摘要
目的观察口腔扁平苔藓(OLP)患者外周血T淋巴细胞亚群及辅助性T淋巴细胞(Th)1/Th2的极化与中医证型的相关性。方法选择OLP患者150例为OLP组,并辨证分为脾胃蕴热型(37例)、肝郁化火型(30例)、肝肾阴虚型(41例)、气血两虚型(42例)4型,同时选择58例无OLP者设为正常对照组,比较各组T淋巴细胞亚群(CD3^+、CD4^+、CD8^+、CD4^+/CD8^+)、γ-干扰素(IFN-γ)、白细胞介素4(IL-4)及IFN-γ/IL-4比值。结果OLP组外周血中T淋巴细胞亚群CD3^+、CD4^+及CD4^+/CD8^+均低于正常对照组(P<0.05),CD8^+高于正常对照组(P<0.05)。脾胃蕴热型OLP患者CD3^+、CD4^+、CD4^+/CD8^+均低于正常对照组(P<0.05);肝郁化火型、肝肾阴虚型及气血两虚型OLP患者CD3^+、CD4^+、CD4^+/CD8^+均低于正常对照组(P<0.05),CD8^+高于正常对照组(P<0.05)。肝肾阴虚型及气血两虚型OLP患者CD3^+、CD4^+、CD4^+/CD8^+均低于脾胃蕴热型(P<0.05),CD8^+高于脾胃蕴热型(P<0.05),肝郁化火型OLP患者CD3^+、CD4^+、CD8^+、CD4^+/CD8^+与脾胃蕴热型比较差异均无统计学意义(P>0.05)。肝肾阴虚型OLP患者CD3^+、CD4^+/CD8^+均低于肝郁化火型(P<0.05)。气血两虚型OLP患者CD3^+、CD4^+、CD4^+/CD8^+均低于肝郁化火型及肝肾阴虚型(P<0.05),气血两虚型OLP患者CD8^+高于肝郁化火型及肝肾阴虚型(P<0.05)。OLP组IFN-γ水平及IFN-γ/IL-4比值均低于正常对照组(P<0.05),IL-4水平高于正常对照组(P<0.05)。脾胃蕴热型OLP患者IFN-γ及IFN-γ/IL-4比值均低于正常对照组(P<0.05),肝郁化火型、肝肾阴虚型、气血两虚型OLP患者IFN-γ及IFN-γ/IL-4比值均低于正常对照组(P<0.05),IL-4高于正常对照组(P<0.05)。肝郁化火型OLP患者IFN-γ均低于脾胃蕴热型(P<0.05)。肝肾阴虚型、气血两虚型OLP患者IFN-γ及IFN-γ/IL-4比值均低于脾胃蕴热型及肝郁化火型(P<0.05),IL-4高于脾胃蕴热型及肝郁化火型(P<0.05)。气血两虚型OLP患者IFN-γ及IFN-γ/IL-4比值均低于肝肾阴虚型(P<0.05),IL-4高于肝肾阴虚型(P<0.05)。结论OLP患者存在免疫功能紊乱及Th1/Th2的极化,且与中医证型有一定的相关性。
Objective To observe the correlation between polarization of peripheral blood T lymphocyte subsets and helper T lymphocyte 1（Th1）/helper T lymphocyte 2（Th2）in patients with oral lichen planus（OLP）and TCM syndromes.Methods 150 patients with OLP were divided into four types according to syndrome differentia-tion：spleen-stomach heat accumulation type（37cases）,liver stagnation transforming into fire type（30cases）,liver-kidney Yin deficiency type（41 cases）,and Qi-blood deficiency type（42 cases）.58 patients without OLP were selected as normal control group.The levels of T-lymphocyte subsets（CD3＋,CD4＋,CD8＋,CD4＋/CD8＋）,interferon-γ（IFN-γ）and interleukin-4（IL-4）in each group were compared.Results The peripheral blood T lymphocyte subsets CD3＋,CD4＋and CD4＋/CD8＋in patients were lower than the normal control group（P〈0. 05）,and CD8＋was higher than the normal control group（P〈0. 05）.The CD3＋,CD4＋,CD4＋/CD8＋in patients with spleen-stomach heat accumulation type were lower than those in the normal control group（P〈0. 05）.The CD3＋,CD4＋,CD4＋/CD8＋in patients with liver stagnation transforming into fire type,liver-kidney Yin deficiency type and Qi-blood deficiency type were lower than normal control group（P〈0. 05）,CD8＋was higher than normal control group（P〈0. 05）.The CD3＋,CD4＋,CD4＋/CD8＋were lower in liver-kidney Yin deficiency type and Qi-blood deficiency type than in spleen-stomach heat accumulation type（P〈0. 05）,CD8＋was higher than spleen-stomach heat accumulation type（P〈0. 05）,there was no significant difference between the liver stagnation transforming into fire type and spleen-stomach heat accumulation type（P〈0. 05）.The CD3＋,CD4＋/CD8＋in liver-kidney Yin deficiency type were lower than liver stagnation transforming into fire type（P〈0. 05）.The CD3＋,CD4＋,CD4＋/CD8＋in Qi-blood deficiency type were lower than the liver stagnation transforming into fire type,liver-kidney Yin deficiency type（P〈0. 05）,CD8＋in Qi-blood deficiency type was higher than liver stagnation transforming into fire type and liver-kidney Yin deficiency type（P〈0. 05）.The IFN-γlevel and IFN-γ/IL-4 ratio in OLP group were lower than those in the normal control group（P〈0. 05）,and the IL-4 level was higher than the normal control group（P〈0. 05）.The IFN-γand IFN-γ/IL-4 in patients with spleen-stomach heat accumulation type were lower than those in normal control group（P〈0. 05）,the IFN-γand IFN-γ/IL-4 in liver stagnation transforming into fire type,liver-kidney Yin deficiency type and Qi-blood deficiency type was lower than the normal control group（P〈0. 05）,and IL-4 was higher than the normal control group（P〈0. 05）.The IFN-γin liver stagnation transforming into fire type was lower than spleen and stomach heat accumulation type（P〈0. 05）.The IFN-γand IFN-γ/IL-4 liver-kidney Yin deficiency type and Qi-blood deficiency type were lower than spleen-stomach heat accumulation type,liver stagnation transforming into fire type（P〈0. 05）,IL-4 was higher than the spleen and stomach heat type and liver stagnation transforming into fire type（P〈0. 05）.The IFN-γand IFN-γ/IL-4 of Qi-blood deficiency type were lower than that of liverkidney yin deficiency（P〈0. 05）,and IL-4 was higher than that of liver-kidney yin deficiency（P〈0. 05）.Conclusion OLP patients have immune dysfunction and polarization of Th1/Th2,and have certain correlation with TCM syndromes.
作者
魏俭铭
郭秀敏
穆宏肖
遵胜
庞莹
艾淑珍
WEI Jianming;GUO Xiumin;MU Hong(Department of Stomatology,Cangzhou Central Hospital,Hebei 061001)
出处
《河北中医》
2018年第8期1136-1141,1155,共7页
Hebei Journal of Traditional Chinese Medicine
基金
河北省中医药管理局2018年度中医药类科研计划(编号:2018506)
