支气管哮喘患者中医证候与血清骨膜蛋白、肺功能的相关性研究OA
Correlations between TCM syndrome patterns,serum periostin,and pulmonary function in patients with bronchial asthma
目的 观察支气管哮喘患者血清骨膜蛋白(Periostin)、肺功能水平变化及中医证候特点,并分析中医证候与血清 Periostin、肺功能水平的相关性.方法 选取 197 例支气管哮喘患者作为研究组,按照不同中医证候分为 4 组,另选同期 187 名健康体检者作为对照组.比较各组血清 Periostin、肺功能相关指标[峰值呼气流速(PEF)、第 1s 用力呼气容积(FEV1)、用力肺活量(FVC)、最大呼气中期流量(MMEF75/25)]水平及哮喘控制测试(ACT)评分.ROC 曲线分析血清 Periostin、肺功能对支气管哮喘的诊断价值.Pearson 相关性分析中医证候与肺功能、Periostin 的关系.结果 与对照组比较,研究组 Periostin 水平升高,FEV1、MMEF75/25、FVC、PEF 水平降低(P<0.05).ROC 曲线分析结果显示,FEV1、Periostin、MMEF75/25、PEF、FVC 联合检测敏感度为 93.91%、AUC 值为0.843、准确度为 78.39%、95%CI 为0.805～0.882 均高于各单项检测 的 敏 感 度、AUC 值、准确度及 95%CI.197 例支气管哮喘患者共包含 4 种中医证候,即热哮 80 例(40.61%)、风哮 48 例(24.37%)、冷哮 44 例(22.34%)、虚哮 25 例(12.69%).与热哮组比较,风哮组、冷哮组、虚哮组Periostin 水平降低,ACT 评分、FEV1、PEF、MMEF75/25、FVC 均升高;与风哮组比较,冷哮组、虚哮组 ACT 评分、FVC、PEF、FEV1、MMEF75/25 升高,Periostin 水平降低;与冷哮组比较,虚哮组 FEV1、PEF、MMEF75/25、FVC、ACT 评分升高,Periostin 水平降低(均 P<0.05).Pearson 分析结果显示,支气管哮喘风哮、虚哮、热哮、冷哮与 Periostin 呈正相关,与PEF、FVC、MMEF75/25、FEV1 呈负相关(P<0.05).结论 支气管哮喘患者主要中医证候为热哮证、风哮证、冷哮证、虚哮证,且血清 Periostin 水平升高,肺功能降低,不同中医证候的支气管哮喘患者存在 Periostin 及肺功能的不同变化.
Objective To characterize serum periostin and pulmonary function changes in bronchial asthma patients,describe their traditional Chinese medicine(TCM)syndrome patterns,and analyze correlations between these TCM patterns and periostin levels and pulmonary function.Methods We enrolled 197 patients with bronchial asthma as the study group and clas-sified them into four TCM syndrome patterns.A contemporaneous control group comprised 187 healthy individuals.Serum periostin and pulmonary function parameters,including peak expiratory flow(PEF),forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),and maximal mid-expiratory flow(MMEF75/25),were measured and compared across groups.ROC curve analysis assessed the diagnostic performance of periostin and pulmonary function indices for bronchial asthma.Pearson correlation analysis evaluated relationships between TCM syndrome patterns and periostin and pulmonary function.Results Compared with controls,asthma patients had significantly higher serum periostin and significantly lower FEV1,MMEF75/25,FVC,and PEF(P<0.05).Combined testing(FEV1,periostin,MMEF75/25,PEF,FVC)yielded sensitivity of 93.91%,AUC of 0.843,accuracy of 78.39%,and 95%CI 0.805～0.882,outperforming individual measures.Among the 197 patients,distribution of TCM patterns was:heat-type 80(40.61%),wind-type 48(24.37%),cold-type 44(22.34%),and deficiency-type 25(12.69%).Relative to the heat-type group,the wind-,cold-,and deficiency-type groups demonstrated lower periostin levels and higher FEV1,PEF,ACT score,MMEF75/25,and FVC.Relative to the wind-type group,the cold-and deficiency-type groups showed further increases in FVC,PEF,ACT score,FEV1,and MMEF75/25 and reductions in periostin.Compared with the cold-type group,the deficiency-type group had higher FEV1,PEF,MMEF75/25,FVC,and ACT score and lower periostin;all differences reached statistical significance(P<0.05).Pearson correlation analysis indicated that the presence of the listed TCM patterns(wind-,deficiency-,heat-,and cold-type)was positively associated with periostin and negatively associated with PEF,FVC,MMEF75/25,and FEV1(P<0.05).Conclusion In bronchial asthma,the predominant TCM syndrome patterns are heat-,wind-,cold-,and deficiency-type.These patients exhibit elevated serum periostin and impaired pulmonary function,and distinct TCM patterns correspond to different periostin and pulmonary function profiles.
刘芳;周旋;宋晓娟
南京医科大学第四附属医院呼吸内科,江苏 南京 210000南京医科大学第四附属医院呼吸内科,江苏 南京 210000南京医科大学第四附属医院急诊科,江苏 南京 210000
医药卫生
支气管哮喘中医证候骨膜蛋白肺功能
Bronchial asthmaTraditional Chinese medicine syndrome patternsPeriostinPulmonary function
《河北中医》 2026 (5)
727-731,5
南京市卫生健康委员会医药卫生科研课题(编号:YKK24238)
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