撤热存津颗粒治疗原发性干燥综合征的临床疗效及对外周血Th17/Treg细胞免疫平衡的影响  

Clinical Efficacy of Chere Cunjin Keli(撤热存津颗粒)in the Treatment of Primary Sjögren's Syndrome and Its Effect on the Immune Balance of Peripheral Blood Cells Th17/Treg

作　　者：楼蒙妮 李延萍[2] 吴斌[2] LOU Meng-ni;LI Yan-ping;WU Bin

机构地区：[1]重庆市大足区中医院,重庆402360 [2]重庆市中医院,重庆400021

出　　处：《风湿病与关节炎》2022年第5期6-9,20,共5页Rheumatism and Arthritis

基　　金：重庆市科委项目(cstc2018jxj1130084)。

摘　　要：目的:研究撤热存津颗粒治疗原发性干燥综合征(pSS)的临床疗效及对外周血Th17/Treg细胞免疫平衡的影响。方法:选取阴虚燥热证pSS患者27例为pSS组,20例健康志愿者为对照组,对入组的pSS患者予口服撤热存津颗粒治疗,3个月为1个疗程,比较治疗前后中医证候评分、欧洲抗风湿病联盟干燥综合征患者报告指数(ESSPRI)评分、腺体功能SchirmerⅠ试验、唾液流率、红细胞沉降率、C反应蛋白、免疫球蛋白的变化,外周血Th17细胞和Treg细胞占CD4^(+)T细胞的比例、Th17/Treg及IL-6、IL-17A的浓度差异。结果:入组时pSS组的IL-6、IL-17A、Th17、Th17/Treg均高于对照组(P<0.05),而pSS组的Treg均值较对照组差异无统计学意义(P>0.05)。pSS组患者治疗后中医证候评分、ESSPRI评分较治疗前明显下降(P<0.001),腺体功能SchirmerⅠ试验、唾液流率均较治疗前升高(P<0.05),CRP、ESR、IgG较治疗前差异无统计学意义(P>0.05);20例pSS患者治疗达到有效,治疗后IL-6、IL-17A、Th17、Th17/Treg较治疗前明显下降(P<0.05),Treg明显升高(P<0.05)。结论:撤热存津颗粒的临床疗效可能与调节pSS的Th17/Treg免疫平衡有关,通过下调pSS患者外周血IL-6、IL-17A的含量,抑制Th17细胞的生成并促进Treg细胞的分化诱导Th17/Treg细胞恢复免疫平衡。Objective:To study the clinical efficacy of Chere Cunjin Keli(撤热存津颗粒)in the treatment of primary Sjögren's syndrome(pSS)and its effect on the immune balance of peripheral blood cells Th17/Treg.Methods:Twenty-seven patients with pSS of yin deficiency and dryness heat syndrome were selected as the pSS group and 20 healthy volunteers as the healthy control group.The patients with pSS were treated with Chere Cunjin Keli for 3 months.The changes of TCM syndrome score,ESSPRI score,SchirmerⅠtest of gland function,salivary flow rate,erythrocyte sedimentation rate,C-reactive protein and immunoglobulin,as well as the proportion of peripheral blood cells Th17/Treg in cells CD4^(+)T,and the concentration differences of Th17/Treg,IL-6 and IL-17A were compared before and after treatment.Results:When the groups were established,the levels of IL-6,IL-17A,Th17and Th17/Treg in the pSS group were higher than those in the healthy control group(P<0.05),while the mean value of Treg in the pSS group was lower than that in the healthy group(P>0.05).The TCM syndrome score and ESSPRI score of pSS patients after treatment were significantly lower than those before treatment(P<0.001),and the gland function SchirmerⅠtest and salivary flow rate were higher than those before treatment(P<0.05).There was no significant difference in CRP,ESR and IgG(P>0.05);After treatment,IL-6,IL-17A,Th17,Treg and Th17/Treg were significantly lower than those before treatment(P<0.05).Conclusion:The clinical efficacy of Chere Cunjin Keli may be related to the regulation of Th17/Treg immune balance of pSS.It can induce Th17/Treg cells to restore immune balance by down regulating the contents of IL-6 and IL-17A in peripheral blood of pSS patients,inhibiting the production of Th17 cells and promoting the differentiation of Treg cells.

关 键 词：原发性干燥综合征 撤热存津颗粒 TH17/TREG细胞 CD4+T细胞 免疫平衡 

分 类 号：R73[医药卫生—肿瘤]