反复
呼吸道
感染
儿童
中医
体质
功能
维生素
关系
探讨
郁燕
5 王斌,李毅,韩雅玲.稳定性冠心病诊断与治疗指南 J.中华心血管病杂志,2018,46(9):680-694.6 中国中西医结合学会心血管病学会.冠心病稳定型心绞痛中医诊疗指南 J.中医杂志,2019,60(21):1880-1890.7 胡盛寿,高润霖,刘力生,等.中国心血管病报告 2018 概要 J.中国循环杂志,2019,34(3):209-220.8 冯汝丽,曲文白,曲信彦,等.口服中药治疗稳定型心绞痛疗效及安全性的 Meta 分析 J.世界中医药,2021,16(5):784-794.9 王震.周亚滨运用“三辨”法治疗稳定型心绞痛 J.山东中医杂志,2021,40(4):399-402.10 徐海燕,秦琬玲.秦琬玲治疗痰瘀互结型胸痹心痛病经验浅析J.江西中医药,2020,51(4):33-34.11 曾国飞,杨华,梁旭倩,等.冠状动脉 CT 斑块稳定性分析与冠心病中医辨证分型的相关性研究 J.中国中医急症,2020,29(5):797-801.12 赵瑛,徐红新,吕永楠,等.血脂异常对不稳定型心绞痛和急性心肌梗死患者临床识别的价值研究 J.中国循证心血管医学杂志,2020,12(6):720-722,727.13 赵洁,李淑英,张英,等.低密度脂蛋白胆固醇与中青年冠心病患者冠状动脉病变程度的相关性分析 J.河北医科大学学报,2021,42(3):278-280.14 林子祥,刘丹,薛雅芝,等.血清膜联蛋白 A2 在冠心病患者血清中明显升高 J.南方医科大学学报,2020,40(3):382-387.15 王静,范秀风,职利琴,等.稳定型心绞痛不同中医证型与Lp-PLA2、hs-CRP 的相关性研究 J.现代中西医结合杂志,2021,30(13):1420-1422,1426.16 汪佩,王军奎,潘硕.不稳定性心绞痛白细胞计数与冠状动脉SYNTAX 评分的相关性 J.中国医学影像学杂志,2021,29(11):1089-1092,1094.17 段唐海,刘庆,缪希莉,等.老年冠心病患者血栓弹力图与常规凝血试验的相关性 J.中国老年学杂志,2020,40(21):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、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、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、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 Tract 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 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 healthy 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 detected 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 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 those 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 spleen-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 the 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 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