T淋巴细胞亚群(CD4^+,CD8^+,CD4^+/CD8^+)与免疫性血小板减少性紫癜中医证型相关性研究

T lymphocyte Subsets(CD4^+,CD8^+,CD4^+/CD8^+)with Immune Thrombocytopenic Purpura Correlation between TCM Syndrome Type

[目的]观察特发性血小板减少性紫癜(ITP)、T淋巴细胞亚群(CD4+,CD8+,CD4+/CD8+)与中医辨证分型相关性。[方法]使用前瞻性设计方法,将86例临床血象和骨髓检查确诊ITP住院及门诊患者辨证分为阴虚火旺、气不摄血、瘀血内阻、血热妄行4个证型;在辽宁中医药大学附属医院健康体检者中选择健康对照人30例。用流式细胞仪测定T淋巴细胞亚群(CD4+,CD8+,CD4+/CD8+)含量。[结果]CD4+、CD4+/CD8+各证型总趋势阴虚火旺<气不摄血<瘀血内阻<血热妄行<正常人。CD4+计数以及CD4+/CD8+值各证型均低于健康对照(P<0.05);各证型两两比较:阴虚火旺显著低于血热妄行(P<0.01)、低于瘀血内阻型(P<0.05)、低于气不摄血(P<0.05);气不摄血低于血热妄行(P<0.05)、低于瘀血内阻(P<0.05)。[结论]ITP患者T淋巴细胞亚群(CD4+,CD8+,CD4+/CD8+)与血热妄行、瘀血内阻、气不摄血、阴虚火旺4种证型及正常人具有相关性。T淋巴细胞亚群等指标检测可作ITP辨证分型参考依据。

[Objective]Observation of idiopathic thrombocytopenic purpura T lymphocyte subsets（CD4＋,CD8＋,CD4＋/CD8＋）and TCM Syndrome Types.[Methods] Using a prospective design method,86 cases of inpatient and outpatient ITP patients,Diagnosis is based on clinical hemogram and bone marrow examination,According to Zhang Zhinan blood disease diagnosis and curative effect standard of Third Edition,Syndrome differentiation is divided Bleeding due to blood heat,Qi dysfunction in blood control,Hyperactivity of fire due to yin deficiency;In 30 cases of normal people,With the determination of the content of T lymphocyte subsets（CD4＋,CD8＋,CD4＋/CD8＋）by flow cytometry. [Results]The general trend of CD4＋、CD4＋/CD8＋ syndrome of hyperactivity of Hyperactivity of fire due to yin deficiency groupQi failing to control blood groupCongestion resistance groupBleeding due to blood heat group normal people,Every syndrome type CD4＋ count and CD4＋/ CD8＋was lower than that of normal group;ITP syndrome type CD4 ＋ count two two comparison results：Hyperactivity of fire due to yin deficiency type group CD4＋count was Obviously lower than Bleeding due to blood heat（P0.01）;lower than Congestion resistance group（P0.05）;lower than Qi failing to control blood group（P0.05）;Qi failing to control blood group CD4＋ count was lower than Bleeding due to blood heat group（P0.05）;lower than Congestion resistance group（P0.05）.[Conclusion]ITP T lymphocyte subsets（CD4＋,CD4＋/CD8＋）in patients with bleeding due to blood heat,Congestion resistance,Qi failing to control blood,Hyperactivity of fire due to yin deficiency 4 kinds of syndromes and normal people with relevant,Detection of T lymphocyte subsets and other indicators can be used as reference for ITP syndrome.