摘要
目的:探讨肝豆状核变性患者中医证型与抑郁障碍间的关系以及可能的生物学发生机制。方法:对118例诊断为肝豆状核变性抑郁障碍患者进行辨证分型,通过Hamilton抑郁量表(HAMD)、抑郁自评量表(SDS)、统一Wilson病评定量表(UWDRS)评分以及检测5-羟色胺(5-HT)、去甲肾上腺素(NE)含量水平,评价不同分型患者之间的关系。结果:痰瘀互结组与湿热内蕴组5-HT比较具有统计学意义(P<0.05),痰瘀互结组5-HT数值更低。二组之间NE数值变化不明显,无统计学意义(P>0.05)。痰瘀互结组与湿热内蕴组HAMD、SDS、UWDRS评分比较有统计学意义(P<0.05或P<0.01),痰瘀互结组各项评分更高。结论:肝豆状核变性患者神经、精神症状与抑郁障碍发生呈正相关,该病痰瘀互结型抑郁障碍症状明显,可能与该型5-HT含量更低有关,表明抑郁障碍发生与5-HT关系密切,与NE关系不明显。其可能机制是肝豆状核变性痰瘀互结证患者体内5-HT生成代谢更容易受到阻滞,引起其含量水平降低,影响5-HT调节情感等生理功能,导致抑郁障碍发生。
Objective:To explore the relationship between TCM syndrome types and depressive disorder in patients with hepatolenticular degeneration(HLD)and the possible biological mechanism.Methods:One hundred and eighteen patients with hepatolenticular degeneration depressive disorder were classified according to syndrome differentiation.Hamilton Depression Scale(HAMD),Self-rating Depression Scale(SDS),Unified Wilson Disease Rating Scale(UWDRS)and 5-hydroxytryptamine(5-HT)and Norepi nephrine(NE)levels were measured.The relationship between patients with different classification was evaluated.Results:The 5-HT of phlegm-stasis syndrome group was significantly higher than that of dampness-heat syndrome group(P<0.05),There was no significant difference in the NE value between the two groups(P>0.05).The scores of HAMD,SDS and UWDRS in the phlegm-stasis syndrome group and the dampness-heat syndrome group were statistically significant(P<0.05 or P<0.01),and the phlegm-stasis syndrome group had the highest scores.Conclusion:Neurological and psychiatric symptoms of patients with hepatolenticular degeneration are positively correlated with the occurrence of depressive disorder,and the symptoms of phlegm-blood stasis depressive disorder are obvious,which may be related to the lowest content of 5-HT,indicating that 5-HT is closely related to the occurrence of depressive disorder and has no obvious relationship with NE.The possible mechanism is that the metabolism of 5-HT in patients with hepatolenticular degeneration with phlegm-blood stasis syndrome is more likely to be blocked,resulting in a decrease in the content of 5-HT,affecting physiological functions such as emotion regulation,leading to depression.
作者
李祥
程婷
汪瀚
杨文明
LI Xiang;CHENG Ting;WANG Han;YANG Wen-ming(Encephalopathy Center,The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei 230038,China)
出处
《江西中医药大学学报》
2019年第3期35-37,46,共4页
Journal of Jiangxi University of Chinese Medicine
基金
国家自然科学基金项目(81373599)
关键词
肝豆状核变性
中医证型
抑郁障碍
5-HT
统计分析
Hepatolenticular Degeneration
TCM Syndromes
Depressive Disorder
5-HT
Statistical Analysis
