太阳病中风证、伤寒证患者体质差异的免疫学物质基础研究

目的探讨太阳病中风证与伤寒证患者体质差异的物质基础。方法以健康在校大学生为目标人群,建立病例报告制度;在外感后24 h内联系课题组,根据感受外邪后反应状态的差异分为太阳中风证组和太阳伤寒证组。观察两组患者在外感后第1天、第3天、第5天、第14天的症状,并检测外周血免疫指标(CD4+/CD8+、IL-1、IL-6、IFN-γ/IL-4、IL-12、sIgA、IgM)水平。结果共收集20例志愿者,太阳中风证组和太阳伤寒证组各10例。太阳中风证组症状积分明显低于太阳伤寒证组,太阳伤寒证组外感后第1、3天的恶寒、头痛、肌肉疼痛、咽痛症状积分明显高于太阳中风证组,符合太阳伤寒证"卫闭营郁"的病机。两组患者在外感后不同时间点的外周血免疫状态均存在显著差异。太阳伤寒证组Th1型细胞因子与Th2型细胞因子、sIgA、IgM均呈相对高表达状态,Th1/Th2平衡向Th1型免疫偏移,即促炎相对占优势。太阳中风证组Th1型细胞因子与Th2型细胞因子、sIgA、IgM均呈相对低表达状态,Th1/Th2平衡向Th2型免疫偏移,即抗炎相对占优势。结论太阳伤寒证患者Th1型免疫相对占优势,太阳中风证患者Th2型免疫相对占优势,初步揭示了两种证候患者体质差异的免疫学物质基础。

Research on physical differences between external excess and external deficiency of Taiyang Disease

Objective To observe the difference in constitution between wind-attack syndrome and cold-attack syndrome of taiyang. Methods The healthy college students were chosen as the subjects and their case reports were established; 24 h after invasion of exogenous pathogens,the subjects were divided into two groups：wind-attack syndrome group and cold-attack syndrome group. The symptoms at the 1d,3d,5d,14 d after invasion of exogenous pathogens were observed. The immunity indexes such as CD4＋/CD8＋,IL-1,IL-6,IFN-γ/IL-4,IL-12,sIgA and IgM in peripheral blood were detected. Results Twenty cases were enrolled and divided into two groups,with 10 cases in each group. The symptom score in the wind-attack syndrome group were lower than that of the cold-attack syndrome group. At the 1d,3d after invasion of exogenous pathogens,the symptoms such as aversion to cold,headache,myalgia,pharyngalgia of the cold-attack syndrome group were higher than that of the wind-attack syndrome group,which conform to the pathogenesis. There was significant difference in the immune state of the peripheral blood at different time points between the two groups. Th1-type cytokines,Th2-type cytokines,sIgA,IgM showed relatively high expression in the coldattack syndrome group. The Th1 /Th2 balance shifts to Th1-type immune,so proinflammatory showed superiority. Th1-type cytokines,Th2-type cytokines,sIgA,IgM showed relatively low expression in the wind-attack syndrome group. The Th1 /Th2 balance shifts to Th2-type immune,so anti-inflammatory showed superiority. Conclusion Th1-type immune shows superiority in cold-attack syndrome and Th2-type immune shows superiority in wind-attack syndrome,initially reveals material basis between the two groups in immunological syndromes.