【作者】 张荔群；

【导师】 李植延；

【作者基本信息】 福建中医学院 ， 中医基础理论， 2000， 硕士

【摘要】 目的：观察2型糖尿病患者中医各证型血浆内皮素（ET）、降钙素基因相关肽（CGRP）、肿瘤坏死因子-α（TNF-α）、TXA₂-PGI₂平衡系统的变化及其与中医辨证分型的关系。方法：将121例2型糖尿病患者分为阴虚热盛、气阴两虚、阴阳两虚、血瘀气滞4种证型，另设正常对照组30人，空腹状态下抽取肘静脉血，用放射免疫分析法检测上述指标。结果：1、糖尿病各型患者血浆ET、TNF-α、TXB₂、TXB₂/6-Keto-PGF_1α较正常对照组显著增高（P＜0.05或P＜0.01），CGRP、6-Keto-PGF_1α明显下降（P＜0.05或P＜0.01）；2、糖尿病各型中，血ET值血瘀气滞组＞阴阳两虚组＞气阴两虚组及阴虚热盛组（P＜0.05或P＜0.01），阴虚热盛组与气阴两虚组比较无明显差异，血CGRP值血瘀气滞组及阴阳两虚组＜气阴两虚组＜阴虚热盛组（P＜0.05或P＜0.01），血瘀气滞组与阴阳两虚组之间无明显差异，血TXB₂、6-Keto-PGF_1α、TXB₂/6-Keto-PGF_1α各证型相比皆有明显差异（P＜0.05或P＜0.01），血TNF-α值血瘀气滞组＞阴阳两虚组和气阴两虚组＞阴虚热盛组（P＜0.05或P＜0.01），气阴两 虚组与阴阳两虚组相比无明显差异。结论：1．糖尿病患者以 肾虚为本，血浆挑水平显著升高，各型比较：血瘀气滞组＞阴 阳两虚组＞气阴两虚组及阴虚热盛组，阴虚热盛组与气阴两虚 ，组比较无明显差异；2．糖尿病患者随着病程发展，。。功能异 常，血浆CGRP水平显著降低，各型比较：血瘀气滞组和阴阳＿两虚组＜气阴两虚组＜阴虚热盛组，血瘀气滞组与阴阳两虚组之 间无明显差异Z3．糖尿病循环血中T状；－PG乙平衡失调说明 糖尿病患者体内存在明显血瘀现象，各型比较：血瘀气滞组＞＿阴阳两虚组＞气阴两虚组＞阴虚热盛组；4 糖尿病患者体内WF －a的水平明显高于正常组，说明糖尿病患者体内存在着免疫 功能紊乱的情况，表现为TNF－a的过度表达与释放，各型比 较：血瘀气滞组＞阴阳两虚组及气阴两虚组＞阴虚热盛组，气阴 两虚组与阴阳两虚组相比无明显差异；5．在糖尿病治疗中应－注意补’肾与活血化瘀。更多还原

【Abstract】 Clinical Trial of Relation Between TCM Types of NIDDM and BT, CORP. TXA2-PGI2 Complex and TNF-oMajor: Basis of TCMPostgraduate: Zhang LiqunTutor: Associate Prof .Li ZhiyanABSTRACTPuropose: To investigate the relation between TCM type of non-insulin-dependent diabetes mellitus (NIDDM) and ndothelin(ET), calcitonin gene-related peptide(CGRP), TXA2-PGI2 complex and tumor necrosis factor- a (TNF-a).Method: 121 diabetes patients were randomly divided into Yin-deficiency with excess of heat group (YDEH), deficiency of Qi and Yin group(DBQY),deficiency of both yin and yang group(DBYY), and stagnation of blood and Qi. All subjects were hemospasiaed venomously under fasting condition. The markers above were measured with radioimmunoassay(RIA). Results: l.The levels of ET, TNF-a , TXB2 and the value of TXB^-keto-PGFj 0 were significantly higher in all TCM types of NIDDM compared with those of controlled group(P<0. 05 or P<0. 01) and the levels of CGRP and 6-Reto-PGF! 0 declined significantly(P<0. 05 or P<0. 01); 2. IN all TCM types of NIDDM, the concentration of ET was in the following sequence(frojn high to low): SBQ, DBYY<DBQY(or YDEH), (P<0.05 or P<0. 01), and the difference between DBQY and YDEH was not statically significant. Th levels of CGRP of SBQ and DBYY were lower than that of DBQY, whose level wasbelow the level of YDEH(P<0.05 or P<0.01), and the difference between SBQ and DBYY was not significant. The concentration of TXB2, 6-keto-PGFj0, and the value of TXB2/6-keto-PGFlot were significant among all TCM types of NIDDM(P<0. 05 or P<0. 01). The difference of TNF-a level between SBQ and DBYY or between DBQY and YDEH, was statistically significant (the former higher than the later, P<0. 05,P<0. 01), and the difference between SBQ and DBYY did not show significant difference. Conclusion: 1. The exists kidney deficiency in NIDDM patients, and the level of ET marker increases differently according to different TCM types of NIDDM; 2. The heart function declines accompany the development of diabetes, and the level of CGRP markers declines differently according to different TCM types of NIDDM; 3. The changes of TXA2-PGI2 complex indicates that there exists obvious blood stasis in NIDDM patients; 4.The higher level of TRF-a,of NIDDM patients shows the existence of immune disorder : excessive expression and release of TNF-a; 5. The results of this research suggest such guideline: the principles of invigorating kidney and activating blood and dissolved stagnant.更多还原