不同中医证型皮肌炎患者血清IL-17、TNF-α水平观察

Serum Levels of Interleukin-17 and Tumor Necrosis Factor-α in Dermatomyositis Patients with Different Syndrome Types of Chinese Medicine

目的观察不同中医证型皮肌炎(dermatomyositis,DM)患者血清IL-17、TNF-α水平。方法选择68例皮肌炎患者,按中医辨证分型分组,热毒炽盛证20例,湿热蕴结证14例,寒湿痹阻证12例,脾肾两虚证12例,肝肾阴虚证10例,并选择64名健康志愿者作为健康对照组。检测各证型组及健康对照组血清IL-17、TNF-α水平。结果与健康对照组比较,热毒炽盛组、湿热蕴结组、寒湿痹阻组患者血清IL-17升高(P<0.01),各证型组TNF-α升高(P<0.01,P<0.05)。与热毒炽盛组比较,寒湿痹阻组、脾肾两虚组、肝肾阴虚组患者IL-17降低(P<0.01),脾肾两虚、肝肾阴虚组患者TNF-α降低(P<0.01)。与湿热蕴结组比较,寒湿痹阻、脾肾两虚、肝肾阴虚组患者IL-17降低(P<0.01),脾肾两虚、肝肾阴虚组患者TNF-α降低(P<0.01)。与寒湿痹阻组比较,脾肾两虚、肝肾阴虚组患者IL-17、TNF-α降低(P<0.01,P<0.05)。结论不同中医证型皮肌炎患者血清IL-17、TNF-α水平存在差异。

Objective To observe serum levels of interleukin-17 （IL-17） and tumor necrosis fac- tor-α （TNF-α） in dermatomyositis （DM） patients with different syndrome types of Chinese medicine （CM）. Methods Totally 68 dermatomyositis patients were recruited and grouped by syndrome typing of CM, i.e., heat-toxin flourishing syndrome （20 cases）, damp-heat accumulation syndrome （14 cases）, cold-dampness obstruction syndrome （12 cases）, Pi-Shen deficiency syndrome （12 cases）, Gan-Shen yin deficiency syndrome （10 cases）. Meanwhile, 64 healthy volunteers were recruited as healthy con- trols. The levels of IL-17 and TNF-α in serum were detected in patient groups and the healthy group. Re- sults Compared with the healthy control group, the serum IL-17 level increased in patients with heat- toxin flourishing syndrome, damp-heat accumulation syndrome, and cold-dampness obstruction syn- drome （P 〈0.01 ） ; the serum TNF-α level increased in DM patients with each syndrome （P 〈0.01, P 〈 0.05）. Compared with the heat-toxin flourishing syndrome group, the serum IL-17 level decreased in pa- tients with cold-dampness obstruction syndrome, Pi-Shen deficiency syndrome, and Gan-Shen yin defi- ciency syndrome （P 〈0.01 ） ; and the serum TNF-α level decreased in patients with Pi-Shen deficiency syndrome and Gan-Shen yin deficiency syndrome （P 〈0.01 ）. Compared with the damp-heat accumula- tion syndrome group, the serum IL-17 level decreased in patients with cold-dampness obstruction syn- drome, Pi-Shen deficiency syndrome, and Gan-Shen yin deficiency syndrome （P 〈0.01 ）, and the serum TNF-α level decreased in patients with Pi-Shen deficiency syndrome and Gan-Shen yin deficiency syn- drome （P 〈0.01 ）. Compared with the cold-dampness obstruction syndrome group, the serum levels of IL-17 and TNF-α decreased in patients with Pi-Shen deficiency syndrome and Gan-Shen yin deficiency syndrome （P 〈0.01, P 〈0.05）. Conclusion Serum levels of IL-17 and TNF-α are different in DM patients with different syndrome types of CM.