摘要
目的:探讨CD_4^+/CD_8^+、自然杀伤(natural killer,NK)细胞、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-1β(interleukin-1β,IL^(-1)β)及IL-6水平对职业性尘肺病中医辨证的影响。方法:分析173例职业性尘肺患者的中医证候,采用流式细胞术检测其中虚实夹杂类职业性尘肺病患者外周血CD_4^+/CD_8^+和NK细胞百分比,采用化学发光法检测TNF-α、IL^(-1)β及IL-6水平。结果:(1)实证类共12例(6.93%),其中痰湿阻肺证6例(3.47%),痰热蕴肺证3例(1.73%),瘀血阻络证3例(1.73%);(2)虚证类共16例(9.25%),其中肺脾气虚证5例(2.89%),肺阴亏虚证7例(4.05%),肺肾气虚证4例(2.31%);(3)虚实夹杂证类共145例(83.81%),其中肺阴亏虚、瘀血阻络证84例(48.55%),肺肾气虚、痰热蕴肺证26例(15.03%),肺脾气虚、痰湿阻肺证35例(20.23%)。与肺肾气虚、痰热蕴肺证患者比较,肺阴亏虚、瘀血阻络证患者的CD_4^+/CD_8^+低于肺脾气虚、痰湿阻肺证患者,差异有统计学意义(P<0.05);另肺肾气虚、痰热蕴肺证患者CD_4^+/CD_8^+与肺阴亏虚、瘀血阻络证患者比较,差异无统计学意义(P>0.05)。3类患者的NK细胞、TNF-α、IL^(-1)β及IL-6水平比较,差异均无统计学意义(P>0.05)。结论:CD_4^+/CD_8^+可作为尘肺病中医辨证分型客观化的参考指标之一,在尘肺病的治疗中可有针对性的应用中医中药调节免疫功能。
Objective： To investigate CD4＋/CD8＋,natural killer(NK） cells,tumor necrosis factor-α(TNF-α）,and interleukin-1β(IL-1β） Effects of IL-6 Levels on TCM Syndrome Differentiation of Occupational Pneumoconiosis. Methods： TCM syndromes of 173 patients with occupational pneumoconiosis were analyzed. Percentages of CD4 ＋/CD8 ＋ and NK cells in peripheral blood of patients with occupational pneumoconiosis were measured with flow cytometry. TNF-α,TNF-1β and IL-6 levels were measured by chemiluminescence method. Results： Occupational pneumoconiosis was divided into three kinds in syndrome.（1）12 cases of excessive syndrome(6. 93%）,which includes 6 cases of Phlegm and Dampness Obstructing in Lung Syndrome(3. 47%）,3 cases of Phlegm and Fever in Lung Syndrome(1. 73%）,and 3 cases of Blood Stasis Syndrome(1. 73%）.（2）16 cases of Deficiency Syndrome(9. 25%）,in which 5 cases of Lung and Spleen Qi Deficiency Syndrome(2. 89%）,7 cases of Lung Yin Deficiency Syndrome(4. 05%）,4 cases of Lung and Kidney Qi deficiency Syndrome.（3） There were 145 cases(83. 81%） of mixed syndromes,including 84 cases(48. 55%） of Lung Yin deficiency and Blood Stasis Syndrome,26 cases of Lung and Kidney Qi Deficiency as well as Phlegm and Heat Accumulation in lung Syndrome(15. 03%）. There are 35 cases of Lung and Spleen Qi Deficiency as well as Phlegm obstruction in Lung(20. 23%）. Compared with patients with Lung-Kidney Qi Deficiency and Phlegm-Heat syndrome,the CD4＋/CD8＋levels in patients with Deficiency of Lung Yin and Blood Stasis Syndrome were significantly lower(P 〈 0.05）. There was no significant difference between the patients with Lung-Kidney Qi Deficiency and Phlegm-Heat Syndrome(P 〉 0.05）. There was no significant difference in the levels of NK cells,TNF-α,IL-1β and IL-6 among the three groups(P 〉 0. 05）.Conclusion： CD4＋/CD8＋can be used as one of the reference indicators for the objective TCM syndrome differentiation of pneumoconiosis. In treatment of pneumoconiosis,the traditional Chinese medicine can be used to regulate the immune function.
作者
王慧娟
王永杰
王湘雨
WANG Huijuan;WANG Yongjie;WANG Xiangyu(Henan Institute of Occupational Disease Control, Zhengzhou Henan China 450052;The First Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450000)
出处
《中医学报》
CAS
2018年第5期725-728,共4页
Acta Chinese Medicine
基金
国家临床重点专科建设项目(201117)
