兒童過敏性紫癜證型分布與免疫相關(guān)性研究
發(fā)布時間：2018-11-21 21:02
【摘要】：目的：分析過敏性紫癜（HSP）中醫(yī)辨證分型與外周血T淋巴細胞亞群、食物過敏原、外周血白細胞及血小板計數(shù)的相關(guān)性。從細胞水平探討HSP患兒急性期中醫(yī)證型與上述相關(guān)實驗室檢查的關(guān)系，為HSP的治療提供相應的技術(shù)參數(shù)，對其辨證分型與治療具有一定意義。 研究方法：1.臨床研究方法：采用前瞻性簡單隨機試驗，符合納入標準病例84例，同時設(shè)健康組30例；參考全國普通高等教育中醫(yī)藥類精編教材《中醫(yī)兒科學》對研究病例進行中醫(yī)辨證分型。2.實驗檢測方法：采用免疫熒光法檢測外周血T淋巴細胞亞群(CD3~+、CD4~+、 CD8~+、CD4~+/CD8~+)；采用體外定性酶免疫分析法檢測食物過敏原；采用電阻抗、高頻電導及激光散射聯(lián)合檢測法檢測外周血白細胞及血小板計數(shù)。3.統(tǒng)計方法：采用SPSS17.0for windows統(tǒng)計軟件包進行數(shù)據(jù)處理分析。 結(jié)果: 1．84例HSP患兒急性期中醫(yī)證型分布以風熱傷絡(luò)型（53.6%）最多，其次為濕熱痹阻型（36.9%），其他證型較少（9.5%）。 2. CD4~+、CD4~+/CD8~+HSP組與健康組比較有顯著性差異（P㩳0.01）； CD3~+、 CD8~+與健康組比較無顯著性差異（P＞0.05）；T淋巴細胞亞群在HSP風熱傷絡(luò)型與濕熱痹阻型間比較無顯著性差異（P＞0.05）；T淋巴細胞亞群在HSP急性期與恢復期無顯著性差異（P＞0.05）。 3.HSP患兒食物過敏原檢測陽性者占78.57％，不同種類食物過敏原陽性率分別為：海鮮類（19.05％）、牛奶（15.48％）、雞蛋（13.10％）、肉類（11.90％）、小麥（10.71％）、花生黃豆（8.33％）。各類過敏原在風熱傷絡(luò)型和濕熱痹阻型的分布無顯著性差異（P＞0.05）。 4.外周血白細胞計數(shù)在HSP風熱傷絡(luò)型與濕熱痹阻型間比較有顯著性差異（P㩳0.01）；血小板計數(shù)在兩證型之間無顯著性差異（P㧐0.05）。 結(jié)論: 1.過敏性紫癜患兒急性期中醫(yī)證型分布以風熱傷絡(luò)型、濕熱痹阻型為多見。 2．過敏性紫癜患兒急性期存在細胞免疫功能失調(diào),主要表現(xiàn)在CD4~+、CD4~+/CD8~+明顯降低。 3.海鮮類和牛奶是本次研究的主要食物過敏原。各類過敏原在HSP急性期的中醫(yī)證型分布無顯著性差異。 4.外周血白細胞和血小板計數(shù)在HSP急性期有增高趨勢。外周血白細胞計數(shù)在HSP風熱傷絡(luò)型較濕熱痹阻型顯著增高；血小板計數(shù)在兩證型之間無顯著性差異。
[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.
【學位授予單位】：遼寧中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R272
本文編號：2348250
[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.
【學位授予單位】：遼寧中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R272
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