基于方体相应的阴虚阳虚体质方剂干预研究

【作者】 董伟；

【导师】 倪诚；

【作者基本信息】 北京中医药大学 ， 方剂学， 2014， 博士

【摘要】 在人类生命科学的发展历程中,从希波克拉底到《黄帝内经》,即开始对体质有许多论述,但这些学说比较零散,均未形成体系,没有形成学术流派,缺乏诊断标准及临床应用。从20世纪70年代后期至今,在以王琦为代表的广大中医体质研究工作者不懈努力下,中医体质理论体系得以构建,中医体质学得以创立,国家中医药管理局中医学术流派研究课题组将中医体质学列为“中医学术流派”。由于现代学术流派研究还处于初期阶段,尚缺少关于中医体质学派传承、发展及应用等方面的系统研究,在一定程度上影响了中医体质学特色与优势的发挥。本研究以中医体质学派为背景,提出“方体相应”假说,通过选择阴虚体质和阳虚体质作为研究的切入点,从临床传承和实验角度开展“方体相应”的研究。一方面通过对王琦教授及其学术继承人倪诚教授开展辨体用方的临床传承研究,从而凝练体质学派的学术思想,传承中医体质学术脉络。另一方面通过应用六味地黄丸、桂附地黄丸分别对阴虚体质受试者、阳虚体质受试者干预作用的实验研究,来探究补阴、补阳方药分别对阴虚、阳虚体质的干预效应及部分机制。从而揭示中医阳虚、阴虚体质的现代内涵,论证“方体相应”、“体质可调”的科学原理。主要研究内容如下：1临床传承研究方法：本研究通过界定阳虚体质与阳虚证候、阴虚体质与阴虚证候,选择总结临床上通过改善阳虚体质和阴虚体质治疗疾病的典型案例,对导师的学术思想开展传承研究。通过相关文献调研、定期跟师门诊、医案整理、聆听导师授课讲座等多种途径,在导师的指导下,凝练导师辨体用方的临床诊疗策略和学术思想。进而分别从阳虚体质和阴虚体质选择导师善治的2种病证即怕冷症和盗汗,从诊察的切入点、重点关注的症／证、辨体依据、辨证依据、治疗着眼点、立法组方思路、遣药心得等方面,总结导师辨体用方的临床诊疗策略和方剂配伍、创制、应用方法,临床经验,全面反映中医体质学派学术思想。结果：①基于阳虚体质怕冷症的辨体用方传承研究：本研究基于王琦教授“体质可调”理论和导师倪诚教授“方体相应”假说,从阳虚体质怕冷症与健康相关生命质量下降、阳虚体质与阳虚证候的怕冷症界定、制方法度等方面,总结导师倪诚教授辨体用方治疗阳虚体质怕冷症的学术经验,并结合医案讨论了阳虚体质怕冷症诊治中对体质类型与状态辨识有机结合、辨体结合辨病辨证个性化用方的要点。②基于阴虚体质盗汗的辨体用方传承研究：本研究基于王琦教授提出的“体病相关”和“体质可调”理论和导师倪诚教授“方体相应”假说,从阴虚体质与盗汗、阴虚体质与阴虚证候的盗汗的界定、制方法度等方面,总结导师倪诚教授辨体用方论治盗汗的“阴虚体质”发病观和以及方剂内药组应用的链接思维等导师师承的学术经验,并结合医案讨论了阴虚体质盗汗诊治中对体质类型与状态辨识有机结合、辨体结合辨病辨证个性化用方的要点。通过对以上两种疾病诊治经验的总结传承,反映了中医体质学派在发展过程中三代师承互动、老师传授与学生学习并重的学术传承特色。以及反映了导师师承“辨体用方”的学术思想,即临证时以人的体质为认知对象,从体质状态及不同体质类型的特性进行辨体论治处方,通过改善体质来防治疾病,从而转换了临床思维方式。2实验研究实验一阴虚阳虚体质干预对体质评分的影响方法：选择25-40岁的健康受试者,按体质类型分为平和体质、阳虚体质、阴虚体质,然后在阳虚质中随机分为阳虚体质对照组、阳虚体质干预组,在阴虚体质中随机分为阴虚体质对照组、阴虚体质干预组,共计5组,每组20例。阴虚体质干预组和阳虚体质干预组受试者分别每天服用六味地黄丸和桂附地黄丸,每次6g,每天2次,共计90天。其余3组不服药。对各组服药前后的体质评分情况进行比较。并进一步考察六味地黄丸和桂附地黄丸对阴虚、阳虚体质干预后体质评分的影响。结果：六味地黄丸和桂附地黄丸干预阴虚体质、阳虚体质受试者后,其体质评分均显著降低(Jp<0.01)。而阴虚体质对照组和阳虚体质对照组干预前后体质评分无明显差异(尸>0.05)。结论：桂附地黄丸和六味地黄丸分别对阳虚体质和阴虚体质有干预作用,能够明显改善阳虚体质和阴虚体质受试者的自觉症状。实验二阴虚阳虚体质干预对Th1、Th2、Th17细胞亚群的影响方法：选择25～40岁的健康受试者,按体质类型分为平和体质、阳虚体质、阴虚体质,然后在阳虚质中随机分为阳虚体质对照组、阳虚体质干预组,在阴虚体质中随机分为阴虚体质对照组、阴虚体质干预组,共计5组,每组20例。阳虚体质干预组和阳虚体质干预组受试者分别每天服用六味地黄丸和桂附地黄丸,每次6g,每天2次,共计90天。其余3组不服药。90天后,抽取静脉血,用流式细胞仪检测各组体外诱导的Thl、Th2、Th17水平变化(Th1(%)、Th2(%)、Th1/Th2及Th17(%))以及血清中相关的细胞因子IL-2、INF-γ、TNF-α、IL-4、IL-6、IL-10、IL-17A的水平变化,考察六味地黄丸和桂附地黄丸分别干预阴虚、阳虚体质受试者后上述指标的变化情况。结果：研究结果显示：①与平和体质组比较,阳虚体质对照组及阴虚体质对照组的Th1/Th2显著降低,Thl(%)有降低趋势,Th17(%)有增加趋势,而Th2(%)变化不明显；桂附地黄丸能增加阳虚体质受试者的Th1(%)和Th1/Th2的趋势,有降低Th2(%)的趋势,但对Thl7(%)的改变无明显影响；六味地黄丸具有增加阴虚体质受试者的Th1(%)的趋势,但对Th2(%)、Th1/Th2、以及Th17(%)无明显影响。②与平和体质组比较,阳虚体质对照组IL-2、INF-γ以及TNF-a含量均显著降低,阴虚体质对照组IL-2、INF-γ显著降低,TNF-a有降低趋势；桂附地黄丸可显著增加阳虚体质受试者的IL-2、TNF-α、INF-γ的含量；六味地黄丸可明显增加阴虚体质受试者的INF-γ、 TNF-α含量,有增加IL-2的趋势。③与平和体质组比较,阳虚体质对照组IL-4、IL-6、IL-10及IL-17A含量均显著降低,阴虚体质对照组IL-4及IL-17A含量均显著降低, IL-6、IL-10含量有降低趋势,但无统计学差异。与阳虚体质对照组相比较,桂附地黄丸可显著增加阳虚体质受试者的IL-4、IL-6、IL-10含量,有增加IL-17A含量的趋势；与阴虚体质对照组相比较,六味地黄丸可显著增加阴虚体质受试者的IL-4、IL-6及IL-17A含量,有增加IL-10含量的趋势,但无显著性差异。结论：研究结果显示与平和体质组相比较,阳虚体质对照组及阴虚体质对照组Th1/Th2比值,血清相关细胞因子IL-2、INF-γ、TNF-α、IL-4、IL-6、IL-10及IL-17A的水平均有不同程度的下降,表现出抑制状态；与阳虚体质对照组相比,阴虚体质对照组Th1/Th2比值,IL-2、INF-γ、TNF-α、IL-4、IL-6、IL-10及IL-17A的水平升高,提示阴虚体质与阳虚体质存在Th1类细胞因子分泌方面的差异；桂附地黄丸干预阳虚体质受试者后,IL-2、INF-γ、TNF-α、IL-4、IL-6、IL-10升高,六味地黄丸干预阴虚体质受试者后INF-y、TNF-α、IL-4、IL-10、IL-17A升高,这可能是其分别纠正阴虚体质及阳虚体质,恢复Th细胞平衡的作用点,从而达到改善体质的效果。