月经期哮喘患者肺肾阳虚证与生殖激素、免疫相关性临床研究  

Clinical research on correlativity between lung-kidney yang-deficiency and reproductive hormone,immunity of patient with menstrual asthma

作　　者：李卫青[1] 李巨奇[1] 廖文生[1] 马全庆[1] 夏洪涛[1] 禤少敏[1] 赖伟娇[1] 刘艳艳[1] 秦彩霞[1] 王衍华[2] 

机构地区：[1]广东省深圳市罗湖区人民医院,深圳518001 [2]湖北中医药大学

出　　处：《山西中医》2016年第2期8-12,共5页Shanxi Journal of Traditional Chinese Medicine

基　　金：深圳市科技创新委员会知识创新计划-基础研究项目(编号:JCY20130402092502096)

摘　　要：目的:观察月经期哮喘(PMA)患者生殖激素、T淋巴细胞与呼气峰流速的变化,探讨其相关性及在中医证型肺肾阳虚证(虚寒证)、非肺肾阳虚(非虚寒证)的表达。方法:选择PMA患者161例为研究对象、正常健康女性50例为对照;采用免疫荧光抗体标记和流式细胞仪检测外周血Ⅰ/Ⅱ型T淋巴细胞水平;放射免疫分析法测定血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_2)、睾酮(T)、孕酮(P)的含量;采用GD微型峰流速仪测定气道峰流速(PEF)及变异率。结果:(1)PMA患者在月经前、月经期PEF值明显降低(P<0.05、P<0.01),PEF变异率≧20%例数显著增多(P<0.05);(2)与正常组比较:虚寒证组患者血清T、FSH激素水平的降低(P<0.05),E2激素水平降低则有显著性(P<0.01)。非虚寒证组患者血清P激素水平显著升高(P<0.01),T、LH激素水平亦升高,有统计学意义(P<0.05);(4)与正常组相比,虚寒证组患者外周血中CD_3^+T、CD_3^+CD_8^+T、Th_2、Th_2/Th_1、Tc_2、Tc_1细胞的含量显著降低(P<0.01),Tc_2/Tc_1降低(P<0.05);CD_3^+CD_4^+T细胞含量升高(P<0.05),CD_3^+CD_4^+T/CD_3^+CD_8^+T、Th_1升高(P<0.01)。非虚寒证组患者外周血中CD_3^+T、CD_3^+CD_8^+T、Tc_1细胞的含量降低(P<0.01),CD_3^+CD_4^+T、Th_1细胞含量降低(P<0.05);Th_2/Th_1、Tc_2升高(P<0.05),Tc_2/Tc_1升高(P<0.01)。CD_3^+CD_4^+T/CD_3^+CD_8^+T、Th_2有升高趋势,但无统计学意义(P>0.05)。(4)PMA虚寒证患者T淋巴细胞Th_2、Tc_2、Th_1、Tc_1细胞与血清生殖激素中E_2、P、T、FSH等水平变化相关,与PRL、LH水平变化无明显相关性。Th_1细胞与E_2呈负相关(r=-0.551,P<0.05),Th_2、Tc_2细胞、Th_2/Th_1与T呈正相关(r=0.549,P<0.01;r=0.619,P<0.01;r=0.382,P<0.05),Th1细胞与P、FSH呈负相关(r=-0.353,P<0.05)。结论:PMA患者围月经期存在生殖激素的波动,尤其是E_2和(或)P水平激素水平的异常,对气道呼气峰流速有影响,且与虚寒证的发生相关。Objective ： To observe the changes of reproductive hormone, T lymphocytes and peak expiratory flow in patient with menstrual asthma（PMA） , and to explore its correlativity and the expressions of lung and kidney yang-deficiency （deficiency-cold syndrome） and non lung and kidney yang-deficiency （non deficiency-old syndrome）. Methods： 161 cases of PMA patients were chosen as the research objects,50 cases of normal healthy women as controls; Ⅰ/Ⅱ type T lymphocyte levels in peripheral blood were detected by imnmnofluorescent antibody labeling and flow cytometry; The contents of follicle stimulating hormone （FSH）, luteinizing-hormone （LH）, estradiol（E2）, testosterone （T） and progesterone （P） in serum were determined by radioimmunoassay; the peak expiratory flow（PEF） and the variation rate were determined by GD mini peak flow meter. Results：（ 1 ） PEF values of PMA patients were obviously decreased before the menstruation and during the menstrual period （P 〈 0.05, P 〈0. 01 ）, PEF variation rates≥20% the number of cases were obviously increased （ P 〈 0.05 ）. （2） Compared with normal group： T, FSH hormone levels in serum of patients with deficiency-cold syndrome were decreased （P 〈 0. 05 ） , E2 hormone levels were obviously decreased （ P 〈 0. 01 ）. P hormone levels in serum of patients with non deficiency-cold syndrome were obviously increased （P 〈 0. 01 ）, T, LH hormone levels were also increased, there was statistical significance （P 〈 0. 05）. （3） Compared with the normal group： CD3 T, CD3 CDs T, Th2,Th2/ThI ,Tc2,TcI cell contents in pe- ripheral blood of patients with deficiency-cold syndrome were obviously decreased（P 〈0. 01 ）, Tc2/Tc1 were decreased （P 〈 0. 05）,while CD3＋ CD4 T cell contents were increased （P 〈 0. 05 ）, CD3 CD4 T / CD3 CDs T, Th, were increased （P 〈0.01 ）. CD3＋T, CD3 CD8 T, Tc1 cell contents in peripheral blood of patients with non deficiency-cold syndrome were decreased P

关 键 词：月经相关性哮喘 虚寒证 非虚寒证 性激素水平 Ⅰ/Ⅱ型T淋巴细胞 气道峰流速 

分 类 号：R562.25[医药卫生—呼吸系统]