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研究生:黃英傑
研究生(外文):Huang, Ying-chieh
論文名稱:中醫氣虛證之診治與鈉泵活性之研究
論文名稱(外文):THe association between the Qi vacuity pattern with sodium potassium pump
指導教授:張恆鴻張恆鴻引用關係
學位類別:碩士
校院名稱:中國醫藥學院
系所名稱:中國醫學研究所
學門:醫藥衛生學門
學類:醫學學類
論文種類:學術論文
論文出版年:1997
畢業學年度:85
語文別:中文
論文頁數:45
中文關鍵詞:氣虛證鈉泵紅血球
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氣虛證臨床上常見於多種疾病,而出現全身性的虛弱症狀。一般認為,這種虛弱現象與調控身體內細胞能量生成、利用與代謝的途徑有關。鈉鉀泵利用能量,以維持細胞的活性,體內40%~60%的能量是供泵活動所需,故本項研究以鈉鉀泵作為能量代謝的評估,並觀察補中益氣湯對紅血球鈉鉀泵的活性是否有所影響。
在中醫門診蒐集氣虛證之患者30人與非虛證之患者31人;依中醫診斷確定證型,並以gamma counter偵測紅血球的鈉鉀泵對201Tl攝入量,作為活性評估的指標,採用共變數分析、重複測量變異數分析、簡單線性迴歸等統計方法分析後,研究結果如下:(1)紅血球的鈉鉀泵活性均值,在氣虛組為1115.25±49.90 cpm,在非虛組為3105.03±156.93 cpm,共變數分析顯示氣虛組之鈉鉀泵活性顯著低於非虛組(p<0.0001)。(2)在57.5%、46.0%、28.75%、11.5%及0.0%等不同濃度的補中益氣湯中,氣虛組紅血球鈉鉀泵對201Tl的攝取量有顯著不同(p<0.0001),在越高濃度,其鈉鉀泵活性有亦越高。非虛組中未給藥組之鈉鉀泵活性最高,給予各種不同濃度的補中益氣湯後,鈉鉀泵活性反而下降。
補中益氣湯對氣虛證患者之紅血球鈉鉀泵活性有顯著提高作用,對非虛證患者則無此效果,符合中醫辨證論治的原則。鈉鉀泵活性與中醫氣虛證有顯著相關,如能繼續深入研究或可作為中醫氣虛證的參考指標。

The Qi vacuity pattern in traditional Chinese medicine occurs in many diseases, and is characterized by general asthenia syndromes which is correlated with the production, utility and metabolism of cellular energy.Sodium-potassium pump (Na+, K+- ATPase ) consumes much energy to maintain the activity of cell. Fourty to sixty percent of cell energy is used for the activity of Na+, K+-ATPase in human. Our study was to evaluate the energy metabolism by the Na+, K+-ATPase. Also we examined the effect of Center-Supplementing Qi- Boosting Decoction (CSD) on erythrocyte Na+, K+-ATPase by comparing the Qi vacuity group and Non-vacuity group.
We recruited 30 patients for the Qi vacuity group and 31 patients for the Non-vacuity group. The activity of erythrocyte Na+, K+-ATPase was evaluated by 201Tl uptake. Statistical analyses applied in this study were analysis of covariance, repeated measurement ANOVA, and simple linear regression. After adjusting for age, the activity of Na+, K+-ATPase in the Qi vacuity group was obviousely lower than that of the Non-vacuity group (p<0.0001). The mean activity values of Na+, K+-ATPase were 1115.25 ± 449.90 cpm in the Qi vacuity group and 3105.03 ± 1156.93 cpm in Non-vacuity group. The activities of Na+, K+- ATPase were various by adding different concentration of CSD, including 57.5%, 46.0%, 28.75%, 11.5% and 0.0%.
In the Qi vacuity group, higher concentration of CSD was associated with higher activity of Na+, K+-ATPase. While in the Non-vacuity pattern, the highest activity appeared with 0.0% of CSD, and the activities were declined after adding CSD. The results of this study were compatible with the principle of “determine treatment by patterns identified” in traditional Chinese medicine. The activity of the sodium-potassium pump was closely related to the Qi vacuity pattern, it might become a indicator for the diagnosis the Qi vacuity pattern .

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