本文選題：系統(tǒng)性紅斑狼瘡 + 中醫(yī)體質(zhì)　； 參考：《廣州中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：系統(tǒng)性紅斑狼瘡(SLE)是一種累及多系統(tǒng)多器官,臨床表現(xiàn)復(fù)雜,病程遷延反復(fù)的自身免疫性疾病,其病因及發(fā)病機制非常復(fù)雜,與遺傳、免疫紊亂、環(huán)境因素、性別因素等密切相關(guān),至今尚未完全明確�，F(xiàn)代醫(yī)學(xué)研究認為凋亡細胞清除缺陷和T、B淋巴細胞凋亡異常是SLE發(fā)病的重要原因,Fas作為介導(dǎo)淋巴細胞凋亡的主要膜受體,與SLE發(fā)病有關(guān)。中醫(yī)認為體質(zhì)是疾病發(fā)生、發(fā)展的重要因素,體質(zhì)對于揭示疾病病因有獨特的優(yōu)勢。因此把中醫(yī)體質(zhì)學(xué)觀點和現(xiàn)代醫(yī)學(xué)研究成果相結(jié)合,有利于揭示SLE的發(fā)病原因,為SLE的中醫(yī)藥防治奠定更科學(xué)的理論基礎(chǔ)。目的：本課題通過比較虛性體質(zhì)和實性體質(zhì)系統(tǒng)性紅斑狼瘡患者的外周血T、B淋巴細胞Fas表達率及凋亡率,探討系統(tǒng)性紅斑狼瘡發(fā)病的中醫(yī)本質(zhì)及機理,為中醫(yī)藥有效防治系統(tǒng)性紅斑狼瘡提供更科學(xué)的理論依據(jù)。方法：研究收集2015年8月至2016年2月廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院風(fēng)濕病科門診及住院部符合SLE分類標準的病人共46例,收集病人姓名、年齡、性別、病程等一般情況資料；按照2009年4月9日實施的《中醫(yī)體質(zhì)分類與判定》標準判定體質(zhì)狀況,把陽虛體質(zhì)、陰虛體質(zhì)、氣虛體質(zhì)歸為虛性體質(zhì),氣郁體質(zhì)、痰濕體質(zhì)、瘀血體質(zhì)、濕熱體質(zhì)歸為實性體質(zhì),特稟質(zhì)及平和質(zhì)暫不納入虛、實性體質(zhì)研究范圍；并結(jié)合患者病情進行狼瘡疾病活動指數(shù)評分(SLEDAI評分)；每一位患者抽取靜脈血,采用流式細胞術(shù)檢測T淋巴細胞Fas表達率、B淋巴細胞Fas表達率以及T、B淋巴細胞凋亡率；最后采用spss22.0統(tǒng)計軟件將以上數(shù)據(jù)作統(tǒng)計學(xué)分析,比較虛性體質(zhì)和實性體質(zhì)SLE患者的T、B淋巴細胞Fas表達率及凋亡率,并對T、B淋巴細胞Fas表達率及凋亡率與抗ds-DNA水平、SLE疾病活動評分進行相關(guān)性分析,得出結(jié)論。結(jié)果：1.虛性體質(zhì)的SLE患者的外周血T淋巴凋亡率顯著高于實性體質(zhì)SLE患者。2.SLE患者外周血T淋巴細胞Fas表達率與SLE疾病活動度、抗ds-DNA抗體水平正相關(guān)。3.活動期SLE患者外周血B淋巴細胞Fas表達率與B淋巴細胞凋亡率正相關(guān)。結(jié)論：1.本次研究發(fā)現(xiàn)虛性體質(zhì)組的T淋巴細胞凋亡率較實性體質(zhì)組顯著升高。目前經(jīng)大量研究證實SLE外周血T淋巴細胞凋亡率較健康人升高,反映了SLE患者存在凋亡物質(zhì)清除缺陷,這與SLE發(fā)病密切相關(guān)。因而我們認為虛性體質(zhì)人群較實性體質(zhì)人群具有更明顯的凋亡物質(zhì)清除缺陷,因而更容易患SLE。這揭示了SLE患者以虛性體質(zhì)常見的原因,也和中醫(yī)認為SLE的病機是以先天稟賦不足,正氣虧虛為本的這一認識相一致,因而我們可以認為“體虛”為SLE發(fā)病之本。2.SLE患者外周血T淋巴細胞Fas表達率與SLE疾病活動度、抗ds-DNA水平正相關(guān),因此外周血T淋巴細胞Fas表達率在評估SLE疾病活動度方面具有重要價值。3.Fas介導(dǎo)的細胞凋亡途徑可能是活動期SLE患者外周血B淋巴細胞凋亡的主要途徑。
[Abstract]:Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple systems and organs with complex clinical manifestations and repeated course of disease. Gender factors and other closely related, so far has not been completely clear. Modern medical studies suggest that the defect of apoptotic cell clearance and the abnormal apoptosis of T _ (B) B lymphocytes are the important reasons for the pathogenesis of SLE. FAS is the main membrane receptor that mediates the apoptosis of lymphocytes, which is related to the pathogenesis of SLE. TCM believes that physique is an important factor in the occurrence and development of disease, and physique has a unique advantage in revealing the etiology of disease. Therefore, combining the viewpoint of TCM physique with the research results of modern medicine is helpful to reveal the pathogenesis of SLE and to lay a more scientific theoretical foundation for the prevention and treatment of SLE by TCM. Objective: to investigate the nature and mechanism of systemic lupus erythematosus (SLE) by comparing the FAS expression rate and apoptosis rate of peripheral blood TnB lymphocytes in patients with systemic lupus erythematosus (SLE). To provide a more scientific theoretical basis for the effective prevention and treatment of systemic lupus erythematosus by traditional Chinese medicine. Methods: from August 2015 to February 2016, 46 patients in