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促肾上腺皮质激素(ACTH)释放的各个方面(基础分泌、昼夜节律、应激引起释放和反馈性调节)受中枢神经介质的调节,已证实有胆碱能、肾上腺素能及血清素能介质参与。在增生型皮质醇增多症(柯兴氏病)中,上述ACTH释放调节的几个方面都出现异常,提示中枢神经系统功能紊乱可能和神经介质的浓度或敏感性发生变化有关。本文试用抗血清素药物赛庚啶(Cypnoheptadin)治疗3例皮质醇增多症,临床症状和实验室检查迅速得到改善。赛庚啶分次口服,剂量从每天8毫克逐渐增加到24毫克。
Various aspects of ACTH release (basal secretion, circadian rhythm, stress-induced release and feedback regulation) are mediated by the central nervous system and choline, adrenergic and serotonergic mediators have been shown to be involved . In hyperplastic cortisol hyperactivity disorder (Cushing’s disease), several aspects of the regulation of ACTH release are abnormal, suggesting that central nervous system dysfunction may be related to changes in nerve medium concentration or sensitivity. In this paper, the trial of Cypnoheptadin, an anti-serotonin drug, was used to treat 3 patients with Cushing’s disease. Clinical symptoms and laboratory tests were rapidly improved. Cyproheptadine orally, divided doses, gradually increased from 8 mg per day to 24 mg.