实验三阴虚阳虚体质干预对神经-内分泌变化的影响方法：选择25-40岁的健康受试者,按体质类型分为平和体质、阳虚体质、阴虚体质,然后在阳虚质中随机分为阳虚体质对照组、阳虚体质干预组,在阴虚体质中随机分为阴虚体质对照组、阴虚体质干预组,共计5组,每组20例。阳虚体质干预组和阳虚体质干预组受试者分别每天服用六味地黄丸和桂附地黄丸,每次6g,每天2次,共计90天。其余3组不服药。90天后,抽取静脉血,检测各组受试者血浆去甲肾上腺素、多巴胺、肾上腺素、五羟色胺(5-HT)、促肾上腺皮质激素(ACTH),血清皮质醇(Cor)、IgA、IgG、IgM的水平。考察六味地黄丸和桂附地黄丸分别干预阴虚、阳虚体质受试者后神经-内分泌指标的变化情况。结果：研究结果显示：①与平和体质组相比较,阳虚体质对照组中血清Cor及血浆ACTH含量显著降低,血浆5-HT有降低趋势；阴虚体质对照组中血浆ACTH显著降低,而血清Cor及血浆5-HT有降低趋势但无统计学差异；与阳虚体质对照组相比较,桂附地黄丸有增加阳虚体质受试者的血浆5-HT、血清Cor及血浆ACTH含量的趋势。与阴虚体质对照组相比较,六味地黄丸有增加阴虚体质受试者的血浆5-HT、血清Cor及血浆ACTH含量的趋势。②与平和体质组相比较,阳虚体质对照组去甲肾上腺素稍有增加的趋势,阴虚对照组去甲肾上腺素及多巴胺有明显增加的趋势,但均无统计学差异。桂附地黄丸有降低阳虚体质受试者的去甲肾上腺素含量趋势,对多巴胺及肾上腺素无明显影响,而六味地黄丸有降低阴虚体质受试者多巴胺的含量趋势,对去甲肾上腺素及肾上腺素无明显影响。③与平和体质组相比较,阳虚体质对照组和阳虚体质对照组血清IgA、IgG、IgM含量均无明显改变。桂附地黄丸对阳虚体质受试者以及六味地黄丸对阴虚体质受试者血清IgA、IgG、IgM含量无明显影响。结论：研究显示无论阳虚体质还是阴虚体质,其血清Cor及血浆ACTH含量下降,提示其下丘脑-垂体-肾上腺轴功能减退,但桂附地黄丸和六味地黄丸干预后,虽然干预组受试者自觉症状改善较多,但与对照组相比血清Cor及血浆ACTH含量改变不多,这可能与干预时间短以及体质具有相对稳定性处于稳态状态未受到应激刺激有关。本研究的主要发现是：①从对阴虚体质、阳虚体质体质干预临床传承的研究来看,“方体相应”假说是指人的不同体质状态与所用方药之间的高度针对性,即不同个体对所应用方药有不同的适应性与反应表达。“方体相应”以人的体质类型与状态为依据,使之“方为人所宜”,体现了辨体论治的中医诊疗特色。②从阴虚体质、阳虚体质干预的实验研究来看,阳虚体质、阴虚体质Thl、Th2细胞亚群受到抑制从而导致其分泌相关细胞因子IL-2、INF-γ、TNF-α、IL-4、IL-6、IL-10及IL-17A的水平均有不同程度的下降,有向Th2细胞亚群漂移的趋势；其血清Cor及血浆ACTH含量下降,提示其下丘脑-垂体-肾上腺轴功能减退。阴虚体质Thl/Th2比值, IL-2、INF-γ、TNF-α、IL-4、IL-6、IL-10及IL-17A的水平相比阳虚体质较高,提示阴虚体质与阳虚体质存在Thl类细胞因子分泌方面的差异,为阴虚体质的内热表现提供了部分解释。而阳虚体质Th1/Th2比值,IL-2、INF-γ、TNF-α、IL-4、IL-6、IL-10及IL-17A的水平相比阴虚体质较低,Thl类细胞因子分泌相对不足,为阳虚体质不耐寒冷的表现提供了部分解释。桂附地黄丸对阳虚体质有干预作用,其作用可能与升高IL-2、INF-γ、TNF-α、IL-4、IL-6、IL-10有关,六味地黄丸对阴虚体质干预有干预作用,其作用可能与升高INF-γ、TNF-α、IL-4、IL-10、IL-17A有关,这是其分别纠正阳虚体质及阴虚体质,达到改善体质效果的原因。更多还原

【Abstract】 In the history of biosciences, there were many knowledges about Constitution in ancient Eastern and Western. But those scattered knowledges, which were lack of academic schools, diagnostic criteria and clinical applications, did not formed systemlized theroies. After continued efforts of researchers, led by Wang Qi, the theoretical system of TCM constitution was constructed, the Constitution theory in traditional Chinese medicine was founded and the constitution academic school was authenticated by State Administration of Traditional Chinese Medicine from the late1970s to the present.The modern academic school research is still in its early stages and there is a lack of systematic research on TCM constitution school inheritance, development and application etc. So advantages of the TCM constitution can not be developed to a certain extent.Based on the background of constitution in Chinese Medicine School and the hypothesis--"correlation between prescription and constitution", the study was to investigate "prescription based on syndrome differentiation" by choosing yin deficiency constitution and yang deficiency constitution as the research object. The present study includes two parts, ie. the clinical study and the experimental study. The clinical part on the inheritance of professor Wang Qi and academic heirs--professor Ni Cheng was carried out to concise constitution school’s thoughts, write the TCM constitution academic history. the experimental part was to observe the interventions of Liuwei Dihuang pill on yin deficiency constitution