1. 成都中医药大学医学技术学院
2. 彭州市中医院
纸质出版:2016
移动端阅览
[1]辛文瀚,冷平,庞博,周小燕,罗萍.肾虚证候相关检验医学指标的筛选[J].中医杂志,2016,57(16):1402-1405.
XIN Wenhan, LENG Ping, PANG Bo, et al. Screening of Laboratory Medicine Indexes of Kidney Deficiency Syndrome[J]. Journal of Traditional Chinese Medicine2016, 57(16): 1402-1405.
[1]辛文瀚,冷平,庞博,周小燕,罗萍.肾虚证候相关检验医学指标的筛选[J].中医杂志,2016,57(16):1402-1405. DOI: 10.13288/j.11-2166/r.2016.16.014.
XIN Wenhan, LENG Ping, PANG Bo, et al. Screening of Laboratory Medicine Indexes of Kidney Deficiency Syndrome[J]. Journal of Traditional Chinese Medicine2016, 57(16): 1402-1405. DOI: 10.13288/j.11-2166/r.2016.16.014.
目的筛选辅助诊断肾虚证的检验医学指标。方法根据现代生物医学肾虚证候病理机制研究成果
参照文献资料报道的肾虚患者检验医学指标异常变化
结合临床常规检验项目开展现状
初步筛选相关检验指标
其中免疫指标7个
包括免疫球蛋白A(Ig A)、免疫球蛋白G(Ig G)、免疫球蛋白M(Ig M)、补体C3、补体C4、辅助性T淋巴细胞(CD4+)、抑制细胞毒素性T细胞(CD8+);肾上腺轴相关指标5个
包括肾上腺素(ADR)、去甲肾上腺素(NOR)、促肾上腺皮质激素(ACTH)、多巴胺(DOP)、皮质醇;血清微量元素指标5个
包括钙(Ca)、镁(Mg)、铜(Cu)、锌(Zn)、铁(Fe)。临床选取肾阳虚证者25例
肾阴虚证者25例
健康志愿者24例
分别采集血清进行指标检测与比较。结果与健康对照组比较
肾阳虚证组与肾阴虚证组血清补体C3、CD4+/CD8+、Ig M、ACTH、Mg、Cu、Zn、Fe均显著降低(P<0.01);肾阳虚证组与肾阴虚证组多巴胺水平较健康对照组升高
其中肾阴虚证组的升高程度具有统计学意义(P<0.05);肾阳虚证组NOR、ADR较肾阴虚证组和健康对照组降低显著(P<0.05);肾阴虚证者Ig G水平显著高于健康对照组(P<0.01)。结论肾虚证者表现为机体免疫、肾上腺相关激素和微量元素代谢指标的改变。临床上可以结合患者表观体征
对上述筛选出的指标进行组合检测可实现肾虚证候量化检测和分型诊断。
Objective To screen the laboratory medicine indexes for auxiliary diagnosis of kidney deficiency syndrome. Methods According to research results about modern biomedical pathomechanism of kidney deficiency syndrome
referring to literature reports on abnormal laboratory medicine indexes of patients with deficiency of the kidney
and combined with present situation of clinic routine inspection items
the related laboratory indexes were preliminarily screened. They were 7 immune indexes
including immunoglobulin A( Ig A)
immunoglobulin G( Ig G)
immunoglobulin M( Ig M)
complement C3
complement C4
helper T lymphocytes( CD4 +) and inhibited cytotoxic T cell( CD8 +); 5 indexes related to hypothalamic-pituitary-adrenal axis
including adrenaline( ADR)
norepinephrine( NOR)
adrenocorticotropic hormone( ACTH)
dopamine( DOP)
and cortisol; 5 indexes of serous microelement including calcium( Ca)
magnesium( Mg)
copper( Cu)
zinc( Zn)
and iron( Fe). Twenty-five patients with kidney-Yang deficiency syndrome
25 patients with kidney-Yin deficiency syndrome
and 24 healthy volunteers were chosen to compare the indexes. Results Compared with those in the healthy control group
serous levels of complement C3
CD4 + / CD8 +
Ig M
ACTH
Mg
Cu
Zn
Fe all reduced significantly in the kidneyYang deficiency syndrome group and the kidney-Yin deficiency syndrome group( P < 0. 01); In the kidney-Yang deficiency syndrome group and the kidney-Yin deficiency syndrome group
the levels of dopamine were higher than that in the healthy control group
and there was significant difference in the level of dopamine between the kidney-Yin deficiency syndrome group and the healthy group( P < 0. 05); In the kidney-Yang deficiency syndrome group
levels of NOR and ADR were much lower than those in the kidney-Yin deficiency syndrome group and the healthy control group( P < 0. 05); In the kidney-Yin deficiency syndrome group
level of Ig G was much higher than that in the healthy control group( P < 0. 01). Conclusion Patients with kidney deficiency syndrome showed the changes of body immune
hormones related to adrenal and metabolic indexes of microelement. In clinic
combined with apparent signs of patients
doctors may make combinatorial detection with the above-mentioned indexes to realize quantitative detection and diagnosis by types of kidney deficiency syndrome.
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