摘要
目的:从营卫学说角度阐述滤泡辅助性T细胞(Tfh)/滤泡调节性T细胞(Tfr)失衡与类风湿关节炎中医病机之间的联系。方法:选取2021年9月至2022年12月在南京中医药大学附属中西医结合医院风湿免疫科就诊的门诊及住院类风湿关节炎患者62例,搜集患者一般情况、病史资料、中医辨证信息及血清样本。检测符合入选标准患者的空腹Tfh细胞比例、Tfr细胞比例、白细胞介素(IL)-21水平,描述营卫失调证候积分、Tfh细胞比例、Tfr细胞比例、Tfh/Tfr细胞比值与IL-21在类风湿关节炎患者中的分布,分析营卫失调证候积分、Tfh细胞比例、Tfr细胞比例、Tfh/Tfr细胞比值、IL-21等指标之间的相关性。结果:类风湿关节炎患者营卫失调证候积分与年龄、病程、红细胞沉降率、免疫球蛋白A、关节压痛数、健康评估问卷评分、28个关节病情活动指数评分呈正相关(P<0.05);类风湿关节炎患者的Tfh/Tfr细胞比值、IL-21与营卫失调证候积分呈正相关(P<0.05),Tfr细胞与营卫失调证候积分呈负相关(P<0.05)。结论:营卫失和是类风湿关节炎发生、发展的基本病机,影响患者病情。营卫失和可与Tfh/Tfr细胞失衡对应,Tfh/Tfr细胞平衡可能属于营卫和调在现代理论下的具象体现。
Objective:To elucidate the relationship between rheumatoid arthritis and Tfh/Tfr cell imbalance based on the Ying-Wei Theory.Methods:Sixty-two outpatients and inpatients with rheumatoid arthritis were selected who visited the Rheumatology and Immunology Department of Nanjing Integrated Traditional Chinese and Western Medicine Hospital from September 2021 to December 2022.General information,medical history,TCM syndrome differentiation information,and serum samples were collected from the patients.Detected the fasting Tfh cell and Tfr cell ratio,and interleukin-21 levels of patients who meet the inclusion criteria,described the ying-wei disharmony syndrome score,Tfh cell ratio,Tfr cell ratio,Tfh/Tfr cell ratio,and the distribution of IL-21 in RA patients,and analyzed the correlation between ying-wei disharmony syndrome score,Tfh cell ratio,Tfr cell ratio,Tfh/Tfr cell ratio,IL-21,and other indicators.Results:The ying-wei disharmony syndrome score of RA patients was positively correlated with age,disease duration,erythrocyte sedimentation rate,im-munoglobulin A,number of joint tender-ness,health assessment questionnaire,and 28 joint disease activity index(P<0.05);the Tfh/Tfr cell ratio and IL-21 in RA patients were positively correlated with the ying-wei disharmony syndrome score(P<0.05),while Tfr cells were negatively correlated with the ying-wei disharmony syndrome score(P<0.05).Conclusion:Ying-wei disharmony is the fundamental pathogenesis of the occurrence and development of rheumatoid arthritis,which affects the patient's condition.Ying-wei disharmony can correspond to the imbalance of Tfh/Tfr cells,and the balance of Tfh/Tfr cells may be a concrete manifestation of ying-wei harmony in modern theory.
作者
杨清雅
张芳
杨宁
陈长云
许超
YANG Qing-ya;ZHANG Fang;YANG Ning;CHEN Chang-yun;XU Chao
出处
《风湿病与关节炎》
2024年第7期7-11,共5页
Rheumatism and Arthritis
基金
江苏省中医药科技发展计划项目(YB201927)
江苏省青年自然科学基金项目(BK20201092)
南京中医药大学自然科学基金项目(XZR2023053)。
