益肾解毒通络饮治疗多发性硬化症的疗效及对Th17/Treg细胞因子水平的影响  

The Therapeutic Effect of Tonifying the Kidney,Detoxifying and Dredging Collaterals on Multiple Sclerosis and Its Influence on the Level of Th17/Treg Cytokines

作　　者：赵传清 赵丽娜 郭新伟 张晓佳 时伟 文军 ZHAO Chuan-qing;ZHAO Li-na;GUO Xin-wei;ZHANG Xiao-jia;SHI Wei;WEN Jun(Department of Neurology,Baoding Second Central Hospital,Baoding 072750,China;Department of Neurology,Leting County Hospital,Tangshan 063600,China;Department of Internal Medicine,Baoding Second Central Hospital,Baoding 072750,China;Department of Internal Medicine,Zhuozhou Traditional Chinese Medicine Hospital,Baoding 072750,China)

机构地区：[1]河北省保定市第二中心医院神经内科,保定072750 [2]河北省唐山市乐亭县医院神经内科,唐山063600 [3]河北省保定市第二中心医院内科,保定072750 [4]河北省涿州市中医医院内科,保定072750

出　　处：《微循环学杂志》2023年第4期69-73,共5页Chinese Journal of Microcirculation

基　　金：河北省保定市科技计划项目(2241ZF202)。

摘　　要：目的:分析益肾解毒通络饮治疗多发性硬化症(MS)的疗效及对辅助T细胞17/调节T细胞(Th17/Treg)水平的影响。方法:选取本院2020-11-2022-05收治的90例MS患者,随机分为研究组(45例)和对照组(45例)。对照组给予常规西药治疗,研究组在对照组的基础上给予益肾解毒通络饮。采用扩展残疾状态量表(EDSS)评估患者神经功能障碍程度,蒙特利尔认知评估量表(MoCA)及简易精神状态评价量表(MMSE)评估患者认知功能障碍,比较两组患者治疗前后的中医症状评分、外周血Th17、Treg、Th17/Treg水平以及临床疗效和不良反应的差异。结果:治疗前,两组患者中医症状评分、EDSS评分、MoCA评分、MMSE评分、外周血Th17、Treg、Th17/Treg水平差异均无统计学意义(P>0.05)。治疗后,两组中医症状评分、EDSS评分、外周血Th17、Th17/Treg水平均均降低,MoCA评分、MMSE评分和Treg水平均升高(P均<0.01),且研究组较对照组降低/升高更明显(P<0.01);研究组总有效率高于对照组(P<0.05);两组不良反应发生率差异无统计学意义(P>0.05)。结论:益肾解毒通络饮联合常见西药治疗MS,能够明显改善患者的临床症状、神经功能及认知功能,调节Th17/Treg平衡,提高临床疗效,值得临床推广应用。Objective:To analyze the curative effect of Yishenjiedu Tongluo Yin on multiple sclerosis(MS)and its influence on the level of T helper 17/regulatory T cell(Th17/Treg)cytokines.Method:A total of 90 patients with MS admitted to our hospital from November 2020 to May 2022 were randomly divided into the study group(45 cases)and the control group(45 cases).The control group was treated with conventional western medicine,and the study group was treated with Yishen Jiedu Tongluo Decoction on the basis of methylprednisolone.The extended disability status scale(EDSS)was used to assess the degree of neurological dysfunction of the patients in the two groups before and after treatment,and the Montreal Cognitive Assessment Scale(MoCA)and the Mini Mental State Examination(MMSE)were used to assess the cognitive dysfunction of the patients.The TCM symptom score,perippheral blood Th17,Treg and Th17/Treg levels before and after treatment,the clinical efficacy and adverse reactions of the two groups were compared.Results:Before treatment,there was no statistically significant difference in the TCM symptom score,EDSS score,MoCA score,MMSE score,peripheral blood Th17,Treg,and Th17/Treg levels between the two groups of patients(P>0.05).After treatment,TCM symptom score,EDSS score,MoCA and MMSE scores,Treg levels were increased,Th17,Th17/Treg levels were decreased in both groups(All P<0.01).The decrease/increase in the study group was more obvious than that in the control group(P<0.01).The total effective rate of the study group was higher than that of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Yishenjiedu Tongluo Yin combined with common western medicine in the treatment of MS can significantly improve the clinical symptoms,neurological function and cognitive function of patients,regulate Th17/Treg balance,improve clinical efficacy,and refer to the clinical promotion and application.

关 键 词：益肾解毒通络饮 多发性硬化症 辅助T细胞 调节T细胞 

分 类 号：R744.51[医药卫生—神经病学与精神病学]