子宫内膜异位症性不孕患者腹腔液中细胞因子与中医证候相关性分析

Correlation Analysis between TCM Syndromes and Cytokines in Peritoneal Fluid of Endometriosis-Associated Infertility

目的探讨子宫内膜异位症(EM)性不孕患者的中医辨证分型与腹腔液细胞因子白细胞介素(IL)-6、IL-8及肿瘤坏死因子-α(TNF-α)水平之间的相关性,为临床治疗提供思路。方法选取EM性不孕患者105例,辨证分为肾虚血瘀、气滞血瘀、热郁血瘀、寒凝血瘀、气虚血瘀、痰湿瘀阻六证型组。同时选取非EM性不孕患者30例作为对照组。采用酶联免疫吸附法测定腹腔液中IL-6、IL-8及TNF-α等细胞因子的水平。结果在105例EM性不孕患者中,肾虚血瘀证35例(33.33%),寒凝血瘀证22例(20.95%),气滞血瘀证18例(17.14%),热郁血瘀证10例(9.52%),气虚血瘀证11例(10.48%),痰湿瘀阻证9例(8.57%)。各证型组IL-6、IL-8、TNF-α水平均高于对照组(P<0.01)。肾虚血瘀组IL-6水平高于其他各证型组(P<0.05);肾虚血瘀组、热郁血瘀组IL-8、TNF-α高于其他各组(P<0.05);肾虚血瘀组IL-8与热郁血瘀组比较,P<0.05。结论 EM性不孕患者中医证型与腹腔液细胞因子IL-6、IL-8、TNF-α水平有一定的相关性,可以指导临床认识和治疗EM性不孕。

Objective To discuss the relationship between TCM syndromes and peritoneal fluid cytokine IL-6, IL-8 and TNF-a of endometriosis infertility patients, and provide thoughts for clinical treatment. Methods Totally 105 patients of endometriosis infertility were differentiated to six syndrome groups, including kidney deficiency and blood stasis, qi stagnation and blood stasis, heat stagnation and blood stazis, cold congelation and blood stasis, qi deficiency and blood stasis, phlegm-dampness stagnation. Thirty patients of non-endometriosis infertility were selected as control group. Enzyme-linked immunosorbent assay was used to detect cytokine levels of IL-6, IL-8 and TNF-a. Results In 105 cases of EM infertility, 35 cases （33.33%） were syndrome of kidney deficiency and blood stasis, 22 cases （20.95%） were syndrome of cold congelation and blood stasis, 18 cases （17.14%） were syndrome of qi stagnation and blood stasis, 10 cases （9.52%） were syndrome of heat stagnation and blood stasis, 11 cases {10.48%） were syndrome of qi deficiency and blood stasis, 9 cases （8.57%） were phlegm-dampness stagnation syndrome. The levels of IL-6, IL-8 and TNF-ct in each syndrome group of EM infertility were higher than control group {P〈0.01）. IL-6 level in kidney deficiency and blood stasis group were higher than other syndrome groups （P〈0.05）. The levels of IL-8 and TNF-c, in kidney deficiency and blood stasis group, and heat stagnation and blood stasis group were higher than other syndrome groups （P〈0.05）. IL-8 in kidney deficiency and blood stasis group was higher than that in heat stagnation and blood stasis group （P〈0.05）. Conduslon TCM syndromes in patients with endometriosis infertility have some relevance with peritoneal fluid cytokine levels of IL-6, IL-8, TNF-a, which may guide clinical understanding and treatment of endometriosis infertih＇ty.