the Department of Rheumatology, Department of Rheumatology, first affiliated Hospital of Guangzhou University of traditional Chinese Medicine, who met the classification criteria of SLE, were collected and their names, age, sex and course of disease were collected. According to the standard of TCM constitution classification and judgment implemented on April 9, 2009, the constitution of yang deficiency, yin deficiency and qi deficiency were classified as deficiency constitution, qi depression constitution, phlegm dampness constitution, blood stasis constitution. The dampness and heat constitution is classified as the solid constitution, the special quality and the calming quality are not included in the study of deficiency, and the physical fitness is studied. The disease activity index score (SLEDAI score) is carried out according to the condition of the patient. Each patient takes the venous blood. Flow cytometry was used to detect the FAS expression rate of T lymphocytes, the FAS expression rate of B lymphocytes and the apoptosis rate of B lymphocytes. Finally, the above data were statistically analyzed by spss22.0 software. To compare the FAS expression rate and apoptosis rate between asthenia and solid constitution SLE patients, and to analyze the correlation between FAS expression rate and apoptosis rate and anti-ds-DNA level of SLE disease activity score. The result is 1: 1. The rate of T lymphoid apoptosis in SLE patients with asthenia constitution was significantly higher than that in SLE patients with solid constitution. 2. The FAS expression rate of peripheral blood T lymphocytes in SLE patients was positively correlated with disease activity and anti-ds-DNA antibody level. There was a positive correlation between FAS expression and B lymphocyte apoptosis in active SLE patients. Conclusion 1. The apoptosis rate of T lymphocytes in asthenia constitution group was significantly higher than that in solid constitution group. At present, a large number of studies have confirmed that the apoptosis rate of T lymphocytes in peripheral blood of SLE is higher than that of healthy persons, which indicates that there is a defect in the clearance of apoptotic substances in SLE patients, which is closely related to the pathogenesis of SLE. Therefore, we think that the deficiency body population has more obvious apoptotic substance clearance defect than the real physical group, so it is more likely to suffer from SLE. This reveals the common causes of asthenia in SLE patients, and is consistent with the Chinese medicine's understanding that the pathogenesis of SLE is based on the deficiency of innate endowment and deficiency of qi. Therefore, we can conclude that "body deficiency" is the origin of SLE. 2. There is a positive correlation between FAS expression rate in peripheral blood T lymphocytes and disease activity and anti-ds-DNA level in SLE patients. Therefore, the expression rate of FAS in peripheral blood T lymphocytes has important value in evaluating the disease activity of SLE. 3. FAS mediated apoptosis may be the main pathway of peripheral blood B lymphocyte apoptosis in active SLE patients.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259

