益气解毒中药减少单纯疱疹病毒性角膜炎复发的免疫机理研究  

Immune mechanism research of Yiqi Jiedu Decoction to reduce recurrence of herpes simplex keratitis

作　　者：关瑞娟[1] 亢泽峰[1,2] 李凌[1] 何玉清[1] 马晓梅[1] 张蓉[1] 

机构地区：[1]青海省人民医院眼科,西宁810007 [2]中国中医科学院眼科医院

出　　处：《中国中医眼科杂志》2013年第1期17-20,共4页China Journal of Chinese Ophthalmology

基　　金：国家中药管理局资助项目(No.06-07LP41);青海省科技厅资助项目(No.2007-N-129)

摘　　要：目的探讨益气解毒中药对复发性单纯疱疹病毒性角膜炎(Herpes simplex keratitis,HSK)患者治疗前后T淋巴细胞亚群、IFN-γ、IL-18的影响,进一步阐明益气解毒中药抗HSK复发的的免疫学机制。方法收集复发性HSK患者160例,根据患者的就诊顺序随机分为治疗组80例、对照组80例(奇数为治疗组、偶数为对照组)。两组在年龄、性别方面均无统计学差异。治疗组予黄芪桂枝口服液联合0.15%更昔洛韦眼用凝胶局部点眼,对照组予0.15%更昔洛韦眼用凝胶局部点眼,14天为1个疗程,给药2个疗程;观察所有患者临床总有效率、平均住院日,复发情况,并随访1年(失访率<20%)。通过流式细胞仪测定治疗前后T淋巴细胞变化;ELISA法测定治疗前后IFN-γ、IL-18的变化。结果 (1)治疗组:治疗前后相比CD3、CD4明显升高(P<0.05),CD8下降,CD4/CD8明显升高(P<0.05);(2)对照组:治疗前后相比CD3、CD4、CD8、CD4/CD8均无明显变化(P>0.05);(3)治疗组IL-18、IFN-γ含量较治疗前明显升高(P<0.01)。对照组:IL-18、IFN-γ含量较治疗前无明显变化(P>0.05)。结论益气解毒中药抗复发的机理之一是通过激发体内CD4+淋巴细胞活性,促进IL-18、IFN-γ的分泌,增强自身抑制HSV活化的能力而降低HSK的复发率。OBJECTIVE To observe the changes of peripheral blood T lymphocyte subsets and T cell factors IFN-γ,IL-18 about recurrence of herpes simplex keratitis（HSK） after treatment with Yiqi Jiedu Decoction,further to clarify the immunological mechanism about how the traditional Chinese medicine resisted the recurrence of herpes simplex keratitis.METHODS According to the sequence of seeing the doctors,the data of 160 patients with recurrent HSK were randomly divided into a treatment group and a control group（odds for the treatment group,even as the control group,80 for each group）.There was no statistical difference between the two groups in age and gender（P 0.05）.The treatment group： Huangqi Guizhi oral liquid combined with 0.15% ganciclovir eye ophthalmic gel locally used;the control group： 0.15% ganciclovir eye ophthalmic gel locally used,14 days as a course,2 courses for the treatment.Before and after treatment,serum T lymphocytes changes were measured by flow cytometric technology,IFN-γ and IL-18 changes were measured by ELISA.RESULTS Treatment group： After treatment T lymphocyte subsets CD3,CD4 increased significantly than that before treatment,and the level of T cells CD8 inhibiting reaction was down,immune regulation index CD4/CD8 ratio increased significantly（P 0.05）;Control group： Before and after treatment,T lymphocyte subsets CD3,CD4,CD8 and CD4/CD8 were of no significant change（P 0.05）;The treatment group： after treatment,IL-18,IFN-γ content increased significantly（P 0.01）.Control group： IL-18,and IFN-γ content was of no significant change before treatment（P〉0.05）.CONCLUSIONS One of the mechanism about Yiqi Jiedu Decoction against HSK recurrence was to stimulate the activation of CD4＋ TH1,promote the body IL-18,IFN-γsecretion,promote the immune response,enhance the ability of inhibition HSV recurrence and reduce the HSK recurrence rate.

关 键 词：复发性 单纯疱疹病毒性角膜炎 白介素-18 干扰素-Γ T淋巴细胞亚群 

分 类 号：R772.21[医药卫生—眼科] R242[医药卫生—临床医学]