加味千金苇茎汤对小儿支原体肺炎患儿调节性T细胞及其相关蛋白Foxp3表达的影响  

Effect of Modified Qianjin Weijing Decoction on Expression of Regulatory T Cells and Related Proteins Foxp3 of Children with Mycoplasma Pneumonia

作　　者：柯胜忠 张多 张洪雷[2] KE Shengzhong;ZHANG Duo;ZHANG Honglei(Huangshi Mathernal and Child Health Care Hospital Edong Heahhcare Group,Huhei China 435000;Chongqing Traditional Chinese Medicine Hospital,Chongqing China 400021)

机构地区：[1]鄂东医疗集团黄石市妇幼保健院,湖北黄石435000 [2]重庆市中医院,重庆400021

出　　处：《中医学报》2018年第8期1388-1391,共4页Acta Chinese Medicine

基　　金：国家重点基础研究发展计划项目(2011CBA01006)

摘　　要：目的:观察加味千金苇茎汤治疗小儿支原体肺炎的临床疗效,以及对患儿调节性T细胞及其相关蛋白Foxp3表达的影响。方法:96例支原体肺炎患儿按照随机数字表法,将患儿分为对照组和观察组各48例。对照组患儿给予阿奇霉素治疗,观察组在对照组治疗基础上给予加味千金苇茎汤。治疗后,比较两组患儿中医证候评分、临床治疗情况、临床疗效、不良反应,采用流式细胞系检测CD_4^+CD_(25)^+Treg%和CD_4^+Foxp3^+Treg%。结果:治疗后,观察组有效率为95.83%,对照组为85.0%,两组有效率比较,差异有统计学意义(P<0.05)。两组患者中医证候评分均降低,其中观察组治疗后中医证候评分低于同期对照组,差异有统计学意义(P<0.05)。观察组患儿退热时间、肺部啰音消失时间、咳嗽咳痰消失时间、住院时间均少于对照组,差异具有统计学意义(P<0.05)。治疗后,两组患儿CD_4^+CD_(25)^+Treg%和CD_4^+Foxp3^+Treg%均升高,且观察组高于对照组,差异有统计学意义(P<0.05)。两组患儿不良反应发生情况比较,差异无统计学意义(P>0.05)。结论:加味千金苇茎汤联合阿奇霉素治疗支原体肺炎患儿临床疗效显著,可明显改善患儿症状,缩短病程,并且不良反应少,其作用机制是通过提高Foxp3的表达,使CD_4^+CD_(25)^+Treg细胞的活性及表达升高,从而加强免疫抑制,发挥控制炎症反应的作用。Objective： To observe the clinical efficacy of modified Qianjin Weijing Decoction in treating for mycoplasma pneumonia in children and its influence on the expression of regulatory T cells and related proteins Foxp3. Methods： 96 cases of the patients with mycoplasma pneumonia in our hospital from June 2014 to December 2016,by using a random number table method,were divided into control group and observation group,with 48 cases in each group. The control group was treated with azithromycin while the observation group was treated with modified Qianjin Weijing Decoction according to the symptoms in addition to that of the control group. The course of treatment was 2 weeks. After treatment,the TCM syndrome score,clinical treatment condition,clinical efficacy and adverse reactions of patients of the two groups were compared. The loss of cell line detection of CD4＋CD（25）＋Treg and CD4＋Foxp3＋Treg ratio was evaluated. Results： After treatment,the total effective rate of the observation group was 95. 83%,which was significantly higher than that（ 85%） of the control group（ P〈0. 05）. The scores of TCM syndromes were decreased in the two groups,and the observation group＇s TCM scores were significantly lower than that of the control group（ P〈0. 05）. The time of fever,the time of rales disappearance,the time of cough and expectoration and the length of stay in the observation group were less than those in the control group（ P〈0. 05）. After treatment,the ratio of CD4＋CD（25）＋Treg and CD4＋Foxp3＋Treg in two groups increased,and that in the observation group was significantly higher than that in the control group（ P〈0. 05）. There was no significant difference in adverse reactions between the two groups（ P〈0. 05）. Conclusion： Treatment of mycoplasmal pneumonia in children with modified Qianjin Weijing Decoction has remarkable curative effect,the possible mechanism being the increase of the regulatory T cell content in vivo by enhancing the expression of Foxp3 protein

关 键 词：加味千金苇茎汤 小儿支原体肺炎 调节性T细胞 FOXP3基因 中西医结合 

分 类 号：R259.631[医药卫生—中西医结合]