摘要
目的观察安徽地区类风湿性关节炎(rheumatoid arthritis,RA)不同证型分布规律及其与血小板活化关系。方法根据安徽地区100例RA患者的症状、体征、舌脉象,分析中医辨证分型。检测患者血小板参数、C反应蛋白(C-reactive protein,CRP)、血液沉降率(erythrocyte sedimentation,ESR)、类风湿因子(rheumatoid factor,RF)等指标,血小板参数包括血小板计数(platelet count,PLT)、血小板平均体积(mean platelet volume,MPV)、血小板压积(platelet hematocrit,PCT)、血小板分布宽度(platelet distribution width,PDW)。采用酶联免疫吸附法检测RA患者血小板活化物血小板颗粒膜蛋白(granular membrane protein-140,GMP-140)、血小板活化因子(platelet activating factor,PAF)及E26转录因子-1(E26 transformaction specific-1,ETS-1)。结果安徽地区100例RA患者常见证型依次为湿热痹阻证、痰瘀痹阻证、肝肾亏虚证、寒湿痹阻证。血小板参数异常数最多的为湿热痹阻证。不同证型血小板参数比较差异有统计学意义(P<0.05)。组间比较显示:湿热痹阻证血小板参数较其他3个证型均升高(P<0.01或P<0.05)。血小板活化物GMP-140、PAF、ETS-1在不同证型间比较差异有统计学意义(P<0.05)。湿热痹阻证患者GMP-140、PAF较其他3个证型均升高,肝肾亏虚证、痰瘀痹阻证患者PAF较寒湿痹阻证升高,痰瘀痹阻证患者ETS-1较寒湿痹阻证升高(P<0.01或P<0.05)。相关性分析显示,GMP-140与PLT、CRP、ESR呈正相关,PAF与RF呈正相关,ETS-1与CRP呈正相关(P<0.01或P<0.05)。结论安徽地区RA中医证候以湿热痹阻为主,伴有痰瘀痹阻,且血小板活化参与RA湿热痹阻过程。
Objective To observe the distribution rule of different syndromes of rheumatoid arthritis(RA)in Anhui area and its relationship with plate activation.Methods According to the symptoms,signs and tongue pulse of 100 RA patients in Anhui area,the syndrome differentiation of TCM was analyzed.The patients’platelet parameters of platelet,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),rheumatoid factors(RF)and other indicators were detected.The parameters of platelet include platelet count(PLT),mean platelet volume(MPV),platelet hematocrit(PCT)and platelets distribution width(PDW).The RA patients’platelet activators,including platelet a granule membrane protein(GMP-140),platelet activating factor(PAF)and E26 transcription factor-1(ETS-1),were detected by enzyme-linked immunosorbent assay.Results The common syndrome types of 100 RA patients in Anhui area were successively syndrome of dampness-heat obstruction,syndrome of phlegm-stasis obstruction,syndrome of deficiency both liver and kidney,syndrome of and cold-dampness obstruction.The most abnormal platelet parameters is the syndrome of dampness-heat obstruction.There were significant differences in platelet parameters between different syndrome types(P<0.05).And compared among the different groups,the platelet parameters of syndrome of dampness-heat obstruction were increased compared with the other three syndrome types(P<0.01 or P<0.05).Platelet activators GMP-140,PAF,and ETS-1 were statistically different between different syndrome types(P<0.05).GMP-140 and PAF in syndrome of dampness-heat obstruction were higher than in the other three syndrome types.The PAF level in syndrome of deficiency of both liver and kidney and syndrome of phlegm-stasis obstruction,were higher than in syndrome of cold-dampness obstruction.The ETS-1 level in syndrome of phlegm-stasis obstruction was higher than that in syndrome of cold-dampness obstruction(P<0.01 or P<0.05).Correlation analysis showed that GMP-140 was positively correlated with PLT,CRP and ESR,PAF was positively correlated with RF,and ETS-1 was positively correlated with CRP(P<0.01 or P<0.05).Conclusion The main TCM syndromes of RA in Anhui area was syndrome of dampness-heat obstruction,accompanied by phlegm-stasis obstruction,and platelet activation is involved in the process of RA dampness-heat obstruction.
作者
周丹丹
董昌武
张晓军
ZHOU Dandan;DONG Changwu;ZHANG Xiaojun(Graduate School of Anhui University of Chinese Medicine,Hefei 230031,China)
出处
《环球中医药》
CAS
2021年第2期199-203,共5页
Global Traditional Chinese Medicine
基金
国家自然科学基金面上项目(81973655)
科技部国家重点研发计划中医药现代化研究重点专项(2018YFC1705204)
全国中医药创新骨干人才培训项目(国中医药人教函[2019]128号)
安徽省教育厅高校自然科学研究重点项目(KJ2018A0279)
安徽中医药大学研究生教育教学改革研究项目(2019YJG013)。
关键词
类风湿关节炎
血小板活化
血小板参数
中医证型
湿热痹阻证
Rheumatoid arthritis
Platelet activation
Parameters of platelet
TCM syndrome types
Syndrome of damp-heat obstruction
作者简介
周丹丹(1983-),女,2018级在读硕士研究生,主治医师。研究方向:中医诊断学。E-mail:zhangsa3@sina.com。