participants and Guifu Dihuang pill on yang deficiency constitution participants and to explore the partial regulative mechanisms of traditional Chinese medicine formulas. As a result, the study aims to reveal the modern connotation of yang deficiency and yin deficiency constitution and demonstrate science principle of "correlation between prescription and constitution" and "prescription based on syndrome differentiation".The main contents are as follows:1The clinical studyMethods:In this study, yang deficiency constitution and yang syndrome, yin deficiency constitution and yin syndrome were differentiated.The academic thoughts of thesupervisor, prescription based on syndrome differentiation, were summarized by those methods such as literature researchs, clinic practices, medical record finishing and lectures of the supervisor. We selected two kinds of medical records,aversion to cold and night sweat, to summarize the clinical diagnosis and treatment strategy, prescription compatibility, application methods, the clinical experience and innovative thinking of the supervisor.With those measures adopted, we fully expect to develop the school of constitution in TCM.Results:①The study of traditional Chinese medicine formulas based on yang deficiency constitution for the therapy of the symptom of fearing of cold. Based on the theroy of "constitution being recoverable" romoted by Professor Wang Qi and "correlation between prescription and constitution" promoted by Professor Ni Cheng, this article summarizes Professor Ni Cheng’s academic experiences of prescription in accordance with constitution for treating the symptom of aversion to cold. These includes three aspects, which are correlation between aversion to cold with yang deficiency and the decline in health-related quality of life (HRQOL) of patients with it, the definition of yang deficiency constitution and yang deficiency syndrome of aversion to cold and the principle of prescription. Medical cases are also taken to illustrate some main points of individualized prescription that differentiation constitution should be combined with type of constitution and state of constitution differentiation and with disease and syndrome differentiation in diagnosis and treatment of aversion to cold.②The study of traditional Chinese medicine formulas based on yin deficiency constitution for the therapy of the symptom of night sweats. Based on the theroy of "constitution relating to disease" and "constitution being recoverable" promoted by Professor Wang Qi and "correlation between prescription and constitution" promoted by Professor Ni Cheng, this study summarizes Professor Ni Cheng’s clinical experience about the prevention and therapy of night sweat by traditional Chinese medicine. These includes three aspects, which are correlation between night sweat with yin deficiency consititution, the definition of yin deficiency constitution and yin deficiency syndrome of night sweat and the principle of prescription. Medical cases are also taken to illustrate some main points of individualized prescription that differentiation constitution should