解毒化瘀汤对活动期溃疡性结肠炎Th17/Treg细胞及其细胞因子的影响

摘要

目的 观察解毒化瘀汤对湿热蕴结型活动期溃疡性结肠炎临床疗效及对Th 17/Treg细胞及其相关细胞因子的影响.方法 选取符合诊断和纳入标准的溃疡性结肠炎患者48例,按照随机数字表法分为对照组和治疗组各24例.其中对照组给予美沙拉嗪肠溶片口服,治疗组在对照组的基础上给予解毒化瘀汤口服.两组疗程均为12周,分别观察两组患者临床疗效,ELISA法检测白细胞介素-17 (IL-17)、白细胞介素-10(IL-10)、转化生长因子-β(TGF-β)水平,Real-Time PCR法检测Th 17/Treg细胞的核转录因子RORγt/Foxp3mRNA的表达.结果 治疗组总有效率为91.67％,明显优于对照组(P＜0.05);两组治疗后IL-17较治疗前均明显降低(P＜ 0.01),两组治疗后IL-10、TGF-β较治疗前均明显升高(P＜0.01),治疗后治疗组明显优于对照组(P＜0.01);两组治疗后RORγt mRNA、RORγt/Foxp3比值较治疗前均明显降低(P＜0.01),两组治疗后Foxp3 mRNA较治疗前均明显升高(P＜0.01),治疗后治疗组明显优于对照组(P＜ 0.05或P＜ 0.01).结论 解毒化瘀汤能够明显改善湿热蕴结型活动期溃疡性结肠炎患者临床症状,降低IL-17,增加IL-10、TGF-β水平,调控RORγt、Foxp3 mRNA的表达,促进Th 17/Treg细胞平衡,减少复发率,疗效显著.%Objective:To observe the clinical efficacy of Jiedu Huayu Decoction on patients with active ulcerative colitis and its effect on Th17/Treg cells and related cytokines.Methods:48 patients with active ulcerative colitis of accumulated damp-heat type were divided into the treatment group(24 cases) and the control group(24 cases) according to random number table.The control group was treated with Mesalazin enteric-coated tablets and the treatment group was treated with Mesalazin enteric-coated tablets combined with Jiedu Huayu Decoction.The course of treatment was 12 weeks in both groups.The clinical efficacy were observed;ELISA method was used to detect the levels of plasma IL-17,IL-10 and TGF-β.Real-Time PCR was used to detect the expression of nuclear transcription factor RORγt/Foxp3 mRNA in Th17/Treg cells.Results:The total effective rate of the treatment group was 91.67％,significantly better than that of the control group (P＜ 0.05);IL-17 was reduced significantly after treatment compared with before treatment in both groups (P＜ 0.01) and IL-10 and TGF-β were increased significantly after treatment compared with before treatment in both groups (P＜0.01).After treatment,the treatment group was obviously better than the control group(P＜ 0.01).RORγt mRNA and RORγt/Foxp3 ratio was reduced significantly after treatment compared with before treatment in both groups(P＜0.01) and Foxp3 mRNA was increased significantly after treatment compared with before treatment in both groups.(P ＜ 0.01).After treatment,the treatment group was obviously better than the control group (P＜ 0.05 or P＜ 0.01).Conclusion:Jiedu Huayu Decoction can obviously improve the clinical symptoms of patients with active ulcerative colitis of accumulated damp-heat type,decrease IL-17,increase levels of IL-10 and TGF-β,regulate the expression of RORγt and Foxp3 mRNA,and promote the balance of Th17/Treg cells,with a low recurrence rate and obvious curative effect.