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神经甾体与神经递质与经前期综合征肝阳上亢证和肝郁气滞证的相关性

The correlation between neurosteroids and neurotransmitters with liver yang rising and liver qi stagnation types of premenstrual syndrome.

作者信息

Gao Hui, Shang Ya Zhen, Xia Tian, Qiao Ming Qi, Zhang Hui Yun, Ma Yue Xiang

机构信息

a Department of Traditional Chinese Medicine, Affiliated Hospital of Chengde Medical College Chengde Hebei.

b Institute of Traditional Chinese Medicine, Chengde Medical College Chengde Hebei.

出版信息

Gynecol Endocrinol. 2014;30(12):913-7. doi: 10.3109/09513590.2014.943726. Epub 2014 Sep 11.

Abstract

BACKGROUND

To investigate neural-reproductive hormonal basis of liver yang rising (LYR), liver qi stagnation (LQS) premenstrual syndrome (PMS), and to develop standardized diagnostic criteria for PMS.

METHODS

HPLC, HPLC-MC, ELISA and radioimmunoassay were used to compare levels of serum hormones, plasma neurotransmitters and neurosteroids between LYR PMS patients, LQS PMS patients and healthy controls (30 subjects in each group).

RESULTS

Of the measures, all three groups exhibited no significant differences during the follicular phase. In contrast, during the luteal phase, LYR PMS testosterone levels tended to be higher than controls, while dopamine and 5-HT of the LYR PMS group were significantly higher. Conversely, γ-aminobutyric acid in the LYR PMS group was significantly lower than controls (p < 0.05). On the other hand, epinephrine and norepinephrine levels in both PMS groups were significantly higher than controls (p < 0.05), while pregnenolone and allopregnanolone of LYR and LQS groups were significantly lower than controls, with dehydroepiandrosterone (DHEA) being significantly higher than controls (p < 0.05). The ratios of DHEA/allopregnanolone and DHEA/pregnenolone of both PMS groups were significantly higher than the control group, with the LYR PMS group ratios being significantly higher than in the LQS PMS group (p < 0.05).

CONCLUSION

The decrease in pregnenolone and allopregnenolone, increase in DHEA, DHEA/allopregnanolone and DHEA/pregnenolone during the luteal phase may be one of the biological bases for anger in LYR PMS patients and depression in LQS PMS patients.

摘要

背景

探讨肝阳上亢(LYR)、肝郁气滞(LQS)型经前期综合征(PMS)的神经 - 生殖激素基础,并制定PMS的标准化诊断标准。

方法

采用高效液相色谱法(HPLC)、高效液相色谱 - 质谱联用法(HPLC - MC)、酶联免疫吸附测定法(ELISA)和放射免疫分析法,比较LYR型PMS患者、LQS型PMS患者和健康对照者(每组30例)的血清激素、血浆神经递质和神经甾体水平。

结果

在这些检测指标中,三组在卵泡期均无显著差异。相比之下,在黄体期,LYR型PMS患者的睾酮水平倾向于高于对照组,而LYR型PMS组的多巴胺和5 - 羟色胺显著更高。相反,LYR型PMS组的γ - 氨基丁酸显著低于对照组(p < 0.05)。另一方面,两个PMS组的肾上腺素和去甲肾上腺素水平均显著高于对照组(p < 0.05),而LYR组和LQS组的孕烯醇酮和别孕烯醇酮显著低于对照组,脱氢表雄酮(DHEA)显著高于对照组(p < 0.05)。两个PMS组的DHEA/别孕烯醇酮和DHEA/孕烯醇酮比值均显著高于对照组,LYR型PMS组的比值显著高于LQS型PMS组(p < 0.05)。

结论

黄体期孕烯醇酮和别孕烯醇酮降低,DHEA、DHEA/别孕烯醇酮和DHEA/孕烯醇酮升高,可能是LYR型PMS患者愤怒和LQS型PMS患者抑郁的生物学基础之一。

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