系统性红斑狼疮中医证型与实验室指标关系的探讨  

Exploration into Relationship between TCM Syndrome Type and Laboratory Indexes in Patients with Systemic Lupus Erythematosus

作　　者：刘维[1] 刘晓亚[1] 张宏博[2] 张磊[1] 王熠[1] 房丹[2] 贾宁[2] 于广莹[2] 高春鹤[2] 

机构地区：[1]天津中医药大学第一附属医院,天津300193 [2]天津中医药大学

出　　处：《中国中西医结合杂志》2008年第2期115-117,共3页Chinese Journal of Integrated Traditional and Western Medicine

摘　　要：目的探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)中医证型与实验室指标变化的关系。方法383例SLE患者,根据中医从"毒"辨证,将其分为6型:热毒炽盛型,瘀热蕴毒型,浊毒壅阻型,热毒灼阴型,肝郁毒结型,正虚邪恋型,分别检测补体C3、免疫球蛋白(IgA、IgM、IgG)、ALT、24h尿蛋白定量、白细胞(WBC)、血小板(PLT)以及计算SLEDAI积分等。结果各证型IgA、IgM水平与正常值比较差异无统计学意义;热毒炽盛型、瘀热蕴毒型IgG水平较正常值为高,分别为18713.81mg/L和23131.54mg/L,且瘀热蕴毒型与浊毒壅阻型比较差异有统计学意义(P<0.05)。热毒炽盛型补体C3均值最低(586.32mg/L),正虚邪恋型与其余各证型比较差异有统计学意义(P<0.05)。白细胞计数和血小板计数比较,热毒灼阴型均低于其余5型,与其余5型比较有统计学意义(P<0.05);各证型24h尿蛋白定量水平较正常值为高,其中浊毒壅阻型(2.78g/24h)水平最高;肝郁毒结型ALT(112.75U/L)水平高于其余5型。结论中医证型不同,则各实验室指标不同,这些规律可为SLE临床疗效评价提供参考。Objective To investigate the relationship between TCM syndrome type and laboratory indexes in patients with systemic lupus erythematosus （SLE）. Methods Three hundred and eighty-three SLE patients were differentiated into six syndrome types based on the ＂toxin＂ sydrome differentiation of TCM, Type 1, the heat-toxin flourishing type ; Type 2, the stasis heat with toxin type ; Type 3, the turbid toxin congested type; Type 4, the general deficiency with evll stay type; Type 5, the heat-toxin burning yin type; Type 6, the Gan-stagnant with toxin convergency type. The indexes, including complement C3 （C3）, immunoglobulin A （IgA）, immunoglobulin M （IgM）, immunoglobulin G （IgG）, alanine aminotransferase （ALT）, 24 h urinary protein quantitation, white blood cell （WBC） and platelet （PLT） count, were determined, and the SLEDAI score was calculated. Resuits Levels of IgA and IgM in all patients were basically normal. Level of IgG was higher than the normal range in patients of type 1 and 2, being 18 713.81 mg/L and 23 131.54 mg/L respectively, showing significant difference between the Type 2 and Type 3 （ P 〈 0.05 ） ; the lowest mean value of C3 presented in patients of type 1 （586.32 mg/L）, and that in patients of type 4 was significantly different to that in patients of other types （P 〈 0.05 ） ; count of WBC and PLT was lower in patients of type 5 and significantly different to that in the other five types （ P 〈 0.05 ） ; level of 24 h urinary protein quantitation was higher than normal in all the patients and the highest level （2.78 g,/24 h） was found in patients of type 3 ; and the highest level of ALT （ 112.75 U/L） appeared in patients of type 6 as compared with that in patients of other types. Conclusion Different variations of laboratory indexes present in SLE patients of different syndrome types, there are certain relationship between the TCM syndrome types and the laboratory indexes, and these rules may provide reference for evaluating clinical therap

关 键 词：系统性红斑狼疮 中医证型 实验室指标 

分 类 号：R259[医药卫生—中西医结合]