慢性盆腔炎患者不同中医证型与细胞免疫学指标、血清炎症指标相关性分析

An Analysis of Correlation Between Different TCM Syndrome Types and Cellular Immunologic Indexes and Serum Inflammatory Indexes in Patients with Chronic Pelvic Inflammatory Disease

目的:分析慢性盆腔炎患者不同中医证型与细胞免疫学指标、血清炎症指标的相关性。方法:选取2019年12月至2020年12月山东中医药大学附属医院收治的102例慢性盆腔炎患者为病例组,另选取40例参加体检的健康女性为对照组。对病例组患者进行辨证分型,并检测两组受试者外周血CD3^(+)、CD4^(+)、CD8^(+)、C-反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)水平,分析不同证型慢性盆腔炎患者的细胞免疫学指标及血清炎症指标变化情况。结果:102例慢性盆腔炎患者中,湿热瘀结证47例(46.08%)、气虚血瘀证31例(30.39%)、气滞血瘀证16例(15.69%)和寒凝血瘀证8例(7.84%)。病例组CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)指标水平低于对照组,差异具有统计学意义(P<0.05);病例组血清CRP、IL-6及TNF-α水平均高于对照组,差异具有统计学意义(P<0.05)。湿热瘀结证患者CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平低于气虚血瘀证、气滞血瘀证及寒凝血瘀证,差异具有统计学意义(P<0.05)。湿热瘀结证患者CRP、TNF-α及IL-6水平高于气虚血瘀证、气滞血瘀证、寒凝血瘀证,差异具有统计学意义(P<0.05)。结论:与健康女性比较,慢性盆腔炎患者细胞免疫学指标降低,血清炎症指标升高。细胞免疫学指标及血清炎症指标不仅与慢性盆腔炎有关,还与中医证型存在一定关系,湿热瘀结证患者可能伴随细胞免疫功能紊乱及较高的炎症反应状态。

Objective:To analyze the correlation between different TCM syndrome types and cellular immunologic indexes and serum inflammatory indexes in patients with chronic pelvic inflammatory disease.Methods:A total of 102 patients with chronic pelvic inflammatory disease from December 2019 to December 2020 were selected as the case group,and 40 healthy women undergoing physical examination were selected as the control group.The patients in the case group were classified according to syndrome differentiation.The levels of the peripheral blood CD3^(+),CD4^(+),CD8^(+),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)were detected.And the changes of cellular immunological indexes and serum inflammatory indexes in patients with chronic pelvic inflammatory disease of different syndrome types were analyzed.Results:Among the 102 patients with chronic pelvic inflammatory disease,there were 47 cases of dampness heat and blood stasis syndrome(46.08%),31 cases of qi deficiency and blood stasis syndrome(30.39%),16 cases of qi stagnation and blood stasis syndrome(15.69%)and 8 cases of cold coagulation and blood stasis syndrome(7.84%).The levels of CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) in the case group were significantly lower than those in the control group,and all the differences were statistically significant(P<0.05).The levels of serum CRP,IL-6 and TNF-αin the case group were significantly higher than those in the control group,and all the differences were statistically significant(P<0.05).The levels of CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) in patients with dampness-heat and blood stasis syndrome were significantly lower than those in patients with qi deficiency and blood stasis syndrome,qi stagnation and blood stasis syndrome,and cold coagulation and blood stasis syndrome,and all the differences were statistically significant(P<0.05).The levels of CRP,TNF-α,and IL-6 in patients with dampness-heat stasis syndrome were significantly higher than those of qi deficiency and blood stasis syndrome,qi stagnation and blood stasis syndrome,and cold coagulation and blood stasis syndrome,and all the differences were statistically significant(P<0.05).Conclusion:Compared with healthy women,the cellular immunological indexes of patients with chronic pelvic inflammatory disease are lower and the serum inflammatory indexes are higher.Cellular immunological indexes and serum inflammatory indexes are not only related to chronic pelvic inflammatory disease,but also related to TCM syndrome types.Patients with dampness-heat and blood stasis syndrome may be accompanied by cellular immune disorder and high level of inflammatory response.