1、h2、h3、h4、t1、t2/t5、As、Ad、t, ACTH与h3、h4、t5、Ad、t负相关。结论 脉图在MA戒断不同时期发生动态变化,可能与HPA轴激素水平变化相关。

Objective To summarize the characteristics and mechanism of male methamphetamine(MA)abstainers'pulse parameters during the different withdrawal stages based on repeated measures design,and to provide evidences for objectifying TCM symptoms of drug withdrawal.Methods The pulse parameters,and HPA axis hormone levels were observed and compared during acute,subacute and chronic withdrawal period.Results we observed 96 healthy subjects and 36 MA abstainers at 3 times during withdrawal period.Compared with healthy subjects,the pulsatographic parameters t5/t4,h3/h1 were decreased,h1,h5,t1/t,h2 were increased,and cortisol(COR),endothelin 1(ET-1)increased in the acute phase.In the subacute phase,h1,hr,h4/h1,t3 were decreased,t1,t2,t5,t,h5,h2,were increased,ET-1 was increased and dopamine(DA)was decreased.In the chronic phase,W1/t,t4,hr,h4/h1,t3 decreased,h1,h3,t1,t2,t5,t,h2,As increased,and adrenocorticotropic hormone(ACTH)decreased.Positive correlations were found between COR and t3,t4,h3/h1,t1/t,DA and hr,ACTH and t1/t,ET-1 and t2.Negative correlations were found between DA and h1,h2,h3,h4,t1,t2/t5,As,Ad,t,and ACTH and h3,h4,t5,Ad,t.Conclusion The pulse parameters of MA abstainers had specific changes on different stages of withdrawal,which related to the HPA axis hormone level possibly.