三子补血汤对骨髓增生异常综合征患者Treg及Th17细胞水平的影响  

Effect of Sanzi Buxue Decoction on the levels of Treg cells and Th17 cells in patients with myelodysplastic syndrome

作　　者：贾新颜[1] 陈晨[1] 唐剑飞 刘祥鑫 巢黔[1] JIA Xinyan;CHEN Chen;TANG Jianfei;LIU Xiangxin;CHAO Qian(Department of Hematology,East Hospital,Tongji University,Shanghai200120,China;Department of Orthopedics,Shanghai Sixth People's Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai200235,China)

机构地区：[1]同济大学附属东方医院血液科,上海200120 [2]上海交通大学医学院附属第六人民医院骨科,上海200235

出　　处：《中国当代医药》2023年第31期41-45,共5页China Modern Medicine

基　　金：上海市卫生健康委员会科研课题面上项目(202040109)。

摘　　要：目的研究三子补血汤中药疗法对骨髓增生异常综合征(MDS)患者外周血调节性T淋巴细胞(Treg细胞)、辅助性T细胞17(Th17细胞)水平以及转录因子叉头框蛋白p3/维甲酸相关孤儿受体γt(Foxp3/RORγt)表达水平的影响。方法选取2016年1月至2022年12月在上海市东方医院经规范治疗的76例MDS患者作为研究对象,采用随机数字表法将其分为中药组(38例)和对照组(38例)。中药组患者采用三子补血汤治疗,对照组患者采用常规支持治疗。通过Prism 5.0和SPSS 20.0统计软件对临床特征、分型、中医症候群及疗效等指标进行统计学分析。通过流式细胞技术检测MDS患者外周血Treg细胞和Thl7细胞比例。采用免疫组化方法标记MDS患者骨髓中的转录因子Foxp3与RORγt并检测阳性细胞数。结果治疗6个月后,中药组患者外周血Treg和Th17细胞比例低于治疗前,差别有统计学意义(P<0.05)。中药组患者转录因子Foxp3及RORγt水平低于治疗前,差别有统计学意义(P<0.05)。中药组患者的中医症状积分、骨髓原始细胞比例以及输血依赖程度等指标均低于治疗前,差别有统计学意义(P<0.05)。结论三子补血汤中药疗法能够有效调节MDS患者外周血Treg细胞及Th17细胞比例,从而增强细胞免疫功能,改善症状,提高缓解率并降低向急性白血病转化的风险。中药组患者在治疗期间未出现严重不良反应,方剂安全性良好。因此,本研究认为三子补血汤中药疗法是一种极具潜力的MDS治疗方案,值得进一步地研究及推广应用。Objective To investigate the effect of traditional Chinese medicine therapy of Sanzi Buxue Decoction on the levels of regulatory T lymphocytes(Treg cells),T helper 17 cells(Th17 cells)and the expression of transcription factor forkhead box protein 3/retinoid-related orphan receptor gamma t(Foxp3/RORγt)in peripheral blood of patients with myelodysplastic syndrome(MDS).Methods A total of 76 MDS patients who received standardized treatment at Shanghai East Hospital from January 2016 to December 2022 were randomly grouped into Chinese medicine group(38 cases)and control group(38 cases)by random number table method,in which patients in the Chinese medicine group were treated with Sanzi Buxue Decoction and patients in the control group were treated with conventional supportive therapy.Clinical characteristics,classification,traditional Chinese medicine syndromes,and curative effect were statistically analyzed by Prism 5.0 and SPSS 20.0 statistical software.Flow cytometry was used to detect the proportions of Treg cells and Th17 cells in peripheral blood of MDS patients.Immunohistochemistry was performed to label the transcription factors Foxp3 and RORγt in bone marrow of MDS patients and determine the number of positive cells.Results After 6 months of treatment,the proportion of Treg and Th17 cells in peripheral blood of patients in Chinese medicine group were lower than those before treatment,and the differences were statistically significant(P<0.05).The levels of transcription factors Foxp3 and RORγt in the Chinese medicine group were lower than those before treatment,and the differences were statistically significant(P<0.05).The Chinese medicine syndrome score,the proportion of bone marrow blast cells and the degree of dependence on blood transfusion in the Chinese medicine group were lower than those before treatment,and the differences were statistically significant(P<0.05).Conclusion Sanzi Buxue Decoction can effectively regulate the proportion of Treg cells and Th17 cells in peripheral blood of MDS patients,s

关 键 词：三子补血汤 骨髓增生异常综合征 调节性T淋巴细胞 辅助性T细胞17 叉头框蛋白p3 维甲酸相关孤儿受体γt 

分 类 号：R259[医药卫生—中西医结合]