慢传输型便秘中医证型与血管活性肠肽和P物质关系

目的探究慢传输型便秘(slow transit constipation,STC)中医证型与血管活性肠肽(vasoactive intestinal peptide,VIP)、P物质(substance P,SP)的关系,为中医辨证客观化寻找证据。方法纳入肠道实热证、肠道气滞证、肺脾气虚证、脾肾阳虚证、津亏血少证STC患者各15例,另随机选取15例健康人作为对照组。应用酶联免疫吸附双抗体夹心法检测血清VIP、SP水平。结果 STC患者血清VIP和SP水平显著高于对照组(P0.05,或P0.01);STC虚证患者血清VIP和SP水平显著高于STC实证患者(P0.01);3种虚证(肺脾气虚证、脾肾阳虚证、津亏血少证)患者血清VIP及SP水平比较,以及2种实证(肠道实热证、肠道气滞证)患者血清VIP水平比较,差异均无统计学意义(P0.05);肠道气滞证患者血清SP水平显著低于肠道实热证(P0.05)。结论血清VIP、SP水平与STC中医证型有关,有利于鉴别STC虚证和实证。

Relationship of Traditional Chinese Medicine Syndrome Types with Vasoactive Intestinal Peptide and Substance P in Patients with Slow Transit Constipation

Objective To investigate the relationship of traditional Chinese medicine (TCM) syndrome types with vasoactive intestinal peptide (VIP) and substance P (SP) in patients with slow transit constipation (STC) and to provide evidence for TCM syndrome differentiation. Methods STC patients with syndrome of excessive heat in intestine, syndrome of qi stagnation in intestine, syndrome of lung spleen qi deficiency, syndrome of spleen kidney yang deficiency, and syndrome of fluid depletion and blood deficiency (15 cases for each syndrome), as well as 15 randomly selected healthy controls (as control group), were included in the study. Double antibody sandwich enzyme linked immunosorbent assay was used to determine serum VIP and SP levels. Results The STC patients had significantly higher serum VIP and SP levels than the control group (P<0.05 or P<0.01). The STC patients with deficiency syndromes had significantly higher serum VIP and SP levels than those with excess syndromes (P<0.01). Serum VIP and SP levels showed no significant differences between patients with syndrome of lung spleen qi deficiency, syndrome of spleen kidney yang deficiency, and syndrome of fluid depletion and blood deficiency (P>0.05), and serum VIP level showed no significant difference between patients with syndrome of excessive heat in intestine and syndrome of qi stagnation in intestine (P>0.05). Serum SP level was significantly lower in patients with syndrome of qi stagnation in intestine than in those with syndrome of excessive heat in intestine (P<0.05). Conclusion Serum VIP and SP levels are related to the TCM syndrome types of STC and are useful for differentiation between deficiency syndrome and excess syndrome in STC patients.