[Changes in hypothalamus-pituitary-adrenal (HPA) axis and the deficiency-excess syndrome differentiation on epidemic hemorrhagic fever patients].
In order to understand the relationship between the functional changes of hypothalamus-pituitary-adrenal (HPA) axis and the Deficiency-Excess Syndrome Differentiation of traditional Chinese medicine (TCM), the levels of serum cortisol and urinary 17-hydroxy-corticosteroid (U 17-OH) per 24 hours were studied. 171 serum samples and 139 urinary samples were obtained from 87 patients suffering from epidemic hemorrhagic fever (EHF) in various stage.


RESULTS
The Syndrome displayed as Excess-Heat type accompanied with Blood Stasis in febrile phase of EHF, both the level of serum cortisol and the U 17-OH increased to meet the stress. But the Syndrome converted from the Excess-Heat type to the Cold-Deficiency type in hypotensive and shock phase and the secretion of HPA axis began to reduce. However, in oliguric phase, the Syndrome was Kidney Deficiency complicated with Blood-Heat and Blood Stasis, their U 17-OH lowered significantly (7.53 +/- 3.82 mg/24 h.) in comparing with normal control (P < 0.01), but the level of serum cortisol, on the contrary, raised significantly (1517.96 +/- 421.96 mol/L) in comparing with control (P < 0.01). And in diuretic phase, the Syndrome was the Cold-Deficiency type, the HPA excretion tended to restore gradually but 17-OH maintain at a lower level in serious case. Therefore the change of serum cortisol was closely related with the HPA excretion in all phases of EHF, as well as to the Deficiency-Excess Syndrome Differentiation.(ABSTRACT TRUNCATED AT 250 WORDS)
Liu
J B
JB
Xijing Hospital, 4th Military University, Xi'an.
D015065:17-Hydroxycorticosteroids / Q000652:urine; D000293:Adolescent; D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006480:Hemorrhagic Fever with Renal Syndrome / Q000175:diagnosis*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008297:Male; D008516:Medicine, Chinese Traditional; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000503:physiopathology*
D015065:17-Hydroxycorticosteroids; D006854:Hydrocortisone