中医体质类型与上感后银屑病复发的相关性研究

目的:从中医体质类型及免疫学指标探讨特定诱因-上呼吸道感染对缓解期寻常型银屑病复发的影响,寻找本病复发的靶点,为下一步治疗干预提供依据。方法:选取符合标准的缓解期寻常型患者200例,进行外周血白细胞介素17(Interleukin17,IL-17)/白细胞介素22(Interleukin 22,IL-22)及T淋巴细胞亚群水平测定,并根据量表完成体质类型判定,对半年内出现上感症状或体征者进行观察,两周内进行PASI评分及外周血IL-17/IL-22及T淋巴细胞亚群水平测定,PASI评分≥1分视为复发,对复发组与未复发组患者的体质类型进行统计分析,研究两组体质类型的差异,分析复发组不同体质类型复发前与复发后外周血IL-17/IL-22及T淋巴细胞亚群水平等免疫指标的变化规律。结果:阴虚质、气虚质复发率明显高于其他6种体质,平和质复发率明显低于其他6种体质,差异具有统计学意义(P <0.05)。复发组复发后外周血IL-17、IL-22与复发前相比均增高,外周血CD3、CD4、CD4/CD8降低,CD8升高,差异无统计学意义(P> 0.05)。湿热质中,IL-17与其他体质相比升高显著,差异有统计学意义(P <0.05)。结论:阴虚质、气虚质缓解期寻常型银屑病患者上感后更易复发,湿热质患者上感后IL-17升高显著。

Correlation between TCM constitution type and recurrence of psoriasis after infection

Objective:To explore the effect of the specific inducement--upper respiratory tract infection on the recurrence of psoriasis vulgaris in remission phase from the aspects of TCM constitution type and immunological indexes,and to seek the target of the recurrence of psoriasis vulgaris,so as to provide the basis for the further treatment and intervention.Methods:A total of 200 patients with psoriasis vulgaris in remission phase who met the criteria were selected for peripheral blood IL-17/IL-22 and T lymphocyte subsets,and the judgment of physical type was completed according to the scale.Observation was made on patients with upper sensation symptoms or signs within six months.PASI score and peripheral blood IL-17/IL-22 and T lymphocyte subsets were measured within two weeks,and PASI score≥1 was considered as recurrence.The body types of patients in the relapse group and the non-relapse group were statistically analyzed to study the differences between the two groups in body types,and to analyze the changes of immune indexes such as IL-17/IL-22 in peripheral blood and t-lymphocyte subsets before and after recurrence of different body types in the relapse group.Results:The recurrence rate of Yin deficiency and qi deficiency was significantly higher than that of the other 6 constitutions,and the recurrence rate of the harmony constitution was significantly lower than that of the other 6 constitutions,which was with statistically significant differences(P<0.05).After recurrence,IL-17/IL-22 in peripheral blood of the relapse group was increased compared with that before recurrence,while CD3,CD4 and CD4/CD8 in peripheral blood were decreased and CD8 was increased,which was with no statistically significant difference(P>0.05).Compared with other constitutions,IL-17 was significantly increased in hot and humid plasma,and the difference was statistically significant(P<0.05).Conclusion:Patients with psoriasis vulgaris of Yin deficiency and qi deficiency in the remission stage of are more likely to relapse after sensation,and patients with hot and humid temperament are significantly increased in IL-17 after sensation.