原发性胆汁性胆管炎患者中医证型与免疫指标的关系

目的:通过对原发性胆汁性胆管炎(PBC)患者的症状体征的采集以及免疫指标的检测,探究PBC患者中医证型与免疫指标的关系。方法:采集90例PBC患者的症状体征等四诊资料进行辨证分型。采用流式细胞法检测其外周血T淋巴细胞亚群,用酶联免疫吸附法检测其Th1细胞和Th2细胞分泌的细胞因子。结果:PBC患者的中医证型分为湿热蕴结证、肝郁脾虚证、瘀血阻络证、肝肾阴虚证4型,其中瘀血阻络证39例(43.33%)所占比例最大;主要症状体征分别为:身倦乏力74例(82.22%),绝经69例(76.67%),纳差48例(53.33%),脾肿大41例(45.56%)等。在细胞免疫方面,瘀血阻络证患者的CD8^+与肝郁脾虚证、肝肾阴虚证患者相比更低(P<0.05),伴有血瘀证患者IL-6、IFN-γ较非血瘀证者高(P<0.05)。结论:PBC患者的中医证型以瘀血阻络证占比最多,主要症状及体征有身倦乏力、绝经、纳差、脾肿大等;瘀血阻络证患者CD8^+与肝郁脾虚证、肝肾阴虚证者相比更低;PBC血瘀证患者IL-6、IFN-γ较非血瘀证高。

Relationship between TCM syndromes and immune indexes in 90 patients with primary biliary cholangitis

Objective:We collected the symptoms,signs and immune indicators of patients with primary biliary cholangitis, to explore the relationship between TCM syndromes and immune indicators in PBC patients.Methods:Total of 90 patients were divided into different groups on the basis of the four diagnostic data including symptoms,signs and so on. E).T lymphocyte subsets were detected by flow cytometry.The concentrations of cytokines were detected by enzyme-linked immunosorbent assay(ELISA).Results:TCM syndrome of PBC were divided into dampness heat accumulation group,liver-depression and spleen asthenia group,blood-stasis in collaterals accounted group,liver-kidney yin deficiency group,blood-stasis in collaterals group accounted for 39 cases(43.33%);The number and frequency of the main symptoms and signs of patients:fatigue 74 cases(82.22%),menopause 69 cases(76.67%), anorexia 48 cases(53.33%), splenomegaly 41 patients(45.56%). In cellular immunity, the CD8+ of blood-is in collaterals group was remarkable lower than liver-depression and spleen asthenia group and liver-idney yin deficiency group(P<0.05);the IL-6 and IFN-γ of blood-stasis in collaterals group of PBC patients higher than non-blood stasis syndrome(P<0.05).Conclusion:The ratio of blood-stasis in collaterals group in four groups was highest, the the main symptoms and signs of patients:fatigue,menopause, anorexia, splenomegaly. The damage of live function in dampness heat accumulation group was more severe;the CD8+ of the blood-stasis in collaterals group was remarkable lower than liver-depression and spleen asthenia group and liver-kidney yin deficiency group.The IL-6 and IFN-γ of blood-stasis in collaterals group of PBC patients higher than non-blood stasis syndrome.