寻常型银屑病中医证型外周血T细胞亚群间的关系研究

The Relationship of Peripheral Blood T Cell Subsets with Different TCM Syndromes of Psoriasis Vulgaris

目的本次研究对不同中医证型的银屑病患者进行外周血T细胞亚群(CD3+,CD4+,CD8+,CD4/CD8)的测定。为中医从血分辨证思想找寻现代免疫学检查的依据,使中医证候客观化,为临床辨证提供简便可行的试验室检查依据。方法选择寻常型银屑病常见的三种中医辨证分型,后对临床病例进行搜集整理,共收集病例53例,其中血热证20例,血燥证20例,血瘀证13例。血热证患者中男性9例,女性11例;血燥证患者中男性8例,女性12例;血瘀证患者中男性10例,女性3例。抽取受试者静脉血,采用流式细胞仪对其T细胞亚群水平进行检测(CD3+,CD4+,CD8+,CD4/CD8)并记录比较各组间有无差异。结果按不同中医辨证分型将寻常型银屑病分为血热,血燥,血瘀三组,对三组外周血T淋巴细胞亚群进行分析发现:CD4+T细胞水平上,血热组患者外周血中CD4+T淋巴细胞百分比高于血燥组及血瘀组(P<0.05);而血燥组与血瘀组患者的CD4+T细胞水平无明显差别(P>0.05),而CD8+及CD3+T细胞的百分比三组间均明显差异(P>0.05)。结论寻常型银屑病的发病与T细胞亚群水平的异常相关,其中血热证的患者外周血CD4+T细胞的水平较其他明显升高,故可认为血热型的寻常型银屑病患者的机体细胞免疫功能正处于免疫亢进的状态中。

Object The research measured the levels of blood T cell subsets（ CD3＋,CD4＋,CD8＋,CD4 /CD8） of different TCM syndrome types of psoriasis patients. Try to find the basis of modern immunology examination to explain the blood of traditional Chinese medicine card,make the TCM syndrome objective,provides the simple laboratory examination basis for the clinical syndrome differentiation. Methods Choose three frequently kinds of psoriasis vulgaris of traditional Chinese medicine,to collect clinical cases,after collected 53 cases,including 20 cases of blood heat syndrome,20 cases of blood dryness syndrome and 13 cases of blood stasis syndrome. 9 cases of blood heat syndrome were male,11 female;Blood dryness syndrome had 8 male and 12 female; blood stasis syndrome have 10 male and 3 female. After exsanguinated the patients,using flow cytometry instrument to detect the level of T cell subsets（ CD3＋,CD4＋,CD8＋,CD4/CD8） and record any differences between groups.Results According to different TCM syndromes,psoriasis patients will divided into three types,including blood heat,blood dryness,blood stasis. Analysis the results of the tests. We found that in the blood heat syndrome,level of CD4 ＋ T cell is higher than dry blood and blood stasis group（ P〉 0. 05）; And dry blood and blood stasis group have no significant difference in the level of CD4＋T cells（ P〉0. 05）. The CD8 ＋ and CD3 ＋T cells between the three groups have no significantly difference（ P〉 0. 05）. Conclusion The onset of with psoriasis vulgaris is related to anomalies of the level of T cell. The CD4 ＋ T cells of the blood heat syndrome are significantly higher than other,so it is possible that patients with psoriasis vulgaris who have the blood heat syndrome is in a state of immune hyperfunction.