大承气颗粒对重型脓毒症促炎-抗炎反应平衡的影响  

Effect of Dachengqi Granules on Pro/Anti Inflammatory Balance in Patients with Severe Sepsis

作　　者：于泳浩[1] 崔乃强[2] 傅强[2] 李君[1] 吴咸中[2] 

机构地区：[1]天津医科大学总医院麻醉科,天津300052 [2]天津南开医院外科

出　　处：《中国中西医结合外科杂志》2004年第6期409-412,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：天津市"九五"重点攻关项目 (983 113 411)

摘　　要：目的 :观察大承气颗粒对重型脓毒症 (SS)促炎 -抗炎反应平衡的影响。 方法 :12例严重腹腔感染致SS病人术后第 2d起在常规治疗基础上使用大承气颗粒 ,对照组为常规治疗。观察术后 4 8h、4d、6d内外周血T辅助 (Th)细胞亚群、单核细胞表面HLA -DR表达、血清肿瘤坏死因子 (TNF) -α ,白介素 (IL) - 10、前列腺素E2 (PGE2 )。 结果 :中药组促炎 -抗炎因子恢复明显优于对照组 ,IL - 10在 4 8h即开始降低 ,TNF -α/IL - 10比值恢复明显增加 ;单核细胞HLA -DR表达和Thl/Th2比值的恢复也快于对照组 ,其中HLA -DR在 4d时高于入院 ,而Th亚群恢复始于入院第 6d。 结论 :大承气颗粒不仅可抑制SS病人以TNF -α为代表的促炎因子过度分泌 ,还可促进抗炎介质IL - 10、PGE2 的下降 ,促进Th细胞漂移和HLA -DR表达下降的恢复 ,有利于免疫平衡的恢复。Objective To investigate the therapeutic effect of Dachengqi granules(DG) on pro/anti inflammatory response profile in patients with severe sepsis Methods Serum concentrations of the proinflammatory cytokine TNF α and the anti inflammatory IL 10,PGE 2 were measured in 12 patients with severe sepsis resulting from intra abdominal infection during 6 days after admission and compared with the control.The subset and HLA DR expression on monocytes were also measured.Results The restoration of both pro/anti inflammatory cytokines were significantly better in patients treated with DG,in which IL 10 declined 48 hours after admission and higher TNF α a to IL 10 ratio was found at the same time.The ratio of Th1/Th2 and expression of HLA DR was higher after DG medication,whereas HLA DR at 4 days after admission and the subset in 6 days. Conclusion DG has an inhibiting function for overproduction of proinflammatory cytokine TNF α,and also exerts effects on anti inflammatory IL 10 and PGE 2 and also facilitates the subsets and HLA DR expression.

关 键 词：大承气颗粒 重型脓毒症 T辅助细胞 HLA-DR 白介素-10 

分 类 号：R285.5[医药卫生—中药学] R63[医药卫生—中医学]