基于 Treg/Th17探讨当归饮子联合鼻舒膏鼻部透药治疗顽固性鼻前庭湿疹的疗效及机制  

Efficacy and mechanism of Danggui Yinzi combined with Bishu ointment nasal penetration in treatment of intractable nasal vestibular eczema based on balance of Treg/Th17

作　　者：卫岚 孙麦青[2] 陈文明[2] 靳晓静 张康洁 曹会云 夏雪园 张甜甜 吴楠楠 WEI Lan;SUN Maiqing F;CHEN Wenming(The Second Clinical Medical College,Henan University of Chinese Medicine,Zhengzhou,Henan 450046,China;Henan Province Hospital of TCM,Zhengzhou,Henan 450002,China)

机构地区：[1]河南中医药大学第二临床医学院,河南郑州450046 [2]河南省中医院,河南郑州450002

出　　处：《四川中医》2025年第3期149-154,共6页Journal of Sichuan of Traditional Chinese Medicine

基　　金：河南省中医药科学研究专项课题(编号:2022ZY1079);河南中医药大学研究生科研创新能力提升计划项目(编号:2023KYCX048)。

摘　　要：目的:基于Treg/Th17平衡,探讨当归饮子联合鼻舒膏鼻部透药治疗顽固性鼻前庭湿疹的疗效及对IL-10、IL-17、IL-23、TGF-β的影响。方法:选取120例脾虚血燥证鼻前庭湿疹患者,随机分为观察组和对照组,每组各60例。对照组给予西替利嗪片口服及醋酸氟轻松软膏外用治疗,观察组给予当归饮子口服联合鼻舒膏鼻部透药治疗,1周为1个疗程,均连续治疗2个疗程。观察比较两组患者治疗前后的症状体征积分、中医证候评分、外周血Treg/Th17细胞群比率,以及血清IL-10、IL-17、IL-23、TGF-β细胞因子的表达水平。治疗停药3个月后随访,统计复发率。结果:治疗后2组症状体征积分、中医证候积分均下降(P<0.05),观察组改善效果优于对照组(P<0.05);抗炎因子IL-10、TGF-β含量升高,且观察组高于对照组(P<0.05);IL-17、IL-23含量均较治疗前下降,且观察组低于对照组(P<0.05);观察组外周血Treg/Th17比率治疗后较治疗前升高,对照组外周血Treg/Th17比率治疗前、后无统计学意义。结论:当归饮子联合鼻舒膏鼻部透药治疗通过调节Treg/Th17免疫平衡,能够改善患者鼻部及全身症状,有效降低患者血清IL-17、IL-23水平,升高血清IL-10、TGF-β水平,同时在一定程度上降低临床复发率。Objective: Based on the balance of Treg/Th17,to explore the curative effect of Danggui Yinzi combined with Bishu ointment in the treatment of intractable nasal vestibular eczema and its effect on IL-10,IL-17,IL-23and TGF-β. Methods: A total of 120patients with nasal vestibular eczema of spleen deficiency and blood dryness syndrome were randomly divided into observation group and control group,with 60cases in each group. The control group was treated with cetirizine tablets orally and fluocinonide acetate ointment for external use. The observation group was treated with Danggui Yinzi combined with nasal penetration of Bishu ointment. One week was a course of treatment,and both groups were treated continuously for 2courses. Observe and compare the symptom and sign scores,TCM syndrome scores,peripheral blood Treg/Th17cell group ratios,and serum IL-10,IL- 17,IL-23,and TGF-β cytokine expression levels of the two groups of patients before and after treatment. After 3months of withdrawal of treatment,the recurrence rate was counted. Results: After treatment,the scores of symptoms and signs and TCM syndromes in the two groups were decreased ( P <0.05),and the improvement effect in the observation group was better than that in the control group ( P <0.05). The contents of anti-inflammatory factors IL-10and TGF-β increased,and those in the observation group were higher than the control group ( P <0.05). The levels of IL-17and IL-23were lower than those before treatment,and the observation group was lower than the control group ( P <0.05). The ratio of Treg/Th17in peripheral blood of the observation group was higher than that before treatment,and the ratio of Treg/Th17in peripheral blood of the control group was not statistically significant before and after treatment. Conclusion: Danggui Yinzi combined with nasal penetration of Bishu ointment can improve nasal and systemic symptoms of patients by regulating Treg/Th17immune balance.It can effectively reduce the levels of serum IL-17and IL-23,increase the levels of serum

关 键 词：鼻前庭湿疹 脾虚血燥证 当归饮子 鼻舒膏 Treg/Th17 TGF-Β 

分 类 号：R285[医药卫生—中药学]