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吴峰妹,苏士成,李红,陈黎.支气管哮喘急性发作期气道炎症表型与中医辨证分型的关系[J].浙江中西医结合杂志,2020,30(5):
支气管哮喘急性发作期气道炎症表型与中医辨证分型的关系
Association between TCM Syndrome Types and Airway Inflammation in Acute Exacerbation of Asthma
投稿时间:2019-10-23  修订日期:2020-04-24
DOI:
中文关键词:  支气管哮喘急性发作期  气道炎症表型  中医辨证分型
英文关键词:Acute asthma  Airway inflammation  Syndrome differentiation of TCM
基金项目:
作者单位E-mail
吴峰妹 南京中医药大学附属昆山市中医医院 meimeiangie@sina.com 
苏士成 南京中医药大学附属昆山市中医医院肺病科  
李红 南京中医药大学附属昆山市中医医院肺病科  
陈黎 南京中医药大学附属昆山市中医医院肺病科 305388933@qq.com 
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中文摘要:
      目的 探讨支气管哮喘(哮喘)急性发作期气道炎症表型分布与中医辨证分型的关系。方法 2016年01月至2018年12月,昆山市中医医院109例哮喘急性发作期患者,根据诱导痰细胞学进行气道炎症分型,用血常规中白细胞总数(WBC)及嗜酸粒细胞分类计数,血清总IgE、CRP和FeNO进行全身炎症评价, 并和中医辨证分型进行比较。结果 患者气道炎症表型依次为嗜酸粒细胞型(42.2%,46/109), 中性粒细胞型(23.9%,26/109),混合细胞型(26.6%,29/109)和寡细胞型(7.3%,8/109)。外周血WBC比较,中性粒细胞型哮喘数值高于其它3组(P<0.05)。嗜酸粒细胞型哮喘血嗜酸性粒细胞数,总IgE和FeNO值显著高于其它3组(P<0.05)。中性粒细胞型哮喘和混合细胞型哮喘血清CRP增高,但比较无统计学意义(P>0.05)。中医辨证分型结果显示热哮占37.6%,冷哮占29.4%,风痰哮占20.2%,虚哮占8.2%,寒包热哮占4.6%。冷哮证及风痰哮证患者表现为嗜酸粒细胞型哮喘,热哮证患者表现为嗜酸粒细胞型、中性粒细胞型与混合细胞型哮喘。结论 哮喘急性发作期气道炎症表型与中医辨证分型间具有一定相关性,哮病各中医证型有客观气道炎症表型基础。
英文摘要:
      Objective To investigate the association between airway inflammation phenotype and TCM syndrome type in patients with acute exacerbation of asthma. Methods A total of 109 patients with acute exacerbation of asthma were enrolled from January 2016 to December 2018 in Traditional Chinese Medicine Hospital of Kunshan. Sputum analysis was used to determine airway inflammation. Routine blood test, CRP, IgE and Fractional exhaled nitric oxide(FeNO) test were applied to measure systemic inflammation. All patients were divided into five groups according to the syndrome type of TCM. Results The distributions of airway inflammatory phenotypes of patients with acute exacerbation of asthma were listed as follows: eosinophilic subtype(42.2%,46/109), neutrophilic subtype(23.9%,26/109), mixed granulocytic subtype(26.6%,29/109)and paucigranulocytic subtype(7.3%,8/109). The number of white blood cell in neutrophilic subtype group was significantly higher than the other groups(P<0.05). The level of eosinophilic cell, IgE and FeNO in eosinophilic subtype group were significiantly higher than the others(P<0.05). The level of CRP in mixed granulocytic subtype group and neutrophilic subtype group were higher but no significant difference(P>0.05). According to syndrome type of TCM, heat asthma, cold asthma, wind-phlegm-induced asthma, deficiency asthma, and cold-bundle fever account for 37.6%, 29.4%, 20.2%, 8.2%, and 4.6%, respectively. Patients with cold asthma and wind-phlegm asthma observed in eosinophilic asthma phenotype, while those with hot asthma exhibited eosinophilic asthma,neutrophil asthma and mixed cell asthma.Conclusions There might be a correlation between the airway inflammation phenotype and TCM Syndrome Types. There was an airway inflammatory phenotype for asthma TCM syndromes types.
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