复发性口腔溃疡症状积分与炎性细胞因子的相关性及加味黄连甘草汤的治疗作用  

Correlation between Symptom Scores and Inflammatory Cytokines in Recurrent Oral Ulcer and Therapeutical Effects of Modified Huanglian Gancao Decoction

作　　者：马金昀 徐玲霞[1] 杨月[1] 李国陵[1] 朴雪梅[1] 吴香香[1] 李奔[1] 胡建东[1] 

机构地区：[1]上海中医药大学附属岳阳中西医结合医院风湿科,上海200437

出　　处：《上海中医药大学学报》2017年第1期18-23,共6页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：上海市卫生和计划生育委员会科研基金项目(201440388)

摘　　要：目的:探讨复发性口腔溃疡(ROU)患者症状积分与血清炎性细胞因子的相关性,并评价加味黄连甘草汤对炎性细胞因子的影响。方法:招募符合纳入标准的心脾积热型ROU患者,观察中医症候评分,检测治疗前后患者血清肿瘤坏死因子-α(TNF-α)与白细胞介素(IL-2R、IL-6、IL-10)水平,并用统计软件SPSS分析中医症状积分与TNF-α、IL-2R、IL-6、IL-10的相关性。通过随机、双盲双模拟、平行对照的方法,治疗组采用加味黄连甘草汤颗粒+极低剂量维生素B2片(维生素B210%的药量);对照组维生素B2片+极低剂量加味黄连甘草汤颗粒(含加味黄连甘草汤10%的药量),疗程为2周。评价患者的证候疗效及对细胞炎症因子的影响与不良反应。结果:治疗前患者TNF-α、IL-6较正常值明显升高,IL-2R明显降低(均P<0.05);而IL-10无明显差异。经相关性分析,溃疡症状积分与TNF-α、IL-6具有明显的正相关性,而与IL-2R、IL-10无明显相关性。经治疗,治疗组总有效率明显高于对照组(P<0.01),证候总积分明显低于对照组(P<0.05)。治疗组TNF-α、IL-6值的下降幅度大于对照组,但无显著性差异(P>0.05);治疗组IL-2R较前增加而对照组较前降低,但都在正常范围内变动;IL-10两组均无明显变化。两组患者治疗期间均未发生严重不良反应。结论:炎性细胞因子TNF-α、IL-6与ROU溃疡的严重程度有相关性;加味黄连甘草汤颗粒对心脾积热型ROU有明显的治疗作用。Objective： To discuss the correlation between the symptom scores and serum inflammatory cytokines in patients with recurrent oral ulcer（ROU） ,and evaluate the influence of modified Huanglian Gancao Decoction on inflammatory cytokines. Methods： ROU patients with syndrome of heat accumulation in heart and spleen who met the inclusion criteria were enrolled. The TCM syndrome scores were observed and the serum levels of tumor necrosis factor-α （TNF-α） and interleukin （IL-2R, IL-6, IL-10） were detected before and after treatment. The correlation between the TCM symptom scores and TNF-α, IL-2R, IL-6, IL-10 were analyzed by statistical software SPSS. A randomized, double-blind, double-dummy, parallel-controlled trial was designed for study. The treatment group was treated with modified Huanglian Gancao Decoction Granule and extremely low dose of Vitamin B2 tablets （10% routine dose）,the control group was treated with Vitamin B2 tablets and extremely low dose of modified Huanglian Gaucao Decoction Granule （ 10% routine dose）, with a course of 2 weeks. The syndrome efficacy,the effects on inflammatory cytokines and the adverse reaction were evaluated. Results： Before the treatment, the levels of TNF-α and IL-6 in patients were significantly increased compared with the normal value, and the level of IL-2R was significantly decreased （ P 〈0.05 ） ,the level of IL-10 was not obviously changed. The correlation analysis showed that there were significantly positive correlation between the syndrome scores of ulcer and TNF-α and IL- 6, but no significant correlation between the syndrome scores of ulcer and IL-2R and IL-10 were found. After treatment, the total effective rate of the treatment group was obviously higher than that of the control group （P 〈 0.01 ）, and the syndrome total score of the treatment group was significantly lower than that of the control group （ P 〈 0. 05 ）. The reduction of TNF-α and IL- 6 in the treatment group was greater than that in the control group, b

关 键 词：复发性口腔溃疡 肿瘤坏死因子-α 白细胞介素-2R 白细胞介素-6 白细胞介素-10 加味黄连甘 草汤 心脾积热 

分 类 号：R276.8[医药卫生—中医五官科学]