强直性脊柱炎中医辨证分型与免疫炎症指标的相关性研究

摘要

Objective:To investigate the relationship between different syndromes and immune inflammatory markers,such as ESR,hs-CRP,TNF-α,CD4 + CD25 + CD127-Treg in ankylosing spondylitis (AS).Methods:116 cases of AS patients were divided into damp-heat syndrome,cold syndrome and blood stasis syndrome according to Chinese medicine syndrome differentiation criteria.To observe the change of age,duration,overall VAS score,back pain VAS score,BASFI,BASDAI,ASDAS,ESR,hs-CRP,TNF-α,CD4 + CD25 + CD127-Treg and other immune inflammatory markers in patients,and study the relationship between these indicators and syndromes.Results:The longest average duration was cold syndrome in patients with AS,the second was stasis syndrome,and the third was the damp-heat syndrome patients.There was a significant difference in the Governor cold syndrome patients with damp-heat syndrome patients in the course (P ＜0.01).The highest average age was the cold syndrome patients,and the second was blood stasis syndrome,and the third was the damp-heat syndrome patients.There was a significant difference between the cold syndrome and damp-heat syndrome in patients with an average age (P ＜ 0.01).Compared with damp-heat syndrome,BASDAI,ASDAS were increased in patients with the cold and blood stasis syndrome.The damp-heat syndrome was significantly higher than those the cold syndrome and blood stasis syndrome in active patients (ASDAS ＞ 1.3) (P ＜ 0.01).Compared with the dampheat and cold syndrome,the levels of ESR,hs-CRP,TNF-α were increased in the cold syndrome and blood stasis syndrome (P ＜0.05,P ＜0.01).Compared with the cold,blood stasis,CD4 + CD25 + CD127-Treg was increased in the damp-heat syndrome (P ＜ 0.05).Conclusion:There were association between disease activity,immune function and syndromes in patients with AS.%目的:观察强直性脊柱炎(AS)不同中医证型与ESR、hs-CRP、TNF-α、CD4+ CD25+ CD127-Treg等免疫炎性指标的关系.方法:将116例确诊的AS患者按照中医辨证分型标准分为湿热证、督寒证和血瘀证,观测各组患者的年龄、病程、总体VAS评分、患者背痛VAS评分、BASFI、BASDAI、ASDAS以及ESR、hs-CRP、TNF-α、CD4+ CD25+ CD127-Treg等免疫炎性指标,研究其中医证型分布规律的相关性.结果:AS督寒证患者的平均病程最长,瘀血证患者次之,湿热证患者相对较短,督寒证患者与湿热证患者的病程比较差异有统计学意义(P＜0.01);督寒证患者的平均年龄最大,瘀血证患者次之,湿热证患者相对较小;督寒证与湿热证患者的平均年龄比较差异有统计学意义(P＜0.01);湿热证AS患者BASDAI、ASDAS显著高于督寒证和血瘀证,活动期AS患者中(ASDAS＞1.3),湿热证患者所占比例明显高于督寒证和血瘀证(P＜0.0l);湿热证AS患者的ESR、hs-CRP、TNF-α水平均显著高于血瘀证和督寒证(P＜0.05,P＜0.01),督寒证AS患者的CD4+ CD25+ CD127-Treg水平均显著低于血瘀证和湿热证(P＜0.05).结论:AS患者的病情活动程度、免疫功能状态与中医证候存在关联.