慢性前列腺炎常见中医证型与IL-8、TNF-α、IFN-γ的相关性研究

Study on Relationship between Common Traditional Chinese Medicine Syndromes of Chronic Prostatitis and IL-8,TNF-α,IFN-γ

目的:探讨慢性前列腺炎(CP)常见中医证型与前列腺按摩液(EPS)中白细胞介素8(IL-8)、肿瘤坏死因子α(TNF-α)、干扰素γ(IFN-γ)的相关性,为中医诊断、辨证、治疗慢性前列腺炎提供参考标准。方法:将慢性前列腺炎患者200例先按美国国立卫生院(NIH)标准分为Ⅱ型前列腺炎、Ⅲa型前列腺炎、Ⅲb型前列腺炎,再按中医证型分为湿热蕴结-A组、瘀血阻络-B组;另选50例正常男性作为对照组。采用双抗体夹心ELISA法测定250例受试者前列腺按摩液中IL-8、TNF-α、IFN-γ含量,并分组比较其结果。结果:1、前列腺按摩液中IL-8测试值:在Ⅱ型慢性前列腺炎患者明显高于Ⅲa型慢性前列腺炎患者、Ⅲb型慢性前列腺炎患者及对照组(P<0.05);Ⅲa组明显高于Ⅲb组及对照组(P<0.05);Ⅲb组与对照组之间无明显差异(P>0.05)。2、前列腺按摩液中TNF-α、IFN-γ测试值:在Ⅱ型慢性前列腺炎患者明显高于Ⅲa型慢性前列腺炎患者、Ⅲb型慢性前列腺炎患者及对照组(P<0.05);Ⅲa组明显高于Ⅲb组及对照组(P<0.05);Ⅲb组明显高于对照组(P<0.05)。3、前列腺按摩液中IL-8测试值:在湿热蕴结型患者明显高于瘀血阻络型组及对照组(P<0.05);瘀血阻络组与对照组之间无显著性差异(P>0.05)。4、前列腺按摩液中TNF-α、IFN-γ测试值:湿热蕴结型组明显高于瘀血阻络型组及对照组(P<0.05);湿热蕴结型组明显高于瘀血阻络型组及对照组(P<0.05);瘀血阻络型患者的TNF-α、IFN-γ测试值明显高于对照组(P<0.05)。结论:慢性前列腺炎患者前列腺按摩液中IL-8、TNF-α、IFN-γ检测值均明显增高,提示其参与了前列腺炎症反应。检测显示3种细胞因子含量除IL-8含量在Ⅲb组及对照组之间未见显著性差异外,在Ⅱ型慢性前列腺炎、Ⅲa型慢性前列腺炎、Ⅲb型慢性前列腺炎、对照组中,由高到低依次递减。在慢性前列腺炎中医分型中,除IL-8含量在瘀血阻络组与对照组之间无显著性差异外,在湿热蕴结型、瘀血阻络型、健康对照组中,表现同样趋势,这为临床对慢性前列腺炎的诊断及分型提供了系统依据,同时为慢性前列腺炎的中医分型提供了具体参照标准。

This study was aimed to investigate the relationship of common traditional Chinese medicine （TCM） syndromes of chronic prostatitis （CP） and prostate massage fluid （EPS）, interleukin 8 （IL-8）, tumor necrosis factor alpha （TNF-α）, interferon gamma （IFN-γ） correlation, in order to provide a reference standard for the TCM diagnosis, syndrome differentiation, and treatment of CP. A total of 200 CP cases in the Andrology Outpatient Department, Henan Traditional Chinese Medicine Hospital were collected according to the American National Institutes of Health （NIH） standards and were divided into type II prostatitis, type IU a prostatifis, and type IU b prostatitis. And then the cases were divided into retention of damp-heat （group A）, obstruction of collaterals by blood stasis （group B） according to TCM syndrome type. Another 50 healthy male cases were enrolled as controls. Double antibody sandwich ELISA method was used in the determination the content of IL-8, TNF-α, IFN-γ in the EPS of 250 cases. And results of each group were compared. The results showed that in the determination of IL-8 in the EPS, type II CP cases were obvious higher than the type III a, type III b and the control group （P 〈0.05）; the type ma cases were significantly higher than type lllb and control group （P 〈 0.05）; and there was no significant difference between type III b and control group （P 〉 0.05）. In the determination of TNF-α and IFN-γ in the EPS, type II cases were obviously higher than the type III a, type m b and the control group （P 〈 0.05）; type III a cases were obviously higher than type III b and control cases （P 〈 0.05）; the type III b cases were obviously higher than the control group （P 〈 0.05）. In the determination of IL-8 of EPS, group A cases were obviously higher than group B and control group （P 〈 0.05）; there was no significant difference between group B and control group （P 〉 0.05）. In the determination of TNF-α and IFN-γ in the EPS, group A cases were obviously higher than group B and control group （P 〈 0.05）; group B cases were obviously higher than the control group （P 〈 0.05）. It was concluded that IL-8, TNF-α, IFN-γ in the EPS was significantly increased in CP cases, which suggested its involvement in the inflammation reaction. In the detection of three cytokines content, only the IL-8 content has no significant difference between the HI b group and control group. The IL-8 content in the type II group, type III a group, type III b group, and control group is from high to low in the descending order. In the TCM syndrome differentiation of CP, except IL-8 content had no significant difference between group B and control group, the group A, group B and control group showed same trend, which provide systemic evidences for the clinical diagnosis and syndrome differentiation of CP. It also provides specific reference standard for the TCM syndrome differentiation of CP.