T淋巴细胞亚群和肝功能指标与慢性乙型肝炎患者中医辨证分型的相关性  

Correlation between T lymphocyte subgroup,liver function indexes and TCM syndrome differentiation in chronic hepatitis B patients

作　　者：吴林军[1] 周翼[1] 蒲文杰 刘于嵩 WU Linjun;ZHOU Yi;PU Wenjie;LIU Yusong(Department of Clinical Laboratory,Leshan Traditional Chinese Medicine Hospital,Leshan 614000,Sichuan,China;Clinical Medical Laboratory Center,Sichuan Academy of Medical Sciences,Sichuan Provincial People's Hospital,Chengdu 610072,Sichuan,China)

机构地区：[1]乐山市中医医院检验科,四川乐山614000 [2]四川省医学科学院,四川省人民医院临床医学检验中心,四川成都610072

出　　处：《检验医学》2024年第2期166-170,共5页Laboratory Medicine

基　　金：乐山市重点科技项目(22SZD129)。

摘　　要：目的 分析T淋巴细胞亚群和肝功能指标与慢性乙型肝炎(CHB)患者中医辨证分型的相关性,为临床中医辨证分型、治疗方案选择和疗效观察提供科学依据。方法 选取2020年1—12月乐山市中医医院983例CHB患者,其中中医辩证分型实证270例(湿热中阻证75例、瘀血阻络证195例)、虚证713例(肝郁脾虚证662例、肝肾阴虚证28例、脾肾阳虚证23例)。检测各证型患者肝功能相关指标[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总蛋白(TP)、白蛋白(Alb)、总胆红素(TB)、直接胆红素(DBil)]和T细胞(CD3~+、CD4~+、CD8~+)计数,分析各项指标与CHB中医证型的相关性。结果 肝郁脾虚证、瘀血阻络证、湿热中阻证、肝肾阴虚证、脾肾阳虚证临床CHB频率依次升高。CHB各证型中,脾肾阳虚证患者年龄最大,湿热中阻证患者年龄最小。各证型间肝功能相关指标和T淋巴细胞计数差异均有统计学意义(P<0.05);CD3~+、CD4~+T细胞计数与湿热中阻证呈正相关(P<0.05),与脾肾阳虚证呈负相关(P<0.05)。结论 T淋巴细胞亚群和肝功能相关指标与CHB患者中医辨证分型存在相关性,可为临床中医辨证分型、治疗方案选择和疗效观察提供客观依据。Objective To study the correlation between T lymphocyte subgroup,liver function indexes and traditional Chinese medicine(TCM)syndrome differentiation in chronic hepatitis B(CHB)patients,and to provide a reference for clinical TCM syndrome differentiation,choice of treatment and observation of therapeutic efficacy.Methods Totally,983 patients with CHB were enrolled,and the types of TCM syndrome differentiation were as follows:solid syndrome(270 cases,including 75 cases of damp-heat obstruction syndrome and 195 cases of blood stasis obstruction syndrome)and deficiency syndrome(713 cases,including 662 cases of liver-depression and spleen-deficiency syndrome,28 cases of liver-kidney yin-deficiency syndrome and 23 cases of spleen-kidney yang-deficiency syndrome).By determining liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total protein(TP),albumin(Alb),total bilirubin(TB),direct bilirubin(DBIL)]and T lymphocyte counts(CD3+,CD4+,CD8+),the correlation between each index and TCM syndrome was evaluated.Results The frequency of CHB was as follows:liver-depression and spleen-deficiency>blood stasis obstruction>damp-heat obstruction>liver-kidney yin-deficiency>spleen-kidney yang-deficiency.Among the CHB syndromes,the patients with spleen-kidney yang-deficiency syndrome were elder,and the patients with damp-heat obstruction syndrome were young.Liver function indexes and T lymphocyte counts had statistical significance among the different syndromes.CD3+and CD4+cell counts were positively correlated with solid++and damp-heat obstruction syndromes(P<0.05),and CD3 and CD4 T cell counts were negatively correlated with spleen-kidney yang-deficiency syndrome(P<0.05).Conclusions The liver function indexes and T lymphocyte subgroup are correlated with TCM syndrome differentiation in CHB patients,which can provide a reference for clinical TCM syndrome differentiation,choice of treatment and observation of therapeutic efficacy.

关 键 词：T淋巴细胞亚群 肝功能 慢性乙型肝炎 中医辨证分型 

分 类 号：R446.1[医药卫生—诊断学]