儿童过敏性紫癜证型分布与免疫相关性研究

发布时间：2018-11-21 21:02

【摘要】：目的：分析过敏性紫癜（HSP）中医辨证分型与外周血T淋巴细胞亚群、食物过敏原、外周血白细胞及血小板计数的相关性。从细胞水平探讨HSP患儿急性期中医证型与上述相关实验室检查的关系，为HSP的治疗提供相应的技术参数，对其辨证分型与治疗具有一定意义。研究方法：1.临床研究方法：采用前瞻性简单随机试验，符合纳入标准病例84例，同时设健康组30例；参考全国普通高等教育中医药类精编教材《中医儿科学》对研究病例进行中医辨证分型。2.实验检测方法：采用免疫荧光法检测外周血T淋巴细胞亚群(CD3~+、CD4~+、 CD8~+、CD4~+/CD8~+)；采用体外定性酶免疫分析法检测食物过敏原；采用电阻抗、高频电导及激光散射联合检测法检测外周血白细胞及血小板计数。3.统计方法：采用SPSS17.0for windows统计软件包进行数据处理分析。结果: 1．84例HSP患儿急性期中医证型分布以风热伤络型（53.6%）最多，其次为湿热痹阻型（36.9%），其他证型较少（9.5%）。 2. CD4~+、CD4~+/CD8~+HSP组与健康组比较有显著性差异（P㩳0.01）； CD3~+、 CD8~+与健康组比较无显著性差异（P＞0.05）；T淋巴细胞亚群在HSP风热伤络型与湿热痹阻型间比较无显著性差异（P＞0.05）；T淋巴细胞亚群在HSP急性期与恢复期无显著性差异（P＞0.05）。 3.HSP患儿食物过敏原检测阳性者占78.57％，不同种类食物过敏原阳性率分别为：海鲜类（19.05％）、牛奶（15.48％）、鸡蛋（13.10％）、肉类（11.90％）、小麦（10.71％）、花生黄豆（8.33％）。各类过敏原在风热伤络型和湿热痹阻型的分布无显著性差异（P＞0.05）。 4.外周血白细胞计数在HSP风热伤络型与湿热痹阻型间比较有显著性差异（P㩳0.01）；血小板计数在两证型之间无显著性差异（P㧐0.05）。结论: 1.过敏性紫癜患儿急性期中医证型分布以风热伤络型、湿热痹阻型为多见。 2．过敏性紫癜患儿急性期存在细胞免疫功能失调,主要表现在CD4~+、CD4~+/CD8~+明显降低。 3.海鲜类和牛奶是本次研究的主要食物过敏原。各类过敏原在HSP急性期的中医证型分布无显著性差异。 4.外周血白细胞和血小板计数在HSP急性期有增高趋势。外周血白细胞计数在HSP风热伤络型较湿热痹阻型显著增高；血小板计数在两证型之间无显著性差异。
[Abstract]:Objective: to analyze the relationship between (HSP) syndrome differentiation and peripheral blood T lymphocyte subsets, food allergens, peripheral blood leukocytes and platelet count. To explore the relationship between TCM syndromes in acute stage of HSP and the laboratory examination mentioned above from the cell level, to provide the corresponding technical parameters for the treatment of HSP, and to have certain significance for the differentiation and treatment of HSP. Methods: 1. Methods: a prospective and simple randomized trial was conducted in 84 patients who were in accordance with the inclusion criteria and 30 patients in the healthy group. Referring to the teaching material of traditional Chinese Medicine (TCM Pediatrics) in the general higher education of China, this paper classifies the cases into TCM syndrome differentiation and classification. 2. Methods: peripheral blood T lymphocyte subsets (CD3~, CD4~, CD8~, CD4~ / CD8~) were detected by immunofluorescence assay, and food allergens were detected by qualitative enzyme immunoassay in vitro. The peripheral blood leukocyte and platelet count were detected by the method of electrical impedance, high frequency conductance and laser scattering. Statistical method: SPSS17.0for windows statistical software package was used for data processing and analysis. Results: 1.The distribution of TCM syndromes in acute stage of HSP was wind heat and collateral injury type (53.6%) followed by damp-heat arthralgia type (36.9%) and other syndrome types (9.5%). 2. There was significant difference between CD4~, CD4~ / CD8~ HSP group and healthy group (P0. 01), but there was no significant difference between CD3~, CD8~ and healthy group (P > 0. 05). There was no significant difference in T lymphocyte subsets between HSP wind-heat injury syndrome and damp-heat arthralgia type (P > 0. 05). There was no significant difference between HSP acute phase and convalescence stage (P > 0. 05). The positive rates of food allergens in children with 3.HSP were: seafood (19.05%), milk (15.48%), eggs (13.10%), meat (11.90%). Wheat (10.71%), peanut soybean (8.33%). There was no significant difference in the distribution of all kinds of allergens between wind and heat injury and damp-heat arthralgia (P > 0.05). 4. There was significant difference in peripheral blood leukocyte count between HSP wind-heat injury collaterals type and damp-heat arthralgia type (P0. 01), but there was no significant difference in platelet count between the two syndrome types (P0. 05). Conclusion: 1. The distribution of TCM syndromes in children with Henoch-Schonlein purpura at acute stage was wind heat injury and damp-heat arthralgia. 2. There were cellular immune dysfunction in children with Henoch-Schonlein purpura in acute phase, mainly manifested in the decrease of CD4~ and CD4~ / CD8~. 3. Seafood and milk were the main food allergens in this study. There was no significant difference in the distribution of TCM syndromes of all kinds of allergens in the acute stage of HSP. 4. The white blood cell and platelet count in peripheral blood tended to increase in the acute phase of HSP. The peripheral blood leukocyte count in HSP wind-heat injury syndrome was significantly higher than that in damp-heat arthralgia type, and there was no significant difference in platelet count between the two syndrome types.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R272

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