易激灵2号方对大肠湿热型肠易激综合征T细胞亚群的影响  

Effect of soothing liver and invigorating spleen,clearing away heat and eliminating dampness on the express of T cell subsets in patients with irritable bowel syndrome of large intestine damp-heat

作　　者：常东 李健[2] 冯春霞[2] 唐纯志[3] 刘子志[3] 樊亚巍 李辉 何方 

机构地区：[1]武警广东边防总队医院消化内科,广东深圳518029 [2]深圳市中医院消化内科,广东深圳518033 [3]广州中医药大学科研处,广东广州510407

出　　处：《中国中西医结合消化杂志》2014年第4期182-184,188,共4页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：广东省中医药局建设中医药强省科研课题(No:20132023);深圳市罗湖区软科学研究计划项目(No:2012075)

摘　　要：[目的]观察易激灵2号方对大肠湿热型腹泻型肠易激综合征(diarrhea type irritable bowel syndrome,IBS-D)患者T细胞亚群的影响,并探讨其作用机制。[方法]将174例大肠湿热型IBS-D患者随机分为两组,中药组采用易激灵2号方,煎取200ml,早晚分服;西药组采用马来酸曲美布汀片(商品名:舒丽启能)0.1g/次,枯草杆菌二联活菌肠溶胶囊(商品名:美常安)0.5g/次,3次/d,口服;同时设立正常组24名,两组疗程均为4周。采用流式细胞仪测定外周血CD3+、CD4+和CD8+T淋巴细胞分布百分率。[结果]与正常组相比,大肠湿热型IBS-D患者CD4+细胞水平显著降低(P<0.01),CD8+细胞水平显著升高(P<0.05),CD4+/CD8+比值下降明显(P<0.05)。中药组和西药组治疗后,CD4+细胞水平较治疗前均明显升高(P<0.01,P<0.05),但中药组升高更为明显,组间差异有统计学意义(P<0.05);CD8+细胞水平较治疗前均有明显下降(P<0.05),CD4+/CD8+比值均有明显升高(P<0.05)。与西药组相比,中药组治疗后CD8+细胞水平和CD4+/CD8+比值有一定程度升高,但差异无统计学意义。[结论]以抑肝扶脾清热利湿立法的易激灵2号方很可能通过调节T细胞亚群的变化,达到消除或减轻IBS-D患者临床症状的效果。[Objective]To observe the effect of soothing liver and invigorating spleen, clearing-away heat and eliminating dampness on the express of T cell subsets in patients with irritable bowel syndrome of large intestine clamp-heat. [Methods]One hundred and seventy-four patients were assigned to 2 groups： Chi- nese medicine group was treated with Yijiling-2,decocted 200 ml,twice daily by oral administration; west- ern medicine group was treated with Trimebutine maleate tablets 0. 1 g and Meiehang＇an 0.5 g, 3 times dai- ly by oral administration. The therapeutic course was 4 weeks for all. The expression of CD3^＋ , CD4^＋ , CD8^＋ of T lymphocyte was analyzed by flow cytometry. [Results]The percentage of CD4＋ was significantly lower（P〈0. 01）, the percentage of CD8^＋ was significantly higher（P^0. 05）and the ratio of CD4^＋/CD8^＋ were significantly lower（P〈0. 05）in IBS-D patients than in the normal group. After treatment, the expres- sion of CD4^＋ and the ratio of CD4^＋/CD8^＋ were significantly higher in IBS-D patients of Chinese medicine group and western medicine group（P〈0. 01, P〈0. 05）, while the expression of CD8^＋ were significantly lower（P〈0.05）. But the expression of CD4^＋ in Chinese medicine group was significantly higher than that in the western medicine group（P〈0. 05）. [Conclusion]Soothing liver and invigorating spleen, clearing away heat and eliminating dampness might influence the T cell subsets thus eliminate or ameliorate symptoms of IBS patients.

关 键 词：中医疗法 大肠湿热型 肠易激综合征 T细胞亚群 

分 类 号：R574.4[医药卫生—消化系统]