【摘要】 目的:观察不同中医证型甲型H1N1流感患者治疗前后T淋巴细胞亚群的变化。方法:回顾性纳入甲型H1N1流感患者111例,根据中医辨证的方法分为风热犯卫型(55例)、热毒袭肺型(36例)和风寒束表型(20例),按照患者自愿的原则,采用西药(对氨基乙酰酚或布洛芬)、中药汤剂(辨证用药)以及中西药结合的方法对患者进行治疗。另外选择20位健康志愿者做正常对照。应用流式细胞术检测不同证型甲型H1N1流感患者治疗前后T淋巴细胞亚群的变化。结果:治疗前,3种证型患者CD3+、CD4+T淋巴细胞的表达均低于正常对照组(P<0.01);风寒束表证患者CD8+T淋巴细胞的表达与正常对照组比较,差异无统计学意义;风热犯卫和热毒袭肺证患者CD8+T淋巴细胞的表达低于正常对照组(P<0.01);风寒束表证患者CD4+/CD8+的比值与正常对照组比较,差异无统计学意义;风热犯卫和热毒袭肺证患者CD4+/CD8+的比值高于正常对照组(P<0.01)。治疗后,3种证型患者的CD4+T淋巴细胞的表达升高,与正常对照组比较差异无统计学意义;风热犯卫和风寒束表证患者CD3+T淋巴细胞的表达升高,与正常对照组比较差异无统计学意义;热毒袭肺证患者CD3+T淋巴细胞的表达低于正常对照组(P<0.05);风热犯卫和热毒袭肺证患者CD8+T淋巴细胞的表达低于正常对照组(P<0.05);热毒袭肺证患者的CD4+/CD8+比值与正常对照组比较差异无统计学意义;风热犯卫证患者的CD4+/CD8+比值高于正常对照组(P<0.05)。结论:不同中医证型甲型H1N1流感患者的T淋巴细胞亚群的检测可为评价各中医证型甲型H1N1流感患者的细胞免疫功能提供客观依据,也对中医临床辨证分型提供了一定的参考价值。更多还原

【Abstract】 Objective:To investigate the changes in T lymphocyte subsets in patients with different syndrome types infected by influenza A(H1N1)virus after treatment.Methods:In this retrospective study,111 patients with H1N1 influenza were enrolled and divided into three groups according to their syndromes:exterior heat syndrome group(55 cases),exterior cold syndrome group(20 cases)and heat toxin invading lung(HTIL)syndrome group(36 cases).Patients were treated with Western medicine(acetaminophen or ibuprofen suspension),traditional Chinese medicine(herbal medicine according to their syndromes),or a combination of Western medicine and traditional Chinese medicine with patient’s intentions.Another 20 healthy people were selected as normal control.Phenotypic features of T lymphocyte subsets in peripheral vein blood of patients before and after treatment were determined by flow cytometry.Results:Before treatment,the numbers of CD3-and CD4-postive T lymphocytes were lower in H1N1 patients with the three types of syndromes than in the normal controls(P<0.01),and the numbers of CD8-positive T lymphocytes were lower in exterior heat syndrome and HTIL syndrome groups than in normal control group(P<0.01).The ratio of CD4-positive to CD8-positive T lymphocytes in exterior cold syndrome group showed no difference as compared with the normal control group,and the ratios of CD4-positive to CD8-positive T lymphocytes in exterior heat syndrome and HTIL syndrome groups were higher than that in the normal control group(P<0.01).After treatment,the numbers of CD4-positive T lymphocytes increased in all the three types of syndromes in patients with H1N1,and showed no difference compared with the normal control group.The numbers of CD3-positive T lymphocytes in patients with exterior heat syndrome and exterior cold syndrome increased,and showed no difference compared with the normal control group.The number of CD3-positive T lymphocytes in H1N1 patients with HTIL syndrome was lower than that in the normal control group(P<0.05),whereas the numbers of CD8-positive T lymphocytes in patients with exterior heat syndrome and HTIL syndrome were lower than that in the normal control group(P<0.05).The ratio of CD4-positive to CD8-positive T lymphocytes in patients with HTIL syndrome was decreased,and displayed no difference as compared with the normal control group.The ratio of CD4-positive to CD8-positive T lymphocytes in patients with exterior heat syndrome was higher than that in the normal control group(P<0.05).Conclusion:Analysis of T lymphocyte subsets may provide experimental data to support for syndrome differentiation in traditional Chinese medicine and a sound method to establish syndrome differentiation typing for H1N1.更多还原