| 529 | 16 | 96 |
| 下载次数 | 被引频次 | 阅读次数 |
目的:探讨非哺乳期乳腺炎中医证型与自身免疫功能的相关性。方法:收集符合肝经郁热证和痰湿蕴热证的非哺乳期乳腺炎患者各32例,采集并记录临床资料,分析比较两种证型患者的血清免疫指标水平。结果:相较于肝经郁热证患者,痰湿蕴热证患者乳房疼痛明显(P=0.004);两种证型患者细胞免疫功能紊乱均表现为CD3+、CD4+、CD8+、CD8~+CD28~+T细胞表达的上调及CD4~+CD25~+T细胞表达的下调,其中相较于肝经郁热证患者,痰湿蕴热证患者CD3~+T细胞表达异常以升高为主(P=0.024),占12.5%(4/32);两种证型患者体液免疫功能紊乱表现为免疫球蛋白(Ig)G、IgA、IgE、IgM、补体成分4(C4)、50%溶血补体量(CH50)的上调和补体成分3(C3)的下降,其中痰湿蕴热证患者IgG表达较肝经郁热证患者明显(P<0.001)。结论:非哺乳期乳腺炎患者的中医证型与免疫表达状态存在一定相关性,不同证型患者的免疫功能紊乱状态不同,相较于肝经郁热证,痰湿蕴热证患者的免疫表达更为强烈。
Abstract:Objective:To investigate the correlation between the traditional Chinese medicine(TCM) syndromes and immune function of patients with non-lactation mastitis(NLM). Methods:Thirty two patients with NLM of stagnated heat in liver channel syndrome and 32 patients with NLM of accumulated heat of phlegm dampness syndrome were included. Clinical information were collected and recorded,and the serum immunity indexes of both syndromes were analyzed and compared. Results:Compared with patients of stagnated heat of liver channel syndrome,patients with accumulated heat of phlegm dampness showed obvious breast pain(P= 0.004). The cellular immune dysfunction of patients was characterized by up-regulation of CD3+,CD4+,CD8+,CD8~+CD28~+T cells and down-regulation of CD4~+CD25~+T cells. The expression of CD3~+T cells in patients with accumulated heat of phlegm dampness syndrome mainly increased compared with that in patients with stagnated heat of liver channel syndrome(P= 0.024),accounting for 12.5%(4/32). The humoral immune dysfunction of patients showed the up-regulation of immunoglobulin(Ig)G,Ig A,Ig E,Ig M,complement(C)4,50% hemolysis of complement(CH50)and the decrease of C3. The expression of Ig G in patients of accumulated heat of phlegm dampness syndrome was significantly higher than that of patients with stagnated heat of liver channel syndrome(P<0.001).Conclusions:TCM syndrome types of NLM patients are related to immune expression states to a certain degree. Patients of different syndromes types showed different states of immunity disorder. Compared with patients of stagnated heat in liver channel syndrome,the patients of accumulated heat of phlegm dampness syndrome showed more vigorous immune expression.
[1]夏亚茹,陈红风,叶媚娜,等.非哺乳期乳腺炎患者外周血T淋巴细胞、免疫球蛋白及补体水平的变化[J].中华乳腺病杂志(电子版),2012,6(5):504-514.
[2]李爱辉,李洪,王力斌,等.非哺乳期乳腺炎患者血液中自身抗体和免疫指标的变化及意义[J].实用临床医学,2018,19(2):38-39,52.
[3] KESSLER E, WOLLOCH Y. Granulomatous mastitis:a lesion clinically simulating carcinoma[J]. Am J Clin Pathol,1972,58(6):642-646.
[4] LACAMBRA M,THAI T A,LAM C C,et al. Granulomatous mastitis:the histological differentials[J]. J Clin Pathol,2011,64(5):405-411.
[5] BES C,SOY M,VARDI S,et al. Erythema nodosum associated with granulomatous mastitis:report of two cases[J].Rheumatol Int,2010,30(11):1523-1525.
[6]陈迪,章乐虹.类固醇激素联合甲氨喋呤治疗肉芽肿性小叶性乳腺炎一例[J].中华乳腺病杂志(电子版),2010,4(6):754-756.
[7]顾伯华.实用中医外科学[M].上海:上海科学技术出版社,1985:135-136.
[8]陈红风.中医外科学[M]. 4版.北京:中国中医药出版社,2016:107-109.
[9]中华中医药学会.中医外科临床诊疗指南[M].北京:中国中医药出版社,2020:39-46.
[10]邓铁涛.中医证候规范[M].广州:广东科技出版社,1990:142-173.
[11]陆德铭,陆金根.实用中医外科学[M]. 2版.上海:上海科学技术出版社,2010:158-160.
[12]陈帆帆,冯佳梅,高晴倩,等.非哺乳期乳腺炎病人外周血免疫功能检测及其临床意义[J].外科理论与实践,2015,20(3):252-254.
[13] GOPALAKRISHNAN NAIR C,HIRAN,JACOB P,et al.Inflammatory diseases of the non-lactating female breasts[J].Int J Surg,2015(13):8-11.
[14]陆清,夏亚琳,李琼,等.不同时期浆细胞性乳腺炎患者的免疫功能[J].广西医学,2017,39(12):1788-1790.
[15]冯佳梅,蒋思韵,徐瑞敏,等.清化痰湿方治疗痰湿型粉刺性乳痈临床疗效观察[J].上海中医药杂志,2016,50(8):58-59,66.
[16]张超杰,孔成.非哺乳期乳腺炎的免疫学研究进展[J].大连医科大学学报,2014,36(4):307-313.
基本信息:
DOI:10.16295/j.cnki.0257-358x.2022.11.008
中图分类号:R269
引用信息:
[1]谢璐,冯佳梅,吴雪卿,等.非哺乳期乳腺炎中医证型与自身免疫功能的相关性研究[J],2022,41(11):1186-1191.DOI:10.16295/j.cnki.0257-358x.2022.11.008.
基金信息:
上海市科学技术委员会科研计划项目(编号:19401934000)
2021-10-24
2021
2021-12-10
2021
1