加味荆防方联合盐酸西替利嗪片治疗风热型慢性荨麻疹的临床观察  

Clinical Observation of Jiaweijingfang Decoction Combined with Cetirizine Hydrochloride Tablets in Treatment of Chronic Urticaria with Rheumatic Fever

作　　者：胡惠清 李静 方坤 卢彩红 吕保先 龙剑文 HU Huiqing;LI Jing;FANG Kun;LU Caihong;LYU Baoxian;LONG Jianwen(Department of Dermatology,Ninth Hospital of Wuhan,Wuhan 438000,China;Department of Dermatology,the First Clinical Medical School,Hubei University of Chinese Medicine,Wuhan 430061,China)

机构地区：[1]武汉市第九医院皮肤科,湖北武汉438000 [2]湖北中医药大学第一临床学院,湖北武汉430061

出　　处：《中国皮肤性病学杂志》2019年第9期1101-1106,共6页The Chinese Journal of Dermatovenereology

摘　　要：目的观察加味荆防方联合盐酸西替利嗪片对风热型慢性荨麻疹的治疗效果及对患者外周血IFN-γ、IL-4水平和Treg细胞、Th17细胞比例的影响。方法80例风热型慢性荨麻疹患者被随机分为对照组和治疗组。对照组予以口服盐酸西替利嗪片,10 mg/d,共30 d。治疗组在对照组治疗基础上口服加味荆防方,日1剂。采用ELISA法检测患者治疗前后外周血中 IFN-γ和 IL-4 的含量。采用流式细胞仪检测治疗前后患者外周血Treg细胞及Th17细胞占CD4+T细胞的比例。结果在治疗30 d后,治疗组和对照组有效率分别为83.78%和58.33%。治疗前,两组患者血清 IL-4、IFN-γ水平差异无统计学意义(P>0.05)。治疗后,治疗组患者血清 IL-4 水平较治疗前显著降低(P<0.05),而血清 IFN-γ水平显著提高(P<0.05)。对照组患者治疗前后血清中 IFN-γ和 IL-4 水平差异均无统计学意义(P均>0.05)。两组患者治疗前外周血CD4+T细胞中Th17和Treg细胞比例差异无统计学意义,但治疗后治疗组患者外周血CD4+T细胞中Th17细胞的比例较治疗前显著降低(P<0.05),而Treg细胞的比例较治疗前显著增加(P<0.05)。对照组患者治疗前后外周血CD4+T细胞中Th17和Treg细胞比例差异无统计学意义。结论加味荆防方联合盐酸西替利嗪片口服可以有效治疗风热型慢性荨麻疹,可能与其能调节患者体内IFN-γ和IL-4水平,重建Th17/Treg细胞平衡有关。Objective To observe the therapeutic effect of Jiaweijingfang decoction combined with cetirizine hydrochloride tablets on chronic urticaria patients with rheumatic fever and the expression of IFN-γ,IL-4 level and the proportion of Treg cells and Th17 cells .Methods Eighty patients with chronic urticaria with rheumatic fever were randomly divided into the control group and treatment group.The patients in the control 〖HJ〗group took cetirizine hydrochloride tablets orally,10 mg daily for 30 days.The treatment group took orally Jiaweijingfang decoction a daily dose combined with cetirizine hydrochloride tablets 10 mg daily for 30 days.ELISA method was used to detect the levels of IFN-γ and IL-4 in peripheral blood before and after treatment.The proportion of Treg cells and Th17 cells in CD4+T cells was detected by flow cytometry before and after treatment.Results After 30 days of treatment,the effective rates of treatment and control group were 83.78% and 58.33%,respectively.Before treatment,there were no significant differences in serum levels of IL-4 and IFN-γ between the two groups.In the treatmen group,the serum levels of IL-4 significantly decreased and the serum levels of IFN-γ increased significantly after the treatment,which was not observed in the control group.The proportions of Th17 cells and Treg cells in peripheral blood CD4+T cells were not significantly different between the two groups before treatment.In treatmen group,the proportion of Th17 cells dramatically decreased and the proportion of Treg cells increased in peripheral blood CD4+T cells after treatment,which was not seen in the control group.Conclusion Oral administration of Jiaweijingfang decoction combined with cetirizine hydrochloride tablets can effectively treat chronic urticaria with rheumatic fever,by regulating the levels of IFN-γ and IL-4,and the balance of Th17/Treg cells.

关 键 词：慢性荨麻疹 加味荆防方 干扰素-γ 白介素-4 TH17/TREG细胞 

分 类 号：R758.24[医药卫生—皮肤病学与性病学]