不同中医证型腰椎间盘突出症患者CCL5水平及其与疼痛的相关性研究

Study on CLL5 level and its correlation with pain in patients with lumbar disc herniation of different Traditional Chinese Medicine syndroms

目的研究不同中医证型腰椎间盘突出症(LDH)患者趋化因子配体5(CCL5)水平,探究CLL5与LDH患者疼痛程度的相关性。方法选取2019年4月-2021年7月在广州中医药大学第三附属医院脊柱科住院并确诊为LDH的患者160名作为试验组,按照中医证型、椎间盘病理特点分型、疼痛程度的不同分不同的亚组。同时选取40例健康体检者作为对照组。对比试验组与对照组间血清CCL5水平的差异;探究不同中医证型、不同病理特点分型、不同疼痛程度LDH患者CCL5水平的差异。应用相关性分析,明确CCL5与疼痛的相关性。结果试验组最终纳入160例LDH患者,其中男性患者64例,女性患者96例,平均年龄(56.2±10.3)岁。血瘀型、寒湿型、湿热型和肝肾亏虚型患者例数各为40例;膨出型、突出型、脱出型、游离型患者例数分别为15例、45例、68例和32例;轻度疼痛、中度疼痛、重度疼痛患者例数分别为31例、65例和64例。对照组40例,其中男性18例、女性22例,平均年龄(55.3±9.8)岁。试验组与对照组的性别、年龄分布差异无统计学意义(P>0.05)。不同中医证型、不同病理特点分型LDH患者的CCL5水平差异无统计学意义(P>0.05),不同疼痛程度LDH患者的CCL5水平差异有统计学意义(P<0.01),重度疼痛患者的CCL5水平最高,中度疼痛患者的CCL5水平次之,轻度疼痛患者的CCL5水平最低。Pearson相关性分析结果提示,血清CCL5浓度与疼痛程度存在正相关关系(r=0.321,P=0.002)。结论不同中医证型LDH患者的CCL5水平未见明显差异,血清CCL5水平与中医证型、LDH的病理分型无关,与疼痛分级均有正相关关系。CCL5可能是通过疼痛相关机制影响LDH,CCL5有可能成为治疗LDH患者疼痛的靶点。

Objective To study the level of chemokine ligand 5 in patients with lumbar disc herniation of different TCM syndroms,and explore the correlation between CLL5 and pain.Methods One hundred and sixty patients with confirmed LDH in the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from April 2019 to July 2021 were randomly selected as the experimental group.It can be divided into different subgroups according to TCM syndrome type,intervertebral disc pathological characteristics and pain degree.At the same time,40 cases who underwent physical examination were selected as the control group.The difference of serum CCL5 level between experimental group and control group was compared.To explore the difference of CCL5 level in LDH patients with different TCM syndrome types,pathological characteristics and pain degree.Correlation analysis was used to determine the correlation between CCL5 and pain.Results The experimental group included 160 LDH patients,including 64 males and 96 females,with an average age of 56.2±10.3 years.The number of LDH patients with different TCM syndromes was 40 cases respectively.The number of patients with extruding,protruding,prolapse and free were 15,45,68 and 32,respectively.The cases of mild pain,moderate pain and severe pain were 31 cases,65 cases and 64 cases respectively.There were 40 cases in the control group,including 18 males and 22 females,with an average age of 55.3±9.8 years.There was no significant difference in the level of CCL5 in LDH patients with different TCM syndrome types and pathological characteristics(P>0.05),but there was significant difference in the level of CCL5 in LDH patients with different pain degrees(P<0.01).The highest level of CCL5 was found in severe pain patients,followed by moderate pain patients,patients with mild pain had the lowest levels of CCL5.Pearson correlation analysis indicated that there was a positive correlation between serum CCL5 concentration and pain degree(r=0.321,P=0.002).Conclusion There was no significant difference in the level of CCL5 in LDH patients with different TCM syndromes.Serum CCL5 level had no relationship with TCM syndromes and PATHOLOGICAL classification of LDH,but was positively correlated with pain grade.CCL5 may affect LDH through pain-related mechanisms,and CCL5 may become a target for the treatment of pain in LDH patients.