热性惊厥复发患儿体质类型分布及其与免疫功能关系的研究
Study on Constitution Types Distribution and Its Correlation with Immunologic Function of Children with Recurrent Febrile Seizures
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摘要: 目的 调查热性惊厥复发患儿的中医体质类型分布特点,并探讨其与T细胞亚群和免疫球蛋白的相关性,分别从体质调护角度和免疫调节角度为中医药防治热性惊厥复发提供依据。方法 病例组为热性惊厥复发患儿57例,根据惊厥类型分为单纯型热性惊厥(SFS)组36例和复杂型热性惊厥(CFS)组21例,对照组为同期2~6岁的健康平和质儿童20例,填写调查问卷进行体质类型调查,并检测免疫球蛋白(IgA、IgG、IgM)及T细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)。结果 病例组57例患儿中阳盛质25例,占43.9%。SFS组、CFS组的IgA、IgG水平较对照组比较均下降,差异有统计学意义(P<0.05~0.01),CFS组IgG水平下降程度较SFS组更明显,差异有显著统计学意义(P<0.05);而各组IgM水平比较,差异无统计学意义(P>0.05)。CFS组与对照组及SFS组比较,CD4+下降,CD8+升高,CD4+/CD8+比值下降,差异有统计学意义(P<0.01)。阳盛质组、痰湿质组与阴虚质组的IgA、IgG水平,较对照组不同程度降低,差异均有统计学意义(P<0.05~0.01)。阳盛质组、痰湿质组与对照组比较,T细胞亚群各指标水平差异无统计学意义(P>0.05),阴虚质组与对照组比较,仅CD8+升高,差异有统计学意义(P<0.05)。结论 热性惊厥复发患儿存在一定的免疫功能异常,CFS比SFS的程度更明显。结合体质分析,阳盛质、痰湿质与阴虚质多种体质的免疫指标均有异常,主要表现为体液免疫功能紊乱,与T细胞亚群相关性不大。中医药防治热性惊厥复发时应重视体质识别,调理体质时配合免疫调节药物,或利于临床防治热性惊厥。Abstract: OBJECTIVE To investigate the TCM constitution types distribution of children with recurrent febrile seizures, and to explore its correlations with T lymphocytic subsets and immunoglobulin. This study aims to provide evidence for the prevention and treatment of recurrent febrile seizures with Chinese medicine from the perspective of constitution nursing and immunoregulation. METHODS 57 children with recurrent febrile seizures were enrolled in the case group. According to the types of seizures, 36 cases were divided into simple febrile seizures (SFS) group, and 21 cases were divided into complex febrile seizures (CFS) group. And 20 healthy children with normal constitution at the same ages (2~6 years old) were divided into the control group. All the children were required to finished the questionnaire for constitution investigation. Immunoglobulin (IgA, IgG, IgM) and T lymphocytic subsets (CD3+, CD4+, CD8+, CD4+/CD8+) were tested. RESULTS Among the 57 children in the case group, 25 cases were yang excess type (43.9%). Comparing with the control group, IgA and IgG levels in the SFS group and the CFS group were decreased, and the differences were statistically significant (P<0.05, P<0.01). IgG level in the CFS group decreased more significantly than that in the SFS group, the difference was statistically significant (P<0.05). However, the IgM levels differences among each group were not statistically significant (P<0.05). Comparing the CFS group with the control group and SFS group, CD4+ decreased, CD8+ increased, CD4+/CD8+ decreased, and the differences were statistically significant (P<0.01). Comparing with the control group, IgA and IgG levels in groups of yang excess type, phlegm dampness type and yin deficiency type decreased in varying degrees, the differences were statistically significant (P<0.05, P<0.01). Comparing the groups of yang excess type and phlegm dampness type with the control group, there was no significant difference among the levels of T lymphocytic subsets indexes (P>0.05). Comparing the group of yin deficiency with the control group, only CD8+ increased, and the difference was statistically significant (P<0.05). CONCLUSION Children with recurrent febrile seizures has a certain immune dysfunction, and the degree of the CFS is more serious than SFS. Combining the constitution analysis, immune indexes of all children with Yang excess type, phlegm dampness type and Yin deficiency type are abnormal, which mainly manifests as humoral immune dysfunction and has little correlation with T lymphocytic subsets. In recurrent febrile seizures prevention and treatment with Chinese medicine, we should pay more attention to constitution differentiation, and to combine with immunomodulatory drugs during constitution regulation, which may be benefits for clinical prevention and treatment of febrile seizures.