哮喘中医分型及其淋巴细胞亚群与介质、内源性皮质醇变化的研究

Study on Asthma TCM Syndrome and Lymphocyte Subsets with the Media,Changes in Endogenous Cortisol

目的探讨哮喘中医分型与免疫、内分泌紊乱的关系。方法对156例哮喘患者进行西医诊断分型及中医辨证分型。采用放免法对白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、促肾上腺皮质激素(ACTH)、皮质醇(CS)及生长激素(GH)进行检测;采用酶联免疫法(ELISA)对促肾上腺皮质激素释放激素(CRH)进行检测;用流式细胞仪对淋巴细胞亚群及其凋亡进行检测。结果虚哮与其他中医分型比较,平均年龄偏大(P<0.05)。淋巴细胞亚群及其介质CD4、CD8、CD4/CD8、CD11b、CD11b/CD18、CD62P、TNF-α的测定值在虚哮中最高,而淋巴细胞凋亡却最缓慢(P<0.05)。内源性CS、ACTH、CRH测定值在虚哮中最低(P<0.05)。采用Fisher判别法,对虚哮的判别正确率达70.8%。结论建议将哮喘发作期的冷哮、热哮、寒包热哮、风痰哮之分型改为冷痰、热痰、寒包热痰、风痰4种分型。虚哮型哮喘中以肾虚痰瘀者居多。

Objective To explore the relation between TCM type of asthma and the immune and endocrine disorders. Method One hundred and fifty six cases of asthma patients were differentiated with type of western medicine and TCM. Interleukin-1 （IL-1）, IL-6, tumor necrosis factor a （TNF-α）, adrenocorticotropic hormone （ACTH）, cortisol （CS） and growth hormone （GH） were detected by RIA. Corticotropin-releasing hormone （CRH） was tested by ELISA. Lymphocyte subsets and apoptosis were detected with flow cytometry. Results The average age of virtual Asthma was older than other types of TCM （P〈0.05）. Lymphocyte subsets and medium CD4、CD8、CD4/CD8、CD11b、CD11b/CD18、CD62p、TNF-α were the highest in the virtual Asthma, and lymphocyte apoptosis was the slowest （P〈0.05）. Endogenous CS, ACTH, CRH value were the lowest in the virtual asthma （P〈0.05）. The correct rate of Fisher criterion used to determine virtual Asthma was 70.8%. Conclusion In acute stage of asthma, cold Asthma, heat Asthma, cold packing heat Asthma, wind sputum type should be instead of cold phlegm, heat phlegm, cold packing sputum and wind phlegm. Kidney deficiency, phlegm and blood stasis was the majority in virtual Asthma.