祛风凉血法对慢性特发性血小板减少性紫癜患者T细胞亚群及NK细胞的影响

【目的】探讨祛风凉血法在治疗慢性特发性血小板减少性紫癜（ITP）中的作用。【方法】将确诊为慢性血热妄行型ITP患者13例给予祛风凉血中药（主要由苍耳子、蝉蜕、防风、荆芥、水牛角、丹皮、仙鹤草、生地、侧柏叶、赤芍、三七末、甘草等组成）治疗，观察治疗前后ITP患者外周血T细胞亚群和自然杀伤细胞（NK细胞）的变化，并与正常对照组进行比较。【结果】治疗前患者外周血T细胞亚群CD3、CD4、CD4／CD8比值（PCD4/PCD8）和NK细胞水平均低于正常对照组，而CD8含量明显增多（P〈0．001）；经祛风凉血法治疗后，T淋巴细胞CD3、CD4、PCD4／PCD8和NK细胞均有不同程度的上升，而CD8含量则有所下降，与治疗前相比差异均有显著性意义（P〈0．05或P〈0．001）。【结论】祛风凉血法治疗慢性血热妄行型ITP的机理之一可能与其调节T淋巴细胞亚群及NK细胞水平有关。

Influence of Wind-expelling and Blood-cooling Therapy on T Cell Subsets and Natural Killer Cells in Patients with Chronic Idiopathic Thrombocytopenia Purpura

[Objective] To explore the effect of wind-expelling and blood-cooling therapy in treating chronic idiopathic thrombocytopenia purpura (ITP) . [Methods] Thirteen cases of chronic ITP differentiated in TCM as heat-induced blood extravasation (group A) were treated with wind-expelling and blood-cooling therapy. The changes of peripheral T-lymphocyte subsets and natural killer (NK) cells before and after treatment were observed and compared with the normal volunteers (group B). [Results] Before treatment, peripheral T-lymphocyte subsets of CD3 and CD4 levels, CD4/CD8 ratio and NK cells count were lower in group A than those in group B while CD8 level was higher ( P < 0.001). After treatment, peripheral T-lymphocyte subsets of CD3 and CD4 levels, CD4/CD8 ratio and NK cells count were increased to different degrees in group A , and CD8 level was decreased as compared with those before treatment ( P < 0.05 or P < 0.001). [Conclusion] One of the therapeutic mechanisms of wind-expelling and blood-cooling therapy in treating chronic ITP differentiated as heat-induced blood extravasation may be related to the regulation of T-lymphocyte subsets and NK cells.