寻常型银屑病不同中医证候T淋巴细胞的临床研究

Changes of T lymphocytes in different TCM types of psoriasis

目的探讨寻常型银屑病患者中医不同证候外周血T淋巴细胞水平的变化及临床意义。方法将64例寻常型银屑病患者按照中医辨证分为血热证组26例、血瘀证组21例、血燥证组17例。采用流式细胞仪检测患者外周血T淋巴细胞亚群的水平,将3组T淋巴细胞(CD3+T)、辅助性T淋巴细胞(CD4+T)、抑制性T淋巴细胞(CD8+T)、辅助性T淋巴细胞/抑制性T淋巴细胞(CD4/CD8)与相应的正常值进行比较,并进行组间比较。结果 CD3+T3组分别与正常值比较差异均无统计学意义(P>0.05),3组间两两比较差异均无统计学意义(P>0.05)。CD4+T血瘀证组与正常值比较差异无统计学意义(P>0.05),血热证组较正常值降低(P<0.05),血燥证组较正常值升高(P<0.05),3组间两两比较,血燥证组较血瘀证组、血热证组升高(P<0.05),血热证组较血瘀证组降低(P<0.05)。CD8+T血热证组与正常值比较差异无统计学意义(P>0.05),血瘀证组及血燥证组均较正常值降低(P<0.05),血瘀证组及血燥证组均较血热证组降低(P<0.05),血瘀证组与血燥证组比较差异无统计学意义(P>0.05)。CD4/CD8血热证组较正常值降低(P<0.05),血瘀证组及血燥证组均较正常值升高(P<0.05),血瘀证组及血燥证组均较血热证组升高(P<0.05),血瘀证组与血燥证组比较差异无统计学意义(P>0.05)。结论寻常型银屑病患者存在免疫功能的紊乱,CD4+T和CD8+T的水平与中医辨证分型密切相关,银屑病患者的免疫状态与中医证候有一定的相关性。

Objective To investigate the changes and clinical significance of peripheral T lymphocytes in the patients with different TCM syndrome types of psoriasis.Methods The patients with psoriasis（n =64） were divided,according to TCM syndrome differentiation,into blood heat syndrome group（n =26）,blood stasis syndrome group（n = 21） and blood dryness syndrome group（n =17）.The levels of peripheral T lymphocyte subsets were detected by using flow cytometer.The values of CD3 ＋ T,CD4 ＋ T,CD8 ＋ T and CD4/CD8 in 3 groups were compared with normal value,and a comparison was conducted among 3 groups.Results The difference in CD3 ＋ T showed no statistical significance compared with normal value in 3 groups respectively（P 0.05）,and the pairwise comparison showed no statistical significance in 3 groups（P 0.05）.The difference of CD4 ＋ T showed no statistical significance in blood stasis syndrome group compared with normal value（P 0.05）,decreased in blood heat syndrome group（P 0.05） and increased in blood dryness syndrome group（P 0.05）.The pairwise comparison showed CD4 ＋ T increased in blood dryness group than that in blood stasis group and blood heat group（P 0.05）,and decreased in blood heat group than that in blood stasis group（P 0.05）.The difference of CD8 ＋ T showed no statistical significance in blood heat syndrome group compared with normal value（P 0.05）,and decreased in blood stasis syndrome group and blood dryness syndrome group（P 0.05）.CD8 ＋ T was lower in blood stasis syndrome group and blood dryness syndrome group than that in blood heat syndrome group（P 0.05）,and there was no statistical significance in the difference of CD8 ＋ T between blood stasis syndrome group and blood dryness syndrome group（P 0.05）.CD4/CD8 decreased in blood heat syndrome group compared with normal value（P 0.05） and increased in blood stasis syndrome group and blood dryness syndrome group（P 0.05）.CD4/CD8 was higher in blood stasis syndrome group and blood dryness syndrome group than in blood heat syndrome group（P 0.05）,and there was no statistical significance in the difference of CD4/CD8 between blood stasis syndrome group and blood dryness syndrome group（P 0.05）.Conclusion The patients with psoriasis had the disorder of immune function.The levels of CD4 ＋ T,CD8 ＋ T are closely correlated to types of TCM syndrome and immune status of the patients is correlated to TCM syndromes.