摘要
目的探讨脾虚泄泻发病机制的免疫学紊乱及健脾益肾汤治疗方法．方法对７６例脾虚泄泻患者进行实验与临床研究．外周血Ｔ细胞亚群检测采用间接免疫荧光法；血清免疫球蛋白测定采用免疫单扩散法；肠粘膜嗜银细胞检测采用Ｍａｓｓｏｎ硝酸银嗜银染色；肠粘膜肥大细胞检测采用甲苯胺蓝染色；肠粘液凝集素采用生物素－卵白素过氧化物酶复合物法进行染色．脾虚泄泻患者的治疗采用健脾益肾汤进行４ｗｋ．结果脾虚泄泻患者外周血ＣＤ８细胞低于正常人（２６６％±５４％ｖｓ３１７％±６４％，Ｐ＜００５），使ＣＤ４／ＣＤ８比值增高（１７０±０２８ｖｓ１４１±０２７，Ｐ＜００５），血清ＩｇＧ含量亦高于正常人（１７６ｇ／Ｌ±７３ｇ／Ｌｖｓ１３７ｇ／Ｌ±５０ｇ／Ｌ，Ｐ＜００１）；肠粘膜病理检测表明患者回肠末段、盲肠、直肠粘膜腺体中嗜银细胞数（２７±１４ｖｓ１７±１７，２７±１２ｖｓ１９±３，６６±４３ｖｓ５２±３７，７８±４９ｖｓ５９±５３）及肥大细胞数（７２±４０ｖｓ２４±２３，７５±４６ｖｓ２４±２７，８５±５１ｖｓ２９±２８，１０１±６１ｖｓ３５±３０）均高于正常对照（Ｐ＜００１），但４种凝集素粘液组织化学染色与正常对照无差?
AIM To study the pathogenicity and clinical therapy of Pixu diarrhoea (Spleen
deficiency diarrhoea). METHODS Seventy six patients with Pixu diarrhoea were involved in
this study. The T lymphocyte subsets of peripheral blood were detected by indirect
immunofluorescent assay. Argynophils and mast cells of the colon mucosa were examined
pathologically. The patients were treated with Jianpi Yishen decoction for 4 weeks, and after the
treatment, all the above examinations were performed again. RESULTS The CD 8 subset of
the patients was significantly lower than those of normal controls (26 6%±5 4% vs 31 7%
±6 4%, P <0 05);the CD 4/ CD 8 ratio was significantly higher than those of normal controls
(1 70±0 28 vs 1 41±0 27, P <0 05) and the serum level of IgG was higher in Pixu
diarrhoea patients ( 17 6 g/ L ± 7 3 g/ L vs 13 7 g/L ± 5 0 g/ L , P <0 01). The
argynophil cells and mast cells in mucosa of the colon were significantly higher ( P <0 01)
than those of normal controls. After the treatment, 27(35 5%) patients were completely
recovered, 28(36 8%) got excellent results, 16(21 1%) achieved effect and 5(6 6%) had little
effect. The total effective rate was 93 4%. After treatment, CD 3, CD 4 and CD 8 subsets in
peripheral blood rose significantly (61 3%±9 3% vs 65 4%±8 7%, 42 2%±5 6% vs 46
5%±5 3%, 24 1%±7 1% vs 31 5%±7 6%, P <0 05), CD 4/ CD 8 ratio (1 69±0 33 vs
1 40±0 21 P <0 01), serum immunoglobulin IgG ( 18 6 g/ L ± 3 2 g/ L vs 14 3 g/ L
± 2 9 g/ L , P <0 05) and argynophil and mast cells in mucosa of colon sigmoideum were
markedly reduced (69 2±45 1 vs 50 7±36 5, 82 6±45 3 vs 34 9±29 1, P <0 01),
as compared with those before treatment. CONCLUSION The disorder of immunologic function
and chronic inflammation of the mucosa were pathogenetic basis of the Pixu diarrhoea. Jianpi
Yishen decoction has good clinical effects for Pixu diarrhoea. It is worth recommending for
clinical use.
出处
《世界华人消化杂志》
CAS
1999年第4期285-287,共3页
World Chinese Journal of Digestology
关键词
脾虚
腹泻
免疫学
疗效
健脾益肾汤
Spleen deficiency
diarrhoea/ immunology
diarrhoea/ pathology
diarrhoea/ therapy
