慢性再生障碍性贫血患者的性激素水平与中医证候/中医证型的相关性研究

摘要

目的：研究慢性再生障碍性贫血患者的性激素水平与中医证候和中医证型的相关性。方法使用德国SIEMENS公司Centaur XP全自动电化学发光免疫分析系统进行检测分析慢性再生障碍性贫血患者的促卵泡生成素、促黄体生成素、泌乳素、孕酮、雌二醇、睾酮等6项性激素水平。结果①慢性再生障碍性贫血患者的性激素水平均在正常范围；②中医辨证主要症状中的"心悸气短"症状在慢性再生障碍性贫血患者中的排卵期女性最常见，"头晕"症状在绝经期女性最少见；③中医次要症状中的"手足心热"和"尿黄"症状在排卵期女性最常见；④按中医证型分类，男性和黄体期女性以肾阳虚型多见（7/12），排卵期和绝经期女性以肾阴虚型多见；⑤虽然中医辨证肾阳虚在男性多见，但其肾阳虚和肾阴虚组的激素水平在组间无差异。结论①慢性再生障碍性贫血患者的性激素水平未受到雄激素的影响，仍在正常范围；②"心悸气短"和"头晕"等主要症状、"手足心热"等次要症状同时出现似可提示女性慢性再生障碍性贫血患者所处的生理期为排卵期；③女性慢性再生障碍性贫血患者的排卵期和绝经期与中医辨证肾阴虚型明显相关，女性慢性再生障碍性贫血患者的黄体期与中医辨证肾阳虚明显相关，未发现慢性再生障碍性贫血患者性激素水平与中医证型的明显相关性，可能与病例数量较少有关。%Objective:Relations between gonadal hormone conentrations and traditional Chinese syndromes of Chronic aplastic anemia. Methods:Detections were done on fol icle, luteinizing hormone, prolactin, pregnendione, estriol and testosterone in aplastic anemia patients with ful -automatic electrochemluminescence and immunoassay made by SIEMENS Company. Results:Firstly, gonadal hormone concentrations of aplastic anemia patients were in normal levels. Secondly, palpitation and short of breath were seen mainly in female patients during ovulatory period , dizziness rarely in female ones during menopause. Thirdly, warmness of hands and feet and yel ow urine were shown obviously in female cases during ovulatory period. Fourthly, based on syndrome of TCM, kidney-yang deficiency was always in male and female patients during luteal phase (7/12), kidney-yin deficiency was mostly in female patients during ovulatory period and menopause. Final y, though kidney-yang deficiency were obviously in males , hormonal level in kidney-yang and -yin deficiency were undif erentiated. Conclusion:Firstly, gonadal hormone level of chronic aplastic anemia was seemly of no influence made by androgens. Secondly, palpation and short of breath, dizziness and warmness of hands and feet were mainly seen in female patients during ovulatory period. Thirdly, kidney-yin deficiency syndrome was obviously related to female ovulatory period and menopause in aplastic anemia. Kidney-yang deficiency was mainly related to female luteal phase. Til now, no significant relations were found between gonadal hormone concentrations and TCM syndrome of chronic aplastic anemia, perhaps partly because of less cases.