岭南慢性阻塞性肺疾病常见中医证型主要症状分布及不同证型间T淋巴细胞亚群与肺功能指标的差异性初探  

Distribution of main syndromes of common TCM syndromes in Lingnan COPD and the difference between T lymphocyte subsets and pulmonary function indexes among different syndromes

作　　者：彭文照 刘梅[1] 郝小梅[2] PENG Wen-zhao;LIU Mei;HAO Xiao-mei(College of Basic Medical Sciences,Guangzhou University of Traditional Chinese Medicine,Guangzhou 510006,China;Guangdong Second Hospital of Traditional Chinese Medicine,Guangzhou 510095,China)

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

出　　处：《中华中医药杂志》2019年第8期3747-3750,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：广东省中医药局建设中医药强省科研课题(No.20152011);广东省医学科研基金资助项目(No.20152011);广东省高水平大学学科专项资助~~

摘　　要：目的:初步探讨岭南地区慢性阻塞性肺疾病(COPD)患者常见中医证型间T淋巴细胞亚群指标和肺功能指标之间的差异性,以及主要症状分布。方法:对符合纳入标准的COPD患者进行中医辨证,4个证型组各20例,观察主症分布,同期体检未患COPD者20名为正常对照组,比较分析各组间T淋巴细胞亚群指标和肺功能指标差异。结果:排在前9的主症依次是气短、喘息、咳嗽、乏力、痰多、胸闷、发热、便溏、脘腹胀满;各组间T淋巴细胞亚群指标比较:Th17细胞分数痰浊壅肺证组<痰热郁肺证组(P<0.05);Th17、Th22细胞分数、Th17/Treg比值正常对照组<肺脾气虚证组、肺脾肾气虚证组<痰热郁肺证组、痰浊壅肺证组(P<0.05);Treg细胞分数痰热郁肺证组与痰浊壅肺证组高于其他3组;肺功能指标:各组间FEV1%、FEV1/FVC按正常对照组>痰热郁肺证组=痰浊壅肺证组>肺脾气虚证组>肺脾肾气虚证组分布。结论:COPD病情在痰热郁肺证和痰浊壅肺证时,炎性反应与免疫失衡相对加重,或是导致炎性分泌物大量增多的原因之一;随着COPD患者肺功能的逐渐下降,中医辨证中患者“气虚”的症状表现也逐渐加深,由肺脾气虚逐渐向肺脾肾气虚发展,最终导致患者的肺功能进行性下降。Objective:To explore the difference of T lymphocyte subsets and pulmonary function indexes between common TCM syndromes in patients with COPD in Lingnan area and the distribution of main symptoms.Methods:TCM syndrome differentiation was measured for COPD patients who met the inclusion criteria,20 cases were included in the four syndrome groups,the distribution of main symptoms was observed,20 cases without COPD were set as normal control group,the T lymphocyte subsets and pulmonary function indexes among groups were compared and analyzed.Results:The distribution of symptoms in the top 9 shows:shortness of breath,breathing,cough,fatigue,phlegm,chest tightness,fever,loose stools,abdominal distention.The comparison of T lymphocyte subsets in each group showed that the Th17 cell fraction in phlegm turbid stagnation lung syndrome group was lower than that in phlegm heat stagnation lung syndrome group(P<0.05),Th17,Th22 cell fraction and Th17/Treg ratio in normal control group<pulmonary spleen qi deficiency syndrome group,pulmonary spleen and kidney qi deficiency syndrome group<phlegm turbid stagnation lung syndrome group,phlegm heat stagnation lung syndrome group(P<0.05),Treg cell fraction of phlegm turbid stagnation lung syndrome group,phlegm heat stagnation lung syndrome group was higher than the other three groups.The distribution of FEV1%,FEV1/FVC in each group were as follows:normal control group>phlegm heat stagnation lung syndrome group=phlegm turbid stagnation lung syndrome group>pulmonary spleen qi deficiency syndrome group>pulmonary spleen and kidney qi deficiency syndrome group.Conclusion:In COPD patients with phlegm heat stagnation lung syndrome group and phlegm turbid stagnation lung syndrome group,the inflammatory reaction and immune imbalance are relatively aggravated.This may be one of the causes of a large increase in inflammatory secretions with the gradual decline of lung function in patients with chronic obstructive lung,the symptoms of‘qi deficiency’in patients with TCM syndrome differentiation

关 键 词：慢性阻塞性肺疾病 中医证型 T淋巴细胞亚群 肺功能 

分 类 号：R56[医药卫生—呼吸系统]