中药保留灌肠配合蒸热疗法对慢性盆腔炎性后遗症患者Th17/Treg免疫平衡的影响  

Effects of Herbal Retention Enema Joined with Steaming Heat Therapy on Th17/Treg Immune Balance in Patients with Sequelae of Pelvic Inflammatory Disease

作　　者：张岩雪[1] 孙军华[1] 李红艳[1] 王颖[1] ZHANG Yanxue;SUN Junhua;LI Hongyan;WANG Ying(Hebei Provincial Civil Affairs General Hospital,Xingtai 054000,China)

机构地区：[1]河北省民政总医院,河北邢台054000

出　　处：《西部中医药》2021年第10期130-134,共5页Western Journal of Traditional Chinese Medicine

基　　金：邢台市科技支撑计划项目(冀科成转鉴字〔2014〕第9-208号)。

摘　　要：目的:探讨中药保留灌肠配合蒸热疗法治疗慢性盆腔炎性疾病后遗症(sequelae of pelvic inflammatory disease,SPID)(湿热瘀结证)患者的临床效果及对Th17/Treg免疫平衡的影响。方法:选取SPID患者96例,采用随机数字法分为观察组和对照组,每组48例。对照组给予口服常规西药抗感染治疗,观察组在对照组基础上采用中药保留灌肠联合蒸热疗法,两组患者连续治疗30天后进行疗效评价。比较两组临床疗效、不良反应、证候评分、生活质量评分;ELISA法和qRT-PCR法测定血清白细胞介素17(interleukin-17,IL-17)、白细胞介素10(interleukin-10,IL-10)、转化生长因子β(transforming growth factorβ,TGF-β)及外周血单核细胞RORγt mRNA、Foxp3 mRNA与RORγt/Foxp3水平。结果:治疗后,观察组总有效率[89.58%(43/48)]明显高于对照组[70.83%(34/48)](P<0.05);两组均未发生药物不良反应(P>0.05);两组证候积分、生活质量各项评分及IL-17、RORγt mRNA、RORγt/Foxp3水平均降低,IL-10、TGF-β及Foxp3 mRNA表达水平明显升高,观察组变化较对照组更为明显(P<0.05)。结论:中药保留灌肠联合蒸热法可提高常规西药治疗SPID的疗效,有助于改善患者预后生活质量,且安全性高,治疗机制可能与改善血液循环及促进机体Th17/Treg的免疫平衡有关。Objective:To explore clinical effects of herbal retention enema and steaming heat therapy in the treatment of SPID(dampness heat stasis pattern)and its influence on Th17/Treg immune balance.Methods:All 96 SPID patients were chosen and allocated to the observation group and the control group according to random number table method,48 cases in each group.The control group took routine Western medicine to resist the infection,and the observation group accepted herbal retention enema and steaming heat therapy based on Western medicine,to assess clinical effects when both groups were treated for 30 days.To compare clinical effects,adverse reaction,syndrome scores,the scores of quality of life between both groups;ELISA method and qRT-PCR method to determine the levels of IL-17,IL-10,TGF-β,RORγt mRNA,Foxp3 mRNA and RORγt/Foxp3 of monocytes in peripheral blood.Results:After treating,total effective rate[89.58%(43/48)]of the observation group was notably higher than that[70.83%(34/48)]of the control group(P<0.05);no drug adverse reaction happen in both groups(P>0.05);syndrome scores,the scores of quality of life,the levels of IL-17,RORγt mRNA,and RORγt/Foxp3 reduced,the expressions of IL-10,TGF-βand Foxp3 mRNA increased notably,the changes of the observation group were more notable than these of the control group(P<0.05).Conclusion:Herbal retention enema and steaming heat therapy could improve clinical effects of routine Western medicine in the treatment of SPID,it could help improve the prognosis,quality of life with high safety,therapeutic mechanism might be related to improving blood circulation and promoting Th17/Treg immune balance.

关 键 词：盆腔炎性疾病后遗症 中药保留灌肠 蒸热 TH17/TREG 免疫 

分 类 号：R711.33[医药卫生—妇产科学]