茵陈五苓散合藤类药治疗急性痛风性关节炎疗效及对Th17/Treg细胞平衡的影响  

Efficacy of Yinchen Wuling Powder Combined with Rattan Drugs on Acute Gouty Arthritis and Its Effect on the Balance of Th17/Treg Cells

作　　者：曹志娇 张征[1] 李金梅[1] 霍聪[1] 许鸣华 蔡会欣[1] Cao Zhijiao;Zhang Zheng;Li Jinmei;Huo Cong;Xu Minghua;Cai Huixin(Baoding First Central Hospital,Hebei,Baoding 071000,China)

机构地区：[1]河北省保定市第一中心医院,河北保定071000

出　　处：《中国中医急症》2020年第12期2111-2114,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2018148)。

摘　　要：目的观察茵陈五苓散合藤类药治疗急性痛风性关节炎(AGA)临床疗效及对Th17/Treg细胞平衡的影响并探讨其作用机制。方法90例患者按照随机数字表法分为两组,每组45例。两组均接受饮食控制和生活指导,对照组同时应用秋水仙碱片和碳酸氢钠片口服,治疗组在对照组基础上应用中药陈五苓散合藤类药治疗,两组疗程均为2周。比较两组治疗前后关节症状积分、红细胞沉降率(ESR)、尿酸(UA)、血清白细胞介素(IL)-17、转化生长因子β1(TGF-β1)、白细胞介素-10(IL-10)、C反应蛋白(CRP)水平,比较两组外周血Th17细胞、Treg细胞含量和Th17/Treg,并比较两组临床疗效。结果两组治疗前关节疼痛、关节肿胀、关节压痛和关节功能积分,血UA、CRP、ESR、Th17细胞、Th17/Treg及血清IL-17水平、Treg细胞含量及血清TGF-β1、IL-10水平均差别不大(均P>0.05)。两组治疗后关节疼痛、关节肿胀、关节压痛和关节功能积分与治疗前比较均降低(均P<0.01),且治疗组治疗后各项积分均低于对照组(均P<0.01)。两组治疗后血UA、CRP、ESR指标水平与治疗前比较均下降(P<0.01),且治疗组各项指标均低于对照组(均P<0.01)。两组治疗后两组Th17细胞、Th17/Treg与治疗前比较降低(P<0.01),而Treg细胞升高(P<0.01),且治疗组Th17细胞、Th17/Treg低于对照组(P<0.01),Treg细胞高于对照组(P<0.01)。两组治疗后与治疗前比较,血清IL-17含量降低(P<0.01),TGF-β1、IL-10含量升高(P<0.01),且治疗组IL-17含量低于对照组(P<0.01),TGF-β1、IL-10含量高于对照组(P<0.01)。治疗组疗效优于对照组(P<0.01)。结论茵陈五苓散合藤类药有利于调节Th17/Treg细胞亚群失衡,抑制炎症反应,改善症状,治疗AGA疗效确切。Objective:To observe the clinical efficacy of Yinchen Wuling Powder combined with rattan drugs on acute gouty arthritis(AGA)and its effect on the balance of Th17/Treg cells.Methods:A total of 90 AGA pa⁃tients were selected and divided into two groups according to the random number table method,45 patients in each group.Both groups received diet control and life guidance.The control group were treated with colchicine tab⁃lets and sodium bicarbonate tablets orally.The treatment group were treated with Yinchen Wuling Powder and rat⁃tan drugs based on the treatment of the control group.The scores of joint symptoms,erythrocyte sedimentation rate(ESR),uric acid(UA),serum interleukin-17(IL-17),transforming growth factor-β1(TGF-β1),IL-10,C-reac⁃tive protein(CRP)levels were compared between the two groups before and after treatment;the contents of Treg cells and Th17/Treg in peripheral blood and Th17 cells of the two groups were compared;the clinical efficacy of the two groups was compared.Results:Before treatment,there were little differences in the joint pain,joint swell⁃ing,joint tenderness and joint function score,blood UA,CRP,ESR,Th17 cells,Th17/Treg and serum IL-17 levels,Treg cell levels and serum TGF-β1,IL-10 levels between the two groups(all P>0.05).The scores of joint pain,joint swelling,joint tenderness and joint function of the two groups after treatment were all lower than those before treatment(all P<0.01),and the scores of the treatment group after treatment were lower than those of the control group(all P<0.01).After treatment,the blood UA,CRP,and ESR levels of the two groups decreased all compared with those before treatment(P<0.01),and the indices of the treatment group were lower than those of the control group(all P<0.01).After treatment,Th17 cells and Th17/Treg of the two groups were lower than before treatment(P<0.01),while Treg cells were increased(P<0.01);Th17 cells and Th17/Treg of the treatment group were lower than those of the control group after treatment(P<0.01),and the Treg cell

关 键 词：急性痛风性关节炎 中药治疗 茵陈五苓散 藤类药 Th17/Treg细胞平衡 

分 类 号：R589.7[医药卫生—内分泌]