CAJ | 학술논문

目的：通过检测辨证分型治疗母子ABO血型不合前后孕妇外周血中抗A或抗B抗体效价及T淋巴细胞绝对数，了解采用茵陈蒿汤为主的辨证治疗免疫机制。方法随机将2012年6月至2014年5月在陕西省安康市中心医院门诊确诊为母子ABO血型不合的106例孕妇分为对照组（36例）和治疗组（70例），治疗组采用中医辨证治疗分为湿热组（SR，30例）、湿热兼脾气虚组（SR+PQX，13例）和湿热兼肾气虚组（SR+SQX，27例）。两组孕妇分别服用茵陈蒿汤原方和加减对应方进行治疗，疗程30 d。治疗前后分别测定外周血中抗A或抗B抗体效价及CD3+、CD4+、CD8+水平和CD4+/CD8+比值。结果治疗后，对照组孕妇的抗A或抗B抗体效价，14例降为1∶64，4例降为1∶32；治疗组中38例降为1∶64，24例降为1∶32。对照组和治疗组治疗前后T淋巴细胞CD3+计数分别为（1430±396）、（1445±401）、（1488±402）、（1637±401）μL-1，CD4+计数分别为（870±230）、（896±240）、（820±240）、（713±289）μL-1，CD8+计数分别为（540±190）、（560±204）、（590±170）、（715±187）μL-1，CD4+/CD8+比值分别为1.51±0.4、1.56±0.36、1.41±0.28、1.19±0.22，两组孕妇治疗后CD3+、CD4+、CD8+及CD4+/CD8+与治疗前比较，差异均有统计学意义（P<0.05）。而治疗后，治疗组3种证型之间比较，差异均无统计学意义（P>0.05）。结论茵陈蒿汤对淋巴细胞有增殖作用，进而加强了母体的细胞免疫和体液免疫，使胎儿免疫耐受性增强，且茵陈嵩汤辨证方剂较原方更具有优越性。
목적：통과검측변증분형치료모자ABO혈형불합전후잉부외주혈중항A혹항B항체효개급T림파세포절대수，료해채용인진호탕위주적변증치료면역궤제。방법수궤장2012년6월지2014년5월재합서성안강시중심의원문진학진위모자ABO혈형불합적106례잉부분위대조조（36례）화치료조（70례），치료조채용중의변증치료분위습열조（SR，30례）、습열겸비기허조（SR+PQX，13례）화습열겸신기허조（SR+SQX，27례）。량조잉부분별복용인진호탕원방화가감대응방진행치료，료정30 d。치료전후분별측정외주혈중항A혹항B항체효개급CD3+、CD4+、CD8+수평화CD4+/CD8+비치。결과치료후，대조조잉부적항A혹항B항체효개，14례강위1∶64，4례강위1∶32；치료조중38례강위1∶64，24례강위1∶32。대조조화치료조치료전후T림파세포CD3+계수분별위（1430±396）、（1445±401）、（1488±402）、（1637±401）μL-1，CD4+계수분별위（870±230）、（896±240）、（820±240）、（713±289）μL-1，CD8+계수분별위（540±190）、（560±204）、（590±170）、（715±187）μL-1，CD4+/CD8+비치분별위1.51±0.4、1.56±0.36、1.41±0.28、1.19±0.22，량조잉부치료후CD3+、CD4+、CD8+급CD4+/CD8+여치료전비교，차이균유통계학의의（P<0.05）。이치료후，치료조3충증형지간비교，차이균무통계학의의（P>0.05）。결론인진호탕대림파세포유증식작용，진이가강료모체적세포면역화체액면역，사태인면역내수성증강，차인진숭탕변증방제교원방경구유우월성。
Objective Absolute numbers of T—cells and anti—A or anti—B antibody titer in peripheral blood of the pregnant women with maternal—fetal ABO blood—group incompatibility were detected by syndromes different from the treatments to reveal the immunological mechanism of Yinchengao decoction treatment. Methods A total of 106 pregnant women clinically diagnosed with maternal—fetal ABO blood—group incompatibility in the Ankang Municipal Central Hospital from June 2012 to May 2014 were divided into the control group(36 cases) and the treatment group(70 cases). The treatment group was divided into SR group with 30 cases,SR+PQX group with 13 cases and SR+SQX with 27 cases according to sydromes differentiation. The two groups were treated with original Yinchenghao decoction and adjusted Yinchenghao decoction separately ,lasting 30 days. The anti—A or anti—B antibody titer in peripheral blood of and the concentrations of CD3+,CD4+,CD8+as well as the value of CD4+/CD8+before and after the treatment. Results The anti—A or anti—B antibody titer of 14 pregnant women in the control group after the treatment was declined to 1∶64,4 cases to 1∶32 while 38 cases in the treatment group was decreased to 1∶64,24 cases to 1∶32. The CD3+,CD4+and CD8+T lymphocytes numbers per liter were[(1 430±396),(1 445±401),(1 488±402),(1 637±401)]μL-1,[(870±230),(896 ±240),(820±240),(713±289)]μL-1 and [(540±190,560±204,590±170,715±187)]μL-1 respectively in succession before and after the treatment. The value of CD4+/CD8+was(1.51±0.4),(1.56±0.36),(1.41±0.28),(1.19±0.22) respectively. The above pa—rameters after the treatment were compared with those before the treatment and showed that there was statistical significant in dif—ference(P<0.05). The sydromes among the three sydrome groups after the treatment had no statistical significance in difference (P>0.05). Conclusion The Yinchenghao decoction plays a positive role in proliferation response to lymphocyte and strengthen the cellular immunity and humoral immunity capability to improve the fetuses′s tolerance,especially,the altered Yinchenghao de—coction prevailed in superiority .