类风湿性关节炎中医辨证分型与实验室指标的研究  

Study on the Relationship of Traditional Chinese Medicine Types of Rheumatoid Arthriti s and Laboratory Indexes

作　　者：于秀明[1] 刘学明[1] 侯云峰[1] 栗洪波[1] 

机构地区：[1]长春中医药大学第一附属医院免疫室,吉林长春130021

出　　处：《中华中医药学刊》2007年第7期1462-1464,共3页Chinese Archives of Traditional Chinese Medicine

摘　　要：目的:将类风湿性关节炎(RA)中医辨证分型与客观检测指标相结合,为中医诊断客观化提供参考。方法:将210例RA患者按中医辨证分型分为湿热痹阻、寒湿痹阻、肾气虚寒、肝肾阴虚、瘀血痹阻5组。血清类风湿因子(RF)检测采用乳胶凝集法,抗瓜氨酸合成蛋白抗体(CPA)检测采用酶联免疫吸附实验法(ELISA),抗核周因子(APF)检测采用间接免疫荧光法(ⅡF),肿瘤坏死因子-α(TNF-α)检测采用放射免疫法(RIA),各组间数据进行比较及相关分析。结果:RA湿热痹阻型CPA阳性率显著高于寒湿痹阻型和肝肾阴虚型,有高度统计学意义(P<0.01);湿热痹阻型APF阳性率高于瘀血痹阻型,有统计学意义(P<0.05);TNF-α检测结果在各证型组间进行比较,寒湿痹阻型高于肝肾阴虚型和瘀血痹阻型,有统计学意义(P<0.05)。结论:CPA和APF可作为RA辨证分型的客观指标,TNF-α可作为RA活动期或进展期的参考指标。Objective： To combine Traditional Chinese Medicine（TCM） syndrome patterns of RA with objective indexes,and to provide a objective reference on TCM diagnosis of RA. Methods： 210 cases of RA were divided into five TCM syndrome pattern group ： Shi - Re - Bi - Zu group, Han - Shi - Bi - Zu group, Shen - Qi - Xu - Han group, Gan - shen - Yin- xn group and Yu- Xue -Bi -Zu group znlab, we select latex agglutination test on RF, Enzyme Linked Immunosorbent Assay（ELISA） on CPA, Indirect Immunofluorescence（ Ⅱ F） on APF and Radio Immunoassay（RIA） on TNF- α examination respectively, and then use statistic methodology to analyze the results and their relativety. Results： The results showed there are statistic great distinguish between the Shi -Re- Bi -Zu group and Han- Shi- Bi -Zu group,Gan -Shen- Yin -Xu group on CPA（ P 〈0.01 ） ,There are also statistic distinguish between Shi- Re- Bi- Zu group and Yu - Xue - Bi - Zu group on APF（ P 〈 0. 05 ）. The levels of TNF - α in serum from Han - Shi - Bi - Zu group are higher than those of Gan - Shen - Yin - Yu group and Yu - Xue - Bi - Zu group,there statistic significance on TNF - α（ P 〈 0. 05）. Conclusion： CPA and APF can become objective indexes of syndrome pattern of TCM on RA,TNF TNF-α can be regarded as reference indexes of active stage and progression on RA.

关 键 词：类风湿性关节炎 辨证分型 抗瓜氨酸合成蛋白抗体 抗核周因子 肿瘤坏死因子-Α 痹证 

分 类 号：R593.22[医药卫生—内科学]