清营活血汤对原发性胆汁性肝硬化肝胆湿热型的疗效以及对外周血Th17/Treg平衡的影响  

Efficacy of Qingying Huoxue Decoction in Treating Primary Biliary Cirrhosis with Liver-Gallbladder Dampness-Heat Syndrome and Effect on Th17 / Treg Balance in Peripheral Blood

作　　者：甘霞[1] 赵新芳[1] 林红[1] 周云[1] 

机构地区：[1]石河子大学医学院第一附属医院,新疆石河子832000

出　　处：《中国实验方剂学杂志》2016年第11期161-164,共4页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：新疆生产建设兵团科技攻关计划课题(2011BA053)

摘　　要：目的:探讨清营活血汤治疗原发性胆汁性肝硬化(PBC)肝胆湿热证的临床效果以及对血清Th17/Treg水平的影响。方法:选择PBC肝胆湿热证病例共98例,参照数字表法随机分为对照组和治疗组各49例;对照组口服复方甘草酸苷片,2片/次,3次/d,连服2周后,口服熊去氧胆酸胶囊,13~15 mg·kg^(-1)·d^(-1),3次/d,餐后口服;治疗组在对照组用药基础上给予清营活血汤治疗,1剂/d,常规水煎煮2次,分早晚内服;所有患者均给予24周治疗。比较两组中医临床症状积分;分析两组患者治疗24周后的临床疗效;比较两组患者外周血中辅助性T细胞17(Th17)细胞和调节性T细胞(Treg)水平;检测两组血清白细胞介素(IL)-17,IL-6和转化生长因子-β(TGF-β)水平。结果:治疗组治疗后中医临床症状积分均明显低于对照组(P<0.01);治疗组治疗后总反应率为93.88%,对照组为77.55%,治疗组明显高于照组(P<0.05);治疗组治疗后患者外周血中Th17细胞明显低于对照组,而Treg细胞明显高于对照组(P<0.01);治疗后治疗组患者血清IL-17和IL-6水平明显低于对照组,而TGF-β显著高于对照组,比较差异均有统计学意义(P<0.01)。结论:在西医治疗基础上,清营活血汤治疗PBC肝胆湿热证可显著改善患者临床症状,提高临床疗效,调节外周血Th17/Treg平衡及其细胞因子水平可能是其发挥疗效的机制之一。Objective： To discuss the clinical efficacy of Qingying Huoxue decoction in treating primary biliary cirrhosis（ PBC） with liver-gallbladder dampness-heat syndrome,and investigate its effect on Th17 / Treg levels in serum. Method： Ninety-eight PBC patients with liver-gallbladder dampness-heat syndrome were randomly divided into control group（ 49 cases） and treatment group（ 49 cases） by digital table method. The patients of control group received compound glycyrrhizin tablets by oral administration for two weeks（ 2 tablets / time,tid） and then ursodeoxycholic acid capsules were taken by oral administration after meals,13-15 mg·kg^-1·d^-1,tid. The patients of treatment group received Qingying Huoxue decoction based on the treatment of control group（ 1 dose / d,bid）. The treatment course was 24 weeks for both groups. The traditional Chinese medicine（ TCM） clinical symptom scores were compared between two groups; the clinical efficacy of two groups after 24 weeks of treatment were analyzed. Helper T lymphocytes（ Th17） and regulatory T cells（ Treg） in peripheral blood were compared between two groups. The levels of interleukin（ IL）-17,IL-6 and transforming growth factor-β（ TGF-β） in the serum were detected in two groups. Result： The TCM clinical symptom scores in treatment group were significantly lower than those in control group after treatment（ P〈0. 01）. The total response rate was 93. 88% in treatment group,significantly higher than 77. 55% in the control group（ P〈0. 05）. Th17 level in peripheral blood of treatment group was significantly lower than that of control group after treatment,while Treg level was significantly higher than that of control group after treatment（ P〈0. 01）. The levels of IL^-17 and IL-6 in serum of treatment group were significantly lower than those of control group,while TGF-β level was significantly higher than that of control group after treatment,with statistically significant differences（ P〈0. 01）. Conclusion：

关 键 词：清营活血汤 原发性胆汁性肝硬化 肝胆湿热证 辅助性T细胞17 调节性T细胞 

分 类 号：R287[医药卫生—中药学]