补肾为主辨证论治对急性期多发性硬化患者血浆细胞因子的影响  

Influence of treatment based on syndrome differentiation mainly with tonifying the kidney on cytokines in plasm of multiple sclerosis at acute stage

作　　者：宋丽君[1] 樊永平[1] 

机构地区：[1]首都医科大学附属北京天坛医院,北京100050

出　　处：《中华中医药杂志》2010年第5期745-748,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：首都医学发展科研基金(No.2005-SF-Ⅰ)~~

摘　　要：目的:观察补肾为主辨证论治对急性期多发性硬化(MS)患者血浆细胞因子的影响,探索中医药辨证施治治疗MS的机制。方法:将64例住院患者随机分成中药组32例,西药组32例;并另设健康对照组15例。西药组给予甲基强的松龙、醋酸泼尼松等常规治疗;中药组在此基础上施以补肾为主中医辨证论治,连续3-4周。两组治疗前及治疗后均进行多发性硬化伤残量表(EDSS)评分,并采集血液标本,ELISA法对受试者血浆TNF-α,IL-12p40,IFN-γ水平进行测定,并进行组间及治疗前后对照分析。结果:两组治疗后EDSS评分较治疗前均显著降低(P<0.05),但组间比较无显著差异。两组治疗后TNF-α、IFN-γ水平均较治疗前降低(P<0.05),IL-12p40水平均较治疗前增高(P<0.05);治疗后中药组血浆TNF-α表达明显低于西药组(P=0.028<0.05),且与健康对照组相比无差异(P=0.364>0.05),西药组TNF-α表达仍高于健康对照组(P=0.008<0.01);治疗后两组间IFN-γ水平比较无显著差异(P>0.05),与健康组相比均无差异(P>0.05)。治疗后两组IL-12p40水平均低于健康对照组(P<0.05),中药组IL-12p40表达高于西药组,但两组间比较无差异(P>0.05)。结论:中医补肾为主辨证论治结合西医常规治疗可能通过调节血浆TNF-α、IL-12p40、IFN-γ水平发挥治疗作用。下调血浆中TNF-α表达、上调IL-12p40表达可能是中医药辨证论治治疗急性期MS的部分机制所在。Objective：To observe the influences and explore the mechanism of treatment based on syndrome differentiation mainly with tonifying the kidney on cytokines in plasm of multiple sclerosis at acute stage.Methods：64 Cases of hospitalized patients were randomly divided into TCM group（32 cases） and western medicine group（32 cases）,and 15 cases of health as control.In western medicine group,conventional treatment method,mainly with methylprednisolone and prednisone,were administrated;On the base of western medicine group,treatment based on syndrome differentiation was added to TCM group,successive for 3-4 weeks.ELISA was used to determine the level of TNF-α,IL-12 p40,IFN-γ in the plasma of subjects.Results：Difference of EDSS scores between the two groups had no statistical significance（P〉0.05）.In both groups,TNF-α and IFN-γ in plasma reduced after treatment（P〈0.05）,and IL-12 p40 increased after treatment（P〈0.05）;TNF-α in TCM group were lower than that in western medicine group after treatment（P=0.028〈0.05）,then there was no statistical significance between TCM group and control group（P〉0.05）.IL-12 p40 in TCM group were higher than that in western medicine group after treatment,but there was no statistical significance between the two groups（P〈0.05）.Conclusion：The combination of TCM with western medicine was superior to simple western medicine in treating multiple sclerosis.Regulation of cytokines（TNF-α and IL-12 p40） in plasm may be partial reasons for the clinical effects of treatment based on syndrome differentiation.

关 键 词：多发性硬化 辨证论治 急性期 细胞因子 

分 类 号：R277.7[医药卫生—中医学]