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4、:4499-4501.(收稿日期 2022-10-31)通讯作者:沈瑾,本科,主治医师,研究方向:儿科疾病,E-mail:3246873601 。反复呼吸道感染儿童中医体质分析及其与免疫功能、维生素 A 的关系探讨郁燕,沈瑾(上海交通大学医学院附属新华医院崇明分院儿科,上海 202150)摘要:目的:分析反复呼吸道感染(RRTI)儿童中医体质分布及其与免疫功能、维生素 A 的关系。方法:选取2020 年 6 月2021 年 6 月医院收治 RRTI 儿童 141 例作为 RRTI 组,另选取体检健康儿童 76 例作为健康组,比较幼儿中医体质类型分布情况,免疫散射比浊法检测外周血 IgA、IgG
5、、IgM 水平,流式细胞法检测外周血 CD3+、CD3+CD4+、CD4+/CD8+水平,微量荧光法检测外周血维生素 A 水平,比较幼儿 IgA、IgG、IgM、CD3+、CD3+CD4+、CD4+/CD8+和维生素 A 水平,多因素 logistics 回归分析 RRTI 的影响因素,spearman 相关性分析维生素 A 水平与免疫功能指标关系。结果:RTI 组气阴两虚型、脾肺两脏气虚型、积滞蕴热型占比高于健康组(P0.05),IgG、IgA、IgM、CD3+、CD3+CD4+、CD4+/CD8+水平和维生素 A 水平均低于健康组(P0.001)。积滞蕴热型组、脾虚肝旺型组外周血 IgA、
6、IgG 水平均高于气阴两虚型组(P0.05),脾肺两脏气虚型组、积滞蕴热型组、脾虚肝旺型组儿童的外周血 CD3+、CD3+CD4+水平均显著高于气阴两虚型组(P0.05),积滞蕴热型组、脾虚肝旺型组儿童的外周血 CD4+/CD8+水平均显著高于气阴两虚型组(P0.05),脾虚肝旺型组儿童的外周血 CD3+CD4+水平高于脾肺两脏气虚型组(P0.05),外周血维生素 A 水平与 IgA、CD3+、CD3+CD4+、CD4+/CD8+呈正相关(r=0.368、0.426、0.409、0.324,P0.001)。结论:RRTI 患儿中医体质以气阴两虚型、脾肺两脏气虚型、积滞蕴热型为主,且气阴两虚型、
7、脾肺两脏气虚型、CD3+(62%)、维生素 A(0.92mol/L)是儿童 RRTI 独立危险因素,维生素 A 水平与免疫功能存在相关性。关键词:反复呼吸道感染;中医体质;免疫功能;维生素 A 中图分类号:R725.6 文献标志码:A 文章编号:1000-3649(2023)02-0074-05 Analysis on Traditional Chinese Medicine Constitution and Its Relationship with Immune Function and Vitamin Afor Children with Recurrent Respiratory Tr
8、act Infection/YU Yan,SHEN Jin/Pediatric Department,Chongming Branch ofXinhua Hospital(Shanghai 202150,China)Abstract:Objective:To analyze the distribution of TCM constitution and its relationship with immune function and vitaminA in children with recurrent respiratory tract infection(RRTI).Methods:A
9、 total of 141 children with RRTI admitted to the hospi-tal were enrolled as RRTI group between June 2020 and June 2021,while other 76 healthy children undergoing physical examina-47四 川 中 医Journal of Sichuan of Traditional Chinese Medicine2023 年第 41 卷第 2 期Vol.41,No.2,2023tion were enrolled as a healt
10、hy group.The types constitution of TCM constitution in infants was compared.The levels of peripheralblood IgA,IgG and IgM were detected by immuno-scatter turbidmetry.The levels of peripheral blood CD3+,CD3+CD4+andCD4+/CD8+were detected by flow cytometry.The level of peripheral blood vitamin A was de
11、tected by micro-fluorescence method.The levels of IgA,IgG,IgM,CD3+,CD3+CD4+,CD4+/CD8+and vitamin A in infants were compared.The influencing factors ofRRTI were analyzed by multivariate Logistic regression analysis.The relationship between vitamin A and immune function indexeswas analyzed by spearman
12、 correlation analysis.Results:The proportions of cases with Qi-Yin deficiency type,spleen-lung Qi de-ficiency type and stagnation intrinsic heat type in the RRTI group were higher than those in the healthy group(P0.05),whilelevels of IgA,IgG,IgM,CD3+,CD3+CD4+,CD4+/CD8+and vitamin A were lower than t
13、hose in the healthy group(P0.001).The levels of peripheral blood IgA and IgG in the stagnation intrinsic heat type group and the spleen-deficiency liver hyperactivitytype group were higher than those in the Qi-Yin deficiency type group(P0.05).The levels of peripheral blood CD3+and CD3+CD4+in the spl
14、een-lung Qi deficiency type group,the stagnation intrinsic heat type group and the spleen-deficiency liver hyper-activity type group were significantly higher than those in the Qi-Yin deficiency type group(P0.05).The level of peripheralblood CD4+/CD8+in the stagnation intrinsic heat type group and t
15、he spleen-deficiency liver hyperactivity type group was signifi-cantly higher than that in Qi-Yin deficiency type group(P0.05).The level of peripheral blood CD3+CD4+in the spleen-defi-ciency liver hyperactivity type group was higher than that in the spleen-lung Qi deficiency type group(P0.05).Qi-Yin
16、 defi-ciency type,spleen-lung Qi deficiency type,CD3+(62%)and vitamin A(0.92 mol/L)were independent risk factors ofRRTI.The level of peripheral blood vitamin A was positively correlated with IgA,CD3+,CD3+CD4+and CD4+/CD8+(r=0.368,0.426,0.409,0.324,P0.001).Conclusion:The main types of TCM constitution include Qi-Yin deficiency type,spleen-lung Qi deficiency type and stagnation intrinsic heat type in RRTI children.Qi-Yin deficiency type,spleen-lung Qi defi-ciency type,CD3+(62%)and vitamin A(0.92 m