甲型H1N1流感患者T淋巴细胞亚群与中医辨证分型相关性的回顾性研究  

Correlation between T lymphocyte subsets and different syndrome types in patients with influenza A (H1N1):a retrospective study

作　　者：黄羽[1] 曾星[1] 朱伟[2] 李莎莎[1] 周丹[1] 卢传坚[3] 

机构地区：[1]广东省中医院中心实验室,广东广州510006 [2]广东省中医院中药制剂学实验室,广东广州510006 [3]广东省中医院皮肤科,广东广州510006

出　　处：《中西医结合学报》2011年第2期143-147,共5页Journal of Chinese Integrative Medicine

基　　金：中医药行业科研专项(No.200907001-2B)

摘　　要：目的:观察不同中医证型甲型H1N1流感患者治疗前后T淋巴细胞亚群的变化。方法:回顾性纳入甲型H1N1流感患者111例,根据中医辨证的方法分为风热犯卫型(55例)、热毒袭肺型(36例)和风寒束表型(20例),按照患者自愿的原则,采用西药(对氨基乙酰酚或布洛芬)、中药汤剂(辨证用药)以及中西药结合的方法对患者进行治疗。另外选择20位健康志愿者做正常对照。应用流式细胞术检测不同证型甲型H1N1流感患者治疗前后T淋巴细胞亚群的变化。结果:治疗前,3种证型患者CD3+、CD4+T淋巴细胞的表达均低于正常对照组(P<0.01);风寒束表证患者CD8+T淋巴细胞的表达与正常对照组比较,差异无统计学意义;风热犯卫和热毒袭肺证患者CD8+T淋巴细胞的表达低于正常对照组(P<0.01);风寒束表证患者CD4+/CD8+的比值与正常对照组比较,差异无统计学意义;风热犯卫和热毒袭肺证患者CD4+/CD8+的比值高于正常对照组(P<0.01)。治疗后,3种证型患者的CD4+T淋巴细胞的表达升高,与正常对照组比较差异无统计学意义;风热犯卫和风寒束表证患者CD3+T淋巴细胞的表达升高,与正常对照组比较差异无统计学意义;热毒袭肺证患者CD3+T淋巴细胞的表达低于正常对照组(P<0.05);风热犯卫和热毒袭肺证患者CD8+T淋巴细胞的表达低于正常对照组(P<0.05);热毒袭肺证患者的CD4+/CD8+比值与正常对照组比较差异无统计学意义;风热犯卫证患者的CD4+/CD8+比值高于正常对照组(P<0.05)。结论:不同中医证型甲型H1N1流感患者的T淋巴细胞亚群的检测可为评价各中医证型甲型H1N1流感患者的细胞免疫功能提供客观依据,也对中医临床辨证分型提供了一定的参考价值。Objective：To investigate the changes in T lymphocyte subsets in patients with different syndrome types infected by influenza A（H1N1）virus after treatment.Methods：In this retrospective study,111 patients with H1N1 influenza were enrolled and divided into three groups according to their syndromes：exterior heat syndrome group（55 cases）,exterior cold syndrome group（20 cases）and heat toxin invading lung（HTIL）syndrome group（36 cases）.Patients were treated with Western medicine（acetaminophen or ibuprofen suspension）,traditional Chinese medicine（herbal medicine according to their syndromes）,or a combination of Western medicine and traditional Chinese medicine with patient＇s intentions.Another 20 healthy people were selected as normal control.Phenotypic features of T lymphocyte subsets in peripheral vein blood of patients before and after treatment were determined by flow cytometry.Results：Before treatment,the numbers of CD3-and CD4-postive T lymphocytes were lower in H1N1 patients with the three types of syndromes than in the normal controls（P0.01）,and the numbers of CD8-positive T lymphocytes were lower in exterior heat syndrome and HTIL syndrome groups than in normal control group（P0.01）.The ratio of CD4-positive to CD8-positive T lymphocytes in exterior cold syndrome group showed no difference as compared with the normal control group,and the ratios of CD4-positive to CD8-positive T lymphocytes in exterior heat syndrome and HTIL syndrome groups were higher than that in the normal control group（P0.01）.After treatment,the numbers of CD4-positive T lymphocytes increased in all the three types of syndromes in patients with H1N1,and showed no difference compared with the normal control group.The numbers of CD3-positive T lymphocytes in patients with exterior heat syndrome and exterior cold syndrome increased,and showed no difference compared with the normal control group.The number of CD3-positive T lymphocytes in H1N1 patients with HTIL syndrome was lower than that in the

关 键 词：流感病毒A型 H1N1亚型 T淋巴细胞亚群 证候 临床试验 回顾性研究 

分 类 号：R259[医药卫生—中西医结合]