初治继发性肺结核中医证型客观化研究

Objective Study on TCM Syndrome Types of Untreated Secondary Pulmonary Tuberculosis

目的探索初治继发性肺结核的中医证型分布规律与客观指标的联系。方法以150例初治继发性肺结核患者为研究对象,采集中医四诊信息及客观化指标,了解各证型的临床分布情况,并探讨各中医证型与实验室指标的关系。结果肺阴亏虚占60.67%,气阴两虚占20.67%,阴虚火旺占14.00%,肺脾两虚占2.00%,肺肾阴虚占2.00%,阴阳两虚占0.67%。肺阴亏虚证病程短于气阴两虚证(P<0.05)。各中医证型间的性别、年龄段、痰涂片、CD3+T、CD4+T、CD4+T/CD8+T、IL-2、IL-4、IL-6、IL-10、TNF-α比较差异无统计学意义(P>0.05)。肺阴亏虚证较阴虚火旺证、气阴两虚证CD8+T升高(P<0.05),阴虚火旺证较肺阴亏虚证、气阴两虚证IFN-γ升高(P<0.05)。结论初治继发性肺结核以肺阴亏虚证最多,依次为气阴两虚证、阴虚火旺证;病程长短、CD8+T细胞、IFN-γ与证型分布有相关性,为中医证型客观化研究提供了一定依据。

Objective： To explore the relation between traditional Chinese medicine syndrome distribution regularities and objective indicators of untreated secondary pulmonary tuberculosis. Methods： TCM diagnostie information and objective indicators were collected from 150 patients with untreated secondary pulmonary tuberculosis;the distribution of each syndrome was analyzed and the relationship between TCM syndromes and objective indexes was discussed. Results： Syndrome of Yin deficiency of lung occupied 60.7%,syndrome of Qi and Yin deficiency 20.7%,syndrome of hyperactivity fire due to Yin deficiency 14.0% ,syndrome of Qi deficiency of lung and spleen 2.0%,syndrome of Yin deficiency of lung and kidney 2.0%, syndrome of deficiency of Yin and Yang 0.67%. The disease course of patients with syndrome of Yin deficiency of lung was shorter than syndrome of Qi and Yin deficiency （P〈 0.05）. The difference of gender,age,sputum smear,CD3＋T, CD4＋T, CD4＋T/CD8＋T,IL-2, IL-4,IL-6,IL-10,TNF-α had no statistical difference （P〉 0.05）. CD8＋T of patients with syndrome of Yin deficiency of lung was higher than that of patients with syndrome of hyperactivity fire due to Yin deficiency and patients with syndrome of Qi and Yin deficiency,and the differences were statistical significance （P〈 0.05）. IFN-γ of patients with syndrome of hyperactivity fire due to Yin deficiency was higher than that of patients with syndrome of Yin deficiency of lung and patients with syndrome of Qi and Yin deficiency,and the differences were statistical significance （P〈0.05）. Conclusion： Syndrome of Yin deficiency of lung is the most common syndrome of patients with untreated secondary pulmonary tuberculosis,followed by Syndrome of Qi and Yin deficiency,and syndrome of hyperactivity fire due to Yin deficiency. Course of the disease, CD8＋T and IFN-γ may be related to the distribution of TCM syndrome types,which may provide a reference to the study of objectifying TCM syndrome types.