痰湿体质非酒精性脂肪性肝病患者临床特点及其与T细胞亚群TH-17相关性研究  

Study on Phlegm-dampness Constitution in Non-alcoholic Fatty Liver Disease and Its Correlation With TH-17 Cells Imbalance

作　　者：史会连[1] 田文君 刘丽娜[1] 乔飞[1] 叶丽芳[1] 邵铭[1] SHI Huilian;TIAN Wenjun;LIU Lina;QIAO Fei;YE Lifang;SHAO Ming(Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210000,Jiangsu,China;Nanjing Hospital of Traditional Chinese Medicine,Nanjing 210000,Jiangsu,China)

机构地区：[1]南京中医药大学附属医院,江苏南京210000 [2]南京市中医院,江苏南京210000

出　　处：《辽宁中医药大学学报》2020年第11期61-64,共4页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家自然科学基金(81903974)。

摘　　要：目的研究痰湿体质非酒精性脂肪性肝病(NAFLD)患者与非痰湿体质患者之间的特征分析及其与TH-17的相关性分析。方法对南京市城乡258例因NAFLD来医院门诊就诊的NAFLD患者按照体质调查,并进行量表分析,并记录患者检查结果,分析主要痰湿体质和非痰湿体质体质类型与这些指标之间的关系。同时设立健康对照组、痰湿体质NAFLD组和非痰湿体质NAFLD组,通过ELISA法测定T细胞亚群TH-17相关细胞因子白细胞介素(IL-17、IL-6)和转化生长因子-β1(TGF-β1)3组之间的差异,并分析其相关性。结果痰湿体质组在生活方式上,易食用辛辣油腻食物(P<0.001),少动喜卧(P=0.001),从基本情况上,痰湿体质患者罹患糖尿病比例较高(P=0.03),更易身体质量指数(BMI)升高(P<0.001)。从辅助检查上,痰湿体质患者谷丙转氨酶(肝酶)更容易出现异常(P=0.04),B超提示重度脂肪肝比例高(P=0.04)。痰湿体质NAFLD组的IL-17、IL-6和TGF-β1水平高于非痰湿体质NAFLD组及健康对照组(P<0.05)。结论痰湿体质组NAFLD易BMI异常升高,出现重度脂肪肝、肝功能异常,需引起我们临床足够重视,可从生活方式调节及中医辨证论治等方面来调节。从细胞因子方面,痰湿体质NAFLD和IL-17、IL-6和TGF-β1有明显相关性,痰湿体质可能和TH-17细胞亚群及调节免疫有关。Objective To study the characteristic analysis between phlegm-dampnes and non-phlegmdampnes NAFLD patients.Methods 258 patients with NAFLD in nanjing to the hospital were defined by Classification and Determination of Body Constitution in TCM Standard.Then,we examed the scale analysis to determine the phlegm-dampnes,living habits and laboratory examination,in order to explore the relationship between these recorded data and body constitutions.Results The phlegm-dampness group was prone to eat spicy and greasy food(P=0.0001)and doing less exercise and more prone to sleeping(P=0.001).From the basic situation,the phlegm-dampness group had a higher proportion of diabetes(P=0.03)and a higher BMI(P<0.001).In terms of auxiliary examination,liver enzymes in patients with phlegm dampness were more likely to be abnormal(P=0.04),and abdominal ultrasonography indicated a high proportion of severe fatty liver(P=0.04).Conclusion NAFLD in the phlegm-dampness group was prone to abnormal increase in BMI,severe fatty liver and abnormal liver function.It indicated that we should pay enough attention to phlegm-dampness group in our clinical practice,which could be regulated from the aspects of lifestyle regulation and TCM syndrome differentiation,in terms of cytokines,phlegm-dampness group is significantly correlated with Il-17,IL-6 and TGF-β1,which may be related to the influence of T cell interfering with cellular immunity.

关 键 词：非酒精性脂肪肝 痰湿体质 IL-17 

分 类 号：R259[医药卫生—中西医结合]