【參考文獻】

相關(guān)期刊論文 前10條

1 蘇曉;陳薇薇;楊旭鳴;唐華燕;江春春;;復(fù)方生地合劑聯(lián)合西藥治療系統(tǒng)性紅斑狼瘡陰虛內(nèi)熱型33例臨床觀察[J];中醫(yī)雜志;2015年14期

2 趙書濤;武曉東;王策;陳永勤;唐玉國;;流式細胞儀的原理、應(yīng)用及最新進展[J];現(xiàn)代生物醫(yī)學(xué)進展;2011年22期

3 蔣春梅;李娟;;痛風(fēng)危險因素、體質(zhì)類型與中醫(yī)證型的相關(guān)研究[J];熱帶醫(yī)學(xué)雜志;2011年05期

4 王俊志;周泉宇;張海龍;趙玉娟;;狼瘡飲Ⅱ號治療系統(tǒng)性紅斑狼瘡緩解期(氣陰兩虛證)的臨床觀察[J];中醫(yī)藥信息;2011年03期

5 沈敏寧;蘇定雷;季曉輝;徐燕麗;立顏;陳興國;;系統(tǒng)性紅斑狼瘡患者CD8~+T細胞亞群Fas-FasL的表達及凋亡的關(guān)系研究[J];現(xiàn)代免疫學(xué);2009年06期

6 楊坤寧;鄭德勇;;孟如治療系統(tǒng)性紅斑狼瘡診療思路[J];中醫(yī)文獻雜志;2009年05期

7 韓曉偉;馬賢德;關(guān)洪全;;中醫(yī)“氣血津液”學(xué)說與現(xiàn)代免疫學(xué)思想[J];中華中醫(yī)藥學(xué)刊;2009年07期

8 李娜;高俊巖;劉敏;;細胞凋亡和腫瘤的關(guān)系研究進展[J];當(dāng)代醫(yī)學(xué);2009年16期

9 潘春留;閆雷;娜仁圖娜拉;卿素珠;關(guān)偉軍;馬月輝;;流式細胞術(shù)研究細胞凋亡的方法與技術(shù)[J];現(xiàn)代生物醫(yī)學(xué)進展;2009年04期

10 蔡輝;張永文;沈思鈺;;系統(tǒng)性紅斑狼瘡與張仲景陰陽毒探討[J];安徽中醫(yī)學(xué)院學(xué)報;2008年06期

相關(guān)會議論文 前1條

1 汪丹;;淺談中醫(yī)體質(zhì)與正氣對發(fā)病影響的異同[A];中華中醫(yī)藥學(xué)會第七屆中醫(yī)體質(zhì)學(xué)術(shù)研討會論文集[C];2009年

相關(guān)博士學(xué)位論文 前4條

1 關(guān)彤;基于體質(zhì)調(diào)查的小柴胡湯加減治療系統(tǒng)性紅斑狼瘡臨床研究[D];廣州中醫(yī)藥大學(xué);2011年

2 凌志蘭;類風(fēng)濕關(guān)節(jié)炎患者中醫(yī)體質(zhì)特征研究[D];南方醫(yī)科大學(xué);2011年

3 歐陽濤;冠心病痰瘀辨證和體質(zhì)類型與apoE及其受體基因多態(tài)性關(guān)系的研究[D];中國中醫(yī)研究院;2005年

4 弓娟琴;系統(tǒng)性紅斑狼瘡淋巴細胞活化、增殖與凋亡及其相關(guān)性研究[D];中國協(xié)和醫(yī)科大學(xué);2000年

相關(guān)碩士學(xué)位論文 前7條

1 吳夢甜;慢性原發(fā)性腎小球腎炎和狼瘡性腎炎中醫(yī)體質(zhì)分型調(diào)查分析[D];福建中醫(yī)藥大學(xué);2014年

2 鐘興華;基于文獻分析探討系統(tǒng)性紅斑狼瘡的中醫(yī)證治[D];廣州中醫(yī)藥大學(xué);2012年

3 龐湛韻;系統(tǒng)性紅斑狼瘡患者抑郁癥狀與心肝脾臟的關(guān)系探討[D];廣州中醫(yī)藥大學(xué);2011年

4 張明英;我院系統(tǒng)性紅斑狼瘡患者的體質(zhì)調(diào)查[D];廣州中醫(yī)藥大學(xué);2011年

5 宮澤琨;系統(tǒng)性紅斑狼瘡中醫(yī)辯證分型與微觀指標的相關(guān)性研究[D];天津醫(yī)科大學(xué);2008年

6 雷旭杰;中醫(yī)體質(zhì)與強直性脊柱炎患者緩解期功能的相關(guān)性研究[D];廣州中醫(yī)藥大學(xué);2007年

7 陸慧;RA患者中醫(yī)體質(zhì)類型與臨床辨證的相關(guān)性研究[D];廣州中醫(yī)藥大學(xué);2007年

，

本文編號：2051863