益气温阳方对变应性鼻炎患者血清细胞因子水平和免疫耐受功能的影响  

Effect of Yiqi Wenyang Decoction on Clinical Effect,Serum Cytokines and Immune Tolerance in Patients with Allergic Rhinitis

作　　者：刘玉[1] 严道南[2] 王海丹[2] 史军[2] Liu Yu;Yan Daonan;Wang Haidan;Shi Jun(Nanjing Hospital of Integrated Traditional Chinese and Western Medicine,Jiangsu,Nanjing 210014,China)

机构地区：[1]江苏省南京市中西医结合医院,江苏南京210014 [2]江苏省中医院,江苏南京210029

出　　处：《中国中医急症》2020年第10期1763-1765,1780,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家自然科学基金青年项目(81704126);江苏省自然基金项目(BK20171515);江苏省中医药科技项目(YB2017043);南京市科技发展计划项目(201803038)。

摘　　要：目的观察益气温阳方治疗变应性鼻炎(AR)近期疗效及对血清白细胞介素-10(IL-10)、生长转化因子-β1(TGF-β1)和免疫耐受功能的影响并探讨其机制。方法60例AR患者按照随机数字表法分为中药组(益气温阳方)与西药组(氯雷他定)各30例,分别于治疗前后观察病情变化情况,采集血标本,ELISA法检测血清IL-10、TGF-β1等水平和流式细胞仪检测Treg细胞免疫耐受功能。另设正常组(健康人群)30例。结果中药组与西药组疗效比较,中药组优于西药组(P<0.05);中药组治疗后IL-10和TGF-β1水平明显回升(P<0.0001),达到正常组水平,IL-4和IL-13水平明显下降至正常组水平(P<0.0001),Treg细胞数量明显回升,差异有统计学意义(P<0.0001);而西药治疗后IL-10和TGF-β1水平稍有回升,但差异无统计学意义(P>0.05),IL-4和IL-13水平稍有下降,但差异无统计学意义(P>0.05),Treg细胞数量无回升,差异无统计学意义(P>0.05)。结论益气温阳方治疗AR的近期疗效优于氯雷他定,且疗效更稳定,其作用机制可能是通过促进机体的Treg细胞的增多,使其产生的IL-10、TGF-β1水平增加,抑制了Th2细胞产生的IL-4和IL-13炎性介质,从而缓解了AR的症状。Objective:To observe the effect of Yiqi Wenyang Recipe on allergic rhinitis(AR),the level of serum interleukin-10(IL-10),growth transforming factorβ1(TGF-β1)and the function of immune tolerance,and to explore its mechanism.Methods:Based on the principle of informed consent,60 patients were divided into the Chinese medicine group(Yiqi Wenyang Decoction)and western medicine group(loratadine)according to the random number table method,30 cases in each group.Before and after the treatment,the changes of disease conditions were observed,blood samples were collected,serum IL-10,TGF-β1 and Treg cell immune tolerance were detected by ELISA method and flow cytometry.A normal control group of 30 people was also established(healthy people).Results:Compared with the western medicine group,the Chinese medicine group was superior in clinical efficacy to the western medicine group(P<0.05).The concentrations of IL-10 and TGF-β1 in the Chinese medicine group increased significantly(P<0.0001)to the normal group level,and the concentrations of IL-4 and IL-13 decreased significantly(P<0.0001)to the normal group level after treatment,and the number of Treg cells increased significantly(P<0.0001).However,after western medicine treatment,the concentrations of IL-10 and TGF-β1 slightly increased,but there were no statistical differences(P>0.05),the concentrations of IL-4 and IL-13 slightly decreased,but there were no statistical differences(P>0.05),the number of Treg cells did not increase,there was no statistical difference(P>0.05).Conclusion:The short-term efficacy of Yiqi Wenyang Decoction is better than that of loratadine,and the efficacy is more stable.It can promote the growth of Treg cells,increase the concentration of IL-10 and TGF-β1,inhibit the production of IL-4 and IL-13 inflammatory mediators by Th2 cells,and alleviate the symptoms of AR.

关 键 词：变应性鼻炎 细胞因子 免疫耐受 益气温阳方 中医药治疗 

分 类 号：R765[医药卫生—耳鼻咽喉科]