be combined with type of constitution and state of constitution differentiation and with disease and syndrome differentiation in diagnosis and treatment of night sweat.By summing up the inheritance of the above two kinds of disease diagnosis and treatment experience, inheritance characteristic way was continued in the constitution school of TCM. Those usually include the development of new discovery, the theory innovation and academic of thinking training. The academic thought of "prescription based on consititution differentiation" was also inherited and the change of the way of thinking for solving problem was promoted.2The experimental studyResearch1:Yin deficiency and Yang deficiency constitution intervention effects on constitution scoringMethods:Some25-40years old healthy subjects were recruited and divided into3groups according to their constitution type--heathy constitution, yang deficiency constitution and yin deficiency constitution. Then yang deficiency individuals were randomly divided into the control group of yang deficiency constitution and the intervention group of yang deficiency constitution.yin deficiency were randomly divided into the control group of yin deficiency constitution and the intervention group of deficiency constitution.There were a total of5groups and each group at least10cases. Participants in the intervention group of yin deficiency constitution andyang deficiency constitution were daily take Liuwei Dihuang pill and Guifu Dihuang pill respectively,6grams each time,2times a day. The process take90days. The rest3groups did not take medicines. After treatment,theconsititution score of each group were compared. We used constitution scoring to observe the the intervention effects of Liuwei Dihuang pill and Guifu Dihuang pill on the constitutions of yin deficiency and yang deficiency.Results:After the administration,the constitution scoring data showed that Liuwei Dihuang pill treatment significantly decreased the constitution score in yin deficiency participants group, and Guifu Dihuang pill treatment also significantly decreased the constitution score in yang deficiency participants group (P<0.01)Conclustion:Liuwei Dihuang Pill can be used to regulating yin deficiency constitution and Guifu Dihuang Pill can be used to regulating yang deficiency constitution. Both are able to obviously improve subjective symptoms of yang deficiency constitution and yin deficiency constitution subjects.Research2:Yin deficiency and Yang deficiency constitution intervention effects onThl,Th2,Thl7cells subsetsMethods:Some25-40years old healthy subjects were recruited and divided into3groups according to their constitution type--heathy constitution, yang deficiency constitution and yin deficiency constitution. Then yang deficiency individuals were randomly divided into the control group of yang deficiency constitution and the intervention group of yang deficiency constitution.yin deficiency were randomly divided into the control group of yin deficiency constitution and the intervention group of deficiency constitution.There were a total of5groups and each