航天员常见症状的用药与体位性低血压的关系

目的对航天员在航天飞行中与航天飞行后常见症状的用药与体位性低血压的关系进行综述。资料来源与选择该领域公开发表的相关研究论文、综述、报告汇编（包括美国国家航空航天局网站上的公开文献）和著作。资料引用引用公开发表的报刊文献32篇，报告汇编5篇，和著作12部。资料综合航天员在航天飞行中与航天飞行后最常出现的症状分别为头晕、呕吐（航天运动病）、头痛、背部疼痛、失眠和晕厥，对于这些症状的西药治疗有时会对心血管系统产生不良影响。止吐药异丙嗪伴有抑制去甲肾上腺素、肾素、醛固酮分泌的作用；安眠药替马西泮具有松弛骨骼肌张力的作用；升压药氟氢可的松具有抑制去甲肾上腺素分泌的作用。这些药物都会引起血管收缩下降，水钠储留减少，回心血量降低从而造成体位性低血压。结论航天员常见症状的西药疗法常会引起体位性低血压。中国可以运用中药针灸和少量的西药复合疗法来防治航天员的常见症状，从而减少西药对人体的不良作用。

The relationship between different medications and orthostatic hypotension in astronauts

Objective Human beings have flown in space for 50 years.Russia (Soviet),United States,and China are the three countries that have the technology to transport their astronauts into space.The space environment is different from Earth,which can lead to changes or alterations to the human body's physiological functions or cause diseases.The United States has invested energy to study physiological changes or treat diseases in astronauts during and after spaceflight.Common symptoms associated with astronauts during and after spaceflight include dizziness and vomiting (space motion sickness) ; head and back pain; difficulty sleeping (insomnia) ; and orthostatic intolerance and fainting (orthostatic hypotension). Many medications have been used to prevent or treat these symptoms.However,side effects affecting the cardiovascular system have also been reported.The mechanisms of the adverse effects of these medications on orthostatic hypotension in astronauts are discussed in this review. Literature resources selection Research papers,reviews,compilations,and monographs in the subjects regarding space medicine,clinical medicine,western medications,and Chinese herbs. Literature quotation Thirty-two published research articles and reviews,5 compilations,and 12 monographs. Literature synthesis The antiemetic agent promethazine is used for treating space motion sickness.However,promethazine also inhibits norepinephrine,renin,and aldosterone and may reduce blood vessel constriction and plasma volume.While the sedative hypnotic temazepam is used for treating insomnia,it relaxes skeletal muscle,causing blood retention in the lower extremities,and decreases in both venous return and cardiac output.The adrenocorticosteroid fludrocortisone is used for treating orthostatic hypotension,but suppresses norepinephrine and will reduce blood vessel tension.In summary,these medications could inhibit blood vessel constriction,reduce sodium and water retention,and decrease venous return,resulting in orthostatic hypotension.Conclusions In the United States and Russia,patients are usually treated solely by western medicine.However,in China,physicians treat patients using both western medicine and traditional Chinese medicine.Future recommendation is to use herbs and/or acupuncture in combination with small amounts of western medication to prevent and treat diseases in astronauts during and after spaceflight.The reduction in the adverse effects of medication usage on astronauts will be noted.