慢性阻塞性肺疾病中医证型分布及不同证型间T淋巴细胞亚群指标差异性的研究  

Study on the Distribution of Chinese Medicine Syndrome Types in Chronic Obstructive Pulmonary Disease and the Differences Between Indexes in T-lymphocyte Subsets of Different Syndrome Types

作　　者：刘梅[1] 彭文照 郝小梅[2] LIU Mei;PENG Wenzhao;HAO Xiaomei

机构地区：[1]广州中医药大学基础医学院,广东广州510006 [2]广东省第二中医院,广东广州510095

出　　处：《新中医》2018年第7期75-78,共4页New Chinese Medicine

基　　金：广东省中医药局建设中医药强省科研课题(20152011);广东省医学科研基金资助项目(20152011);广东省高水平大学学科专项资助项目

摘　　要：目的:初步探讨慢性阻塞性肺疾病(COPD)患者的中医证候分布,以及比较不同证型间的T淋巴细胞亚群辅助性T淋巴细胞(Th)17、调节性T淋巴细胞(Treg)、Th22是否存在差异。方法:选取115例COPD患者,将20例同期体检未患COPD者设为对照组。将COPD患者根据辨证标准分为8个证型,将风寒束肺证、外寒内饮证、痰热壅肺证、痰湿阻肺证设为偏实证组,将脾肺气虚证、肺肾气虚证、肺肾气阴两虚证、气虚血瘀证设为偏虚证组。分析不同中医证型间的T淋巴细胞亚群指标,并将偏实证组、偏虚证组与对照组进行T淋巴细胞亚群指标的比较。结果:COPD患者中医证候分布:风寒束肺证2例,占1.74%;外寒内饮证1例,占0.87%;痰热壅肺证22例,占19.13%;痰湿阻肺证29例,占25.22%;脾肺气虚证21例,占18.26%;肺肾气虚证23例,占20.00%;肺肾气阴两虚证6例,占5.22%;气虚血瘀证11例,占9.57%。痰热壅肺证组Treg细胞分数、Th17细胞/Treg细胞比值、Th22细胞分数与痰湿阻肺证组相比,差异均无统计意义(P>0.05);脾肺气虚证组Th17细胞分数、Treg细胞分数、Th17细胞/Treg细胞比值、Th22细胞分数与肺肾气虚证组、肺肾气阴两虚证组、气虚血瘀证组相比,差异均无统计学意义(P>0.05)。痰湿阻肺证组Th17细胞分数低于痰热壅肺证组,差异有统计学意义(P<0.05);脾肺气虚证组、肺肾气虚证组、肺肾气阴两虚证组、气虚血瘀证组的Th17细胞分数、Th17细胞/Treg细胞比值、Th22细胞分数均低于痰热壅肺证组与痰湿阻肺证组(P<0.05),Treg细胞分数均高于痰热壅肺证组与痰湿阻肺证组(P<0.05)。偏虚证组和偏实证组的Th17细胞分数、Th17细胞/Treg细胞比值、Th22细胞分数均高于对照组(P<0.05);偏虚证组Treg细胞分数高于对照组(P<0.05),偏实证组Treg细胞分数低于对照组(P<0.05);偏虚证组Th17细胞分数、Th17细胞/Treg细胞比值、Th22细胞分数均低于偏实证组(P<0.05),Treg细胞分�Objective： To preliminarily discuss the distribution of Chinese medicine syndrome types in patients with chronic obstructive pulmonary disease（COPD）,and compare differences between the helper T lymphocytes 17（Th）, regulatory T lymphocytes（Treg）,and Th22 in T-lymphocyte subsets of different syndrome types. Methods：Selected 115 cases of patients with COPD,and set20 cases of patients without COPD as the control group. Divided patients with COPD into eight syndrome types. Set patients with syndrome of wind-cold fettering the lung,syndrome of external cold and internal fluid,syndrome of phlegm-heat obstructing lung,or syndrome of phlegm-damp obstructing lung into the excess dominance group. Set patients with syndrome of spleen-lung qi deficiency,syndrome of lung-kidney qi deficiency,syndrome of deficiency of both qi and yin of lung and kidney or syndrome of qi deficiency and blood stasis into the deficiency dominance group. Compared and analyzed the indexes in T-lymphocyte subsets of different Chinese medicine syndrome types, and compared those indexes among the excess dominance group, the deficiency dominance group and thecontrol group. Results： The distribution of Chinese medicine syndrome types in patients with COPD is as follows： 2 cases with syndrome of wind-cold fettering the lung（1.74%）, 1 case with syndrome of external cold and internal fluid（0.87%）, 22 cases with syndrome of phlegm-heat obstructing lung（19.13%）,29 cases with syndrome of phlegm-damp obstructing lung（25.22%）,21 cases with syndrome of spleen-lung qi deficiency（18.26%）,23 cases with syndrome of lung-kidney qi deficiency（20.00%）,6 cases with syndrome of deficiency of both qi and yin of lung and kidney（5.22%）, 11 cases with syndrome of qi deficiency and blood stasis（9.57%）.No significant difference was found in the comparisons of the Treg fraction,ratio of Th17 to Treg and Th22 fraction between the group with syndrome of phlegm-heat obstructing lung and the group with syndrome of phlegm-damp obstr

关 键 词：慢性阻塞性肺疾病(COPD) 中医证候 T淋巴细胞亚群 炎症 

分 类 号：R563[医药卫生—呼吸系统]