group at least10cases. Participants in the intervention group of yin deficiency constitution andyang deficiency constitution were daily take Liuwei Dihuang pill and Guifu Dihuang pill respectively,6grams each time,2times a day. The process take90days. The rest3groups did not take medicines. After90days treatments, vein blood was drawn. We futher investigated the interventions of Liuwei Dihuang pill and Guifu Dihuang pill on the serum levels of Th1Th2、Th17for the constitutions of yin deficiency and yang deficiency by measuring the levels of Thl, Th2, and Th17in vitro, the serum contents of Thl-related cytokines including IL-2, INF-y and TNF-a, and the serum levels of Th2, Th17-related cytokines including IL-4, IL-6, IL-10and IL-17A, respectively.Results:Our data showed that:①Compared with the normal group, the Thl/Th2index was significantly decreased in both yin deficiency and yang deficiency groups, respectively, but Th1(%), Th17(%), Th2(%) had no statistically significant difference; Guifu Dihuang pill treatment had an obvious tread to increase the indexes of Th1(%) and Thl/Th2in yang deficiency group, and decrease the index of Th2(%),but not obvious for Thl7(%); Liuwei Dihuang pill treatment had an obvious tread to increase the indexes of Th1(%) in yin deficiency group, but not obvious for Th2(%),Th1/Th2, and Th17(%).②Compared with the normal group, the levels of IL-2, INF-y, and TNF-a were significantly decreased in yang deficiency control group, the level of IL-2, INF-y was also significantly decreased in yin deficiency control group, and the levels of TNF-a had an obvious tread to decrease in yin deficiency control group; Guifu Dihuang pill treatment significantly increased the contents of IL-2, TNF-a and INF-y in yang deficiency participants; Liuwei Dihuang pill treatment significantly increased the contents of TNF-α and INF-γ in yin deficiency participants Liuwei Dihuang pill treatment had an obvious tread to increase the contents of IL-2in yin deficiency participants, but there was no statistically significant difference.③Compared with the normal group, the levels of IL-4, IL-6, IL-10and IL-17A were significantly decreased in yang deficiency control group, the levels of IL-4and IL-17A were significantly decreased in yin deficiency control group but not obvious for the levels of IL-6and IL-10; compared with the yang deficiency control group, Guifu Dihuang pill treatment significantly increase the content of IL-4, IL-6, IL-10, and had obvious tread to increase the contents of IL-17A; compared with the yin deficiency control group, Liuwei Dihuang pill treatment significantly increased the content of IL-4, IL-6, IL-17A, and had obvious tread to increase the contents of IL-10, but there was no statistically significant difference.Conclustion:Our results indicated that compared with the normal group, the Thl/Th2index, serum IL-2,INF-γ, TNF-α, IL-4,IL-6,IL-10, and IL-17A in both yin deficiency and yang deficiency control groups had decreased. Compared with yang deficiency control group, the Thl/Th2index, serum IL-2,INF-γ, TNF-α, IL-4,IL-6,IL-10, and IL-17A in both yin