慢性再生障碍性贫血中医证型与多因素相关性研究

Multiple Factors Analysis of TCM Differentation Type in Chronic Aplastic Anemia Patients

目的:探讨免疫、内分泌系统多个指标与慢性再生障碍性贫血(CAA)中医辨证分型的关系。方法:对60例CAA患者进行辨证分型,分为肾阳虚型、肾阴虚型、肾阴阳两虚型3组,并行免疫、内分泌系统的多个指标的实验室检查。结果:(1)与肾阳虚证组相比,肾阴虚证组CD8+、C3、C4、皮质醇(COR)、睾酮(T)、游离甲状腺素(FT4)显著升高(P<0.01,P<0.01,P<0.01,P<0.05,P<0.01,P<0.01),CD4+、雌二醇(E2)显著下降(P<0.01,P<0.01)。肾阴阳两虚证组COR、T、E2、FT4较肾阳虚证组显著升高(P<0.01,P<0.01,P<0.01,P<0.05)。(2)与肾阴虚证组相比,肾阴阳两虚证组E2显著升高(P<0.01),CD8+、C3、C4、COR、T显著下降(P<0.01,P<0.01,P<0.01,P<0.01,P<0.01)。结论:CD4+、CD8+、C3、C4、COR、T、E2、FT4等指标可作为CAA临床辨证分型的客观依据。

Objective：TO discuss the relationship between different factors of endocine system and immune system in patients with chronic aplastic anemia and TCM Differentation Type（TCMDT）. Methods ：Classified the 60 chronic aplastic anemia patients into three groups, respectively kidney-yang deficiency group, kidney-ying deficiency group and kidney-ying-and-yang deficiency group and then dectected different indexes of endocrine system and immune system. Results ： （ 1 ） Compared with kidney-yang deficiency group,CD8^＋ ,CD3, CD4, Cortisol（ COR）, Testosterone （T） and Free Thyroxine （FT4 ）in kidney -ying deficiency group is statistically increased （ P 〈 0. 01,P 〈 0. 01, P 〈 0. 01, P 〈 0. 05, P 〈 0. 01, P 〈 0. 01 ） and CD4^＋ and E2 decreased （ P 〈 0. 01, P 〈 0. 01 ）, while CD4^＋ in kidney-ying- and- yang deficiency group decreased （P 〈 0. 01 ） （2）Compared with kidney-ying deficiency group, Estradiol （ E2 ） in kidney-ying-and-yang deficiency group is statistically increased （ P 〈 0. 01 ）, while CD8^＋, CD3, CD4, COR and T decreased（P 〈0. 01 ,P 〈0. 01 ,P 〈 0. 01 ,P 〈0. 01 ,P 〈0. 01 ）. Conclusion： CD4^＋ ,CD8^＋ ,CD3 ,CD4 ,COR,T,E2 and FT4 has certain regulations among TCMDT groups ,which can be taken as indexes in TCM differentatiun in clinical practice.