槐杞黄对儿童过敏性紫癜Th17/Treg失衡的干预作用

摘要

目的：探讨槐杞黄颗粒对过敏性紫癜（HSP）儿童Th17/Treg失衡的影响及其对HSP复发、肾损伤的作用。方法选取HSP 患儿63例分为常规治疗组和槐杞黄组，两组均给予常规治疗，槐杞黄组加用槐杞黄颗粒口服治疗。收集患者一般情况，检测所有患儿治疗前及治疗2周后Th17细胞（CD3+CD8-IL-17+细胞）、Treg细胞（CD4+CD25+CD127+细胞）及细胞因子IL-17、TGF-β1水平。随访记录各组患儿紫癜复发次数。结果常规治疗组及槐杞黄治疗组两组治疗后与治疗前比较Th17、IL-17、TGF-β1水平均有下降，Treg 水平有升高，差异有统计学意义（P＜0.05）；两组治疗后Treg及TGF-β1水平比较差异无统计学意义（P＞0.05）；但槐杞黄组治疗后的Th17及IL-17水平低于常规治疗组治疗后水平，差异有统计学意义（P＜0.05）。槐杞黄组较常规治疗组复发率少，差异有统计学意义（10.3%vs.33.3%，χ2=4.023，P=0.045），肾损伤率差异无统计学意义（14.7%vs.27.6%；χ2=1.585，P=0.208）。结论槐杞黄辅助常规治疗能调节HSP患儿Th17/Treg失衡，尤其是抑制Th17细胞的分化及其相关因子IL-17；槐杞黄辅助治疗能减少HSP的复发，不能减少肾损伤的发生率。%objective To explore the balance of regulation of Th17/Treg, relapse and the kidney injury in children with HSP by using Huaiqihuang.Methods The research included 63 cases of children with HSP, the objects were divided into 2 groups: conventional therapy group and Huaiqihuang group, the conventional therapy group was treated with routine therapy, while the Huaiqihuang group was treated with routine therapy and oral Huaiqihuang particles. The peripheral frequency of Th17 cell (CD3+CD8-IL-17+ cell) and Treg cell (CD4+CD25+CD127+ cell) of all the objects (including before treatment and 2 weeks after treatment) were detected by flow cytometry, also the concentrations of the plasma cytokine IL-17 and TGF-β1 by ELISA. The frequency of relapse was recorded during the duration of follow-up.ResuIts The proportions of Th17 cell and the plasma concentrations of IL-17, TGF-β1 with two groups before treatment were found to be higher than those after treatment for 2 weeks, but the proportion of Treg cell was increased after 2 weeks of treatment (P<0.05). After 2 weeks of treatment, the proportions of Th17 cell and the plasma concentrations of IL-17 of the Huaiqihuang group were less than those in the conventional therapy group, and no differences of Treg cell and TGF-β1 between the two groups (P>0.05). The relapse in Huqihuang group decreased compare to the conventional therapy group (10.3%vs. 33.3%,χ2=4.023, P=0.045), while the difference was not significant in the incidence of kidney damage between two groups (14.7%vs.27.6%,χ2=1.585,P=0.208).ConcIusionsHualqihuang can regulate the imbalance of Th17/Treg (mainly for Th17 and IL-17 decreasing) in the onset of HSP in children. Furthermore, it can objective To explore the balance of regulation of Th17/Treg, relapse and the kidney injury in children with HSP by using Huaiqihuang.Methods The research included 63 cases of children with HSP, the objects were divided into 2 groups: conventional therapy group and Huaiqihuang group, the conventional therapy group was treated with routine therapy, while the Huaiqihuang group was treated with routine therapy and oral Huaiqihuang particles. The peripheral frequency of Th17 cell (CD3+CD8-IL-17+ cell) and Treg cell (CD4+CD25+CD127+ cell) of all the objects (including before treatment and 2 weeks after treatment) were detected by flow cytometry, also the concentrations of the plasma cytokine IL-17 and TGF-β1 by ELISA. The frequency of relapse was recorded during the duration of follow-up.ResuIts The proportions of Th17 cell and the plasma concentrations of IL-17, TGF-β1 with two groups before treatment were found to be higher than those after treatment for 2 weeks, but the proportion of Treg cell was increased after 2 weeks of treatment (P<0.05). After 2 weeks of treatment, the proportions of Th17 cell and the plasma concentrations of IL-17 of the Huaiqihuang group were less than those in the conventional therapy group, and no differences of Treg cell and TGF-β1 between the two groups (P>0.05). The relapse in Huqihuang group decreased compare to the conventional therapy group (10.3%vs. 33.3%,χ2=4.023, P=0.045), while the difference was not significant in the incidence of kidney damage between two groups (14.7%vs.27.6%,χ2=1.585,P=0.208).ConcIusionsHualqihuang can regulate the imbalance of Th17/Treg (mainly for Th17 and IL-17 decreasing) in the onset of HSP in children. Furthermore, it can decrease the relapse, but not the incidence of kidney damage.