deficiency control groups had increased. It showed that there were Thl type cytokine secretion differences between yang deficiency constitution and yin deficiency constitution. Guifu Dihuang pill treatment significantly increase the content of IL-2, INF-γ, TNF-α, IL-4, IL-6, IL-10of yang deficiency participants. Liuwei Dihuang pill treatment significantly increase the content of INF-γ, TNF-α, IL-4, IL-6, IL-10, IL-17A of yin deficiency participants.These may be the causes of correcting yin deficiency and yang deficiency constitution, restoring Th cell function point of balance and improving the body constitution.Research3:Yin deficiency and Yang deficiency constitution intervention effects ona the neuroendocrine immune systemMethods:Some25-40years old healthy subjects were recruited and divided into3groups according to their constitution type--heathy constitution, yang deficiency constitution and yin deficiency constitution. Then yang deficiency individuals were randomly divided into the control group of yang deficiency constitution and the intervention group of yang deficiency constitution.yin deficiency were randomly divided into the control group of yin deficiency constitution and the intervention group of deficiency constitution.There were a total of5groups and each group at least10cases. Participants in the intervention group of yin deficiency constitution and yang deficiency constitution were daily take Liuwei Dihuang pill and Guifu Dihuang pill respectively,6grams each time,2times a day. The process take90days. The rest3groups did not take medicines. After90days treatments, vein blood was drawn. We futher investigated the interventions of Liuwei Dihuang pill and Guifu Dihuang pill on the constitutions of yin deficiency and yang deficiency via the neuroendocrine immune system, such as the plasma levels of norepinephrine, dopamine and epinephrine,5-hydroxytryptamine and adreno-cortico-tropic-hormone, the contents of serum cortisol, IgA, IgG, and IgM, etc.ResultsrOur data showed that:①Compared with the normal group, the contents of serum cortisol and plasma ACTH significantly decreased in yand deficiency group, but not obvious for plasma5-HT; the contents of plasma ACTH significantly decreased, and the contents of cortisol and plasma5-HT had an obvious tread to decrease in yin deficiency group, but there was no statistically significant difference. Compared with the yang deficiency control group, Guifu Dihuang pill treatment increased the content of plasma5-HT, serum cortisol and plasma ACTH, but there was no statistically significant difference. Compared with the yin deficiency control group, Liuwei Dihuang pill treatment increased the content of plasma5-HT, serum cortisol and plasma ACTH, but there was no statistically significant difference.②Compared with the normal group, the content of norepinephrine had an obvious tread to increase in yang deficiency group, and the contents of both norepinephrine and dopamine had an obvious tread to increase in yin deficiency group, but there was no statistically significant difference. Guifu Dihuang pill treatment had an obvious tendency to decrease the level of norepinephrine, but not obvious for the contents of dopamineand epinephrine. Liuwei Dihuang pill treatment had an obvious tread to decrease the level of dopamine in yin deficiency group, but not obvious for the contents of norepinephrine and epinephrine.