原发性支气管肺癌中医证型与免疫指标、细胞因子的相关性研究  

Study on relativity between type of syndrome differentiation and immunity index and cytokine in primary bronchogenic carcinoma

作　　者：马科[1] 马立凤[2] 施志明[3] 

机构地区：[1]宁夏医学院中医学院中医内科教研室,宁夏750004 [2]银川市第一人民医院内科 [3]上海中医药大学附属龙华医院肿瘤三科

出　　处：《北京中医药大学学报》2008年第1期64-66,共3页Journal of Beijing University of Traditional Chinese Medicine

基　　金：宁夏自然科学基金项目(NoNZ0773)

摘　　要：目的探讨原发性支气管肺癌患者各证型与免疫指标、细胞因子之间的关系,进一步探寻原发性支气管肺癌患者各证型在微观辨证上具有指导意义的相关指标,以期建立其宏观、微观辨证体系。方法对93例肺癌患者应用流式细胞仪、酶联反应法及ELISA方法检测免疫指标和细胞因子,并运用方差分析探讨免疫指标、细胞因子与各证型之间的相关性。结果在痰湿蕴肺肺失宣降证型中CD3偏高(P<0.05);在肺阴亏虚阴虚内热证型中CD62P偏低(P<0.05);在肺脾气虚运化失司证型中IL-2、CD3均偏低(P<0.05),血管内皮生长因子(VEGF)增高趋势明显;在肾阳虚衰肾不纳气证型中CD62P偏高(P<0.05),VEGF增高趋势明显;在气血亏虚阴阳失衡证型中CD3和CD4偏低(P<0.05)。结论据这些微观指标并结合临床经验可初步得出原发性支气管肺癌证型由轻至重的大致演变趋势:痰湿蕴肺肺失宣降→肺阴亏虚阴虚内热→气血亏虚阴阳失衡→肺脾气虚运化失司→肾阳虚衰肾不纳气。提示肺癌发病早期就易出现化热或热相而伤及机体气血津液,中期由于癌变的耗气伤津易造成机体气血阴阳失去平衡,后期由于癌变的进一步内侵则出现肺脾同病、肺肾同病的脏腑病变。Objective To investigate the relativity between primary bronchogenic carcinoma and immunity index and cytokine, further to look for the related index for microcosmic syndrome differentiation of various syndromes of primary bronchogenic carcinoma, try to establish macrocosmic and microcosmic syndrome differentiation system for typing of TCM syndrome of primary bronchogenic carcinoma. Methods Immunity index and cytokine of 93 definite cases were detecteded by flow cytometry, and ELISA. One- Way Analysis of Variance was used to analyze the relativity between type of syndrome differentiation and immunity index and cytokine. Results The CD3 was significantly high in the syndrome of phlegm-damp accumulating in the lung resulting impairment of dispersing and descending function （P 〈 0.05 ） ; the CD62P was significantly low in the syndrome of lung-yin deficiency resulting internal heat （P 〈 0.05 ） ; both of IL-2 and CD3 were obviously low in the syndrome of lung-qi and spleen-qi deficiency and dysfunction of transportation and transformation （ P 〈 0. 05 ） and the VEGF was higher but without statistical meaning（ P 〉 0.05 ） ;the CD62P was low in the syndrome of kidney yang deficiency and failing to promote inspiration （ P 〈 0.05 ） and the VEGF was high but without statistical meaning ; both of CD3 and CD4 were low in the syndrome of qi and blood deficiency and yin-yang imbalance （ P 〈 0. 05 ）. Conclusion The develop from light to severe is in following tendency： phlegm-damp accumulating in the lung resulting impairment of dispersing and descending function→lung-yin deficiency resulting internal heat→qi and blood deficiency and yin-yang imbalance→lung-qi and spleen-qi deficiency and dysfunction of transportation and transformation→ kidney yang deficiency and failing to promote inspiration. It is suggested that in the early stage of lung cancer heat transforming often injured qi-blood and body fluid. In the middle stage, tumor qi consumping and body fluid damaging by tumor resul

关 键 词：原发性支气管肺癌 中医证型 免疫指标 细胞因子 相关性 

分 类 号：R273.42[医药卫生—中西医结合]