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补益肾气法干预老年人高血压病肾气亏虚证性激素水平及性激素受体表达的机制研究
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摘要
本研究出自导师郭伟星教授的国家自然科学基金项目(NO.30873247)“补肾方药干预老年人高血压病肾气亏虚证性激素受体表达及调控机制的研究”。
     目的:探讨与老年人高血压病肾气亏虚证密切相关的特征性性激素和性激素受体表达谱,以期找到老年人高血压病肾气亏虚证与性激素代谢紊乱及其受体表达异常之间的内在联系;通过研究经补益肾气法干预前后老年人高血压病肾气亏虚证患者性激素水平及其受体表达强度的变化,以确定益肾降压颗粒干预该病证在性激素、性激素受体层面上的靶点及作用机制;同时探讨益肾降压颗粒对此型高血压病患者的临床疗效,为补益肾气法治疗老年人高血压病提供理论依据。方法:收集老年人高血压病肾气亏虚证患者60例(男、女各30例)纳入肾气亏虚组,老年人高血压病肝火上炎证患者60例(男、女各30例)纳入肝火上炎组,健康老年人60例(男、女各30例)纳入健康老年人组,采用电化学发光免疫法检测T、E2、FSH、LH等血清性激素指标;采用流式细胞检测法检测ER、AR等性激素受体指标。一方面,观察对三组受试者的性激素水平及性激素受体表达强度的差异;另一方面,用益肾降压颗粒对肾气亏虚组患者进行干预,观察治疗前后患者的性激素水平变化、性激素受体表达强度变化及临床疗效。结果:与健康老年人相比,老年人高血压病肾气亏虚证患者存在性激素代谢的紊乱和性激素受体表达的异常,主要表现为男性患者血清T、E2水平下降,血清FSH、LH水平及T/E2比值上升,外周血中ER、AR的表达强度下降;女性患者的血清E2水平下降,血清FSH水平及T/E2比值上升,外周血中ER、AR的表达强度下降。补益肾气法不仅能够逆转老年人高血压病肾气亏虚证患者的性激素水平的变化,双向调节性激素水平,而且可以显著提高此类患者的性激素受体表达强度,同时还能有效降压、缓解临床症状。结论:性激素代谢紊乱及其受体表达异常可能是老年人高血压病肾气亏虚证发生发展的病理基础;血清性激素指标和外周血性激素受体指标可做为诊断老年人高血压病肾气亏虚证的现代科学指标;益肾降压颗粒是治疗老年人高血压病肾气亏虚证的有效复方;补益肾气法是防治老年人高血压病肾气亏虚证、调节性激素水平及性激素受体表达的可靠方法。
This study comes from the tutor Guo Weixing professor of the National NaturalScience Fund Project (NO.30873247)" kidney tonifying herbs intervention of elderlyhypertension kidney-qi deficiency syndrome sex hormone receptor expression and controlmechanism research ".
     Objective: Explore the features of sex hormone and sex hormone receptor expressionprofiles Which is closely related to the elderly hypertension kidney-qi deficiency syndrometo find the elderly hypertensive kidney-qi deficiency syndrome and sex hormonemetabolism and receptor expression in abnormal relationship between. Study of the elderlyhypertension patients with deficiency of kidney-qi sex hormone level and its receptorexpression intensity changes by the Invigorating kidney qi method before and afterintervention, in order to determine the Yi Shen Antihypertension Granule to intervene inthe disease of sex hormone, sex hormone receptor level on the targets and mechanisms ofaction. At the same time to explore the Yi Shen Antihypertension Granule on this type ofessential hypertensive patients clinical efficacy, for invigorating kidney qi method intreatment of elderly hypertensive disease and provide a theoretical basis. Method:Collection of the elderly hypertension kidney-qi deficiency syndrome in patients with60people cases (male30, female30) into the kidney deficiency group, the elderlyhypertensive liver-fire ascending syndrome in patients with60cases (male30, female30)into the liver-fire ascending groups, healthy older adults with60cases (male30, female30) incorporated the healthy elderly group. Using electrochemiluminescenceimmunoassay for detection of T, E2, FSH, LH and serum sex hormone index and usingflow cytometric assay for detection of ER beta, AR and sex hormone receptor index. Onone hand, observation of the three groups of subjects of sex hormone and sex hormone receptor expression intensity differences. On the other hand, Yi Shen AntihypertensionGranule on kidney deficiency patients for intervention patients were observed before andafter treatment, the changes of sex hormone levels, sex hormone receptor expressionintensity changes and clinical curative effect. Result: Compared to healthy elderly subjects,the elderly hypertension kidney-qi deficiency syndrome in patients with sex hormonemetabolism disorder and the expression of sex hormone receptor abnormalities, the mainmanifestations of male patients with serum T, E2levels drop, serum FSH, LH level andT/E2ratio increased, peripheral blood ER beta, AR expression intensity and female patientswith serum E2level decreased, the levels of serum FSH and T/E2ratio increased,peripheral blood ER beta, AR expression intensity. Invigorating kidney qi method not onlyis able to reverse hypertension kidney-qi deficiency syndrome in patients with changes ofsex hormone levels, bidirectional regulation of sex hormone levels, and can significantlyimprove such patients with sex hormone receptors expression intensity, but also caneffectively alleviate clinical symptoms, blood pressure. Conclusion: Sex hormonemetabolism and receptor expression may be abnormal in the elderly hypertensionkidney-qi deficiency syndrome of the occurrence and development of pathological basis.Serum sex hormones and sex hormone receptors in peripheral indicators indicators can beused as a diagnosis of the elderly hypertension kidney-qi deficiency syndrome withmodern science index. Yi Shen Antihypertension Granule in treatment of hypertension inthe elderly of kidney-qi deficiency syndrome effective compound. Invigorating kidney qi isa method of prevention and treatment of the elderly hypertension kidney-qi deficiencysyndrome, regulate the level of sex hormone and sex hormone receptor expression method.
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