③Compared with the normal group, the levels of serum of IgA, IgG, and IgM in both yang deficiency group and yin deficiency group had no obvious significant change. Bot Guifu Dihuang pill treatment and Liuwei Dihuang pill treatment had no obvious effect in yang deficiency group and yin deficiency group.Conclustion:The research demonstrated that, the decrease of serum Cor and plasma ACTH content decreased in both yang deficiency and yin deficiency constitution. It suggests that the hypothalamic pituitary adrenal axis function decline.Although more subjective symptoms of participants were improved by the intervention of Guifu Dihuang pill and Liuwei Dihuang Pill, serum Cor and plasma ACTH content compared with control group did not change.It perhaps was related to less time of intervention and or poor compliance of subjects.In summary, the findings of the study and the main conclusions are as follows:①The hypothesis--"correlation between prescription and constitution" refer to that different individuals have different responses and adaptability of the application of prescription. The hypothesis is based on types and state of the body constitution and reflects the characteristics of traditional Chinese medical of prescription based on constitution differentiation.②The Th1/Th2index, serum IL-2,INF-γ, TNF-α, IL-4,IL-6,IL-10, and IL-17A in both yin deficiency and yang deficiency had decreased, for Thl, Th2cell subsets was inhibited. There was a tendency to shifting Th2lymphocyte subsets. In addition, the contents of plasma ACTH and serum cortisol also decreased in both yin deficiency and yang deficiency groups, which indicated the dysfunction of the hypothalamic-pituitary-adrenal axis. Compared with yang deficiency, the Thl/Th2index, serum IL-2,INF-γ, TNF-α, IL-4,IL-6,IL-10, and IL-17Ain yin deficiency groups had increased. It showed that there were Thl type cytokine secretion differences between yang deficiency constitution and yin deficiency constitution. This provides a partial explanation for the internal heat performance of yin deficiency constitution. Compared with yin deficiency, the Th1/Th2index, serum IL-2,INF-γ, TNF-α, IL-4,IL-6,IL-10, and IL-17A in yang deficiency groups had decreased. It showed that there were insufficient secretion of Thl type cytokine in yang deficiency constitution. This provides a partial explanation for intolerance to cold performance of yang deficiency constitution.Guifu Dihuang pill treatment significantly increase the content of IL-2, INF-γ, TNF-α, IL-4, IL-6, IL-10of yang deficiency participants. Liuwei Dihuang pill treatment significantly increase the content of INF-γ, TNF-α, IL-4, IL-6, IL-10, IL-17A of yin deficiency participants.These may be the causes of correcting yin deficiency and yang deficiency constitution and improve the body constitution.更多还原