散寒除湿法对寒湿痹阻型类风湿关节炎患者Th17/Treg 细胞平衡的影响
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R259;R593.22

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湖州市科技计划项目(2018GY46)


Effect of Cold- Dissipating and Dampness- Eliminating Method on Th17/Treg Cell Balance in Patients with Rheumatoid Arthritis of Cold-Dampness Obstruction Type
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    摘要:

    目的:观察基于散寒除湿法立方的穴位贴敷治疗类风湿关节炎(RA) 寒湿痹阻证患者的临床疗效及对辅助性T 细胞17(Th17) /调节性T 细胞(Treg) 平衡的影响。方法:将102 例RA 患者随机分为对照组与治疗组。对照组采用甲氨蝶呤联合来氟米特治疗,治疗组在对照组基础上加用中药穴位贴敷治疗。比较2 组治疗前后疾病活动度评价表(DAS28) 评分及中医证候积分。采用流式细胞术检测患者外周血Th17、Treg 细胞的表达比例,采用酶联免疫吸附法测定血清白细胞介素-10(IL-10)、白细胞介素-17(IL-17) 水平。结果:治疗组总有效率为92.31%,高于对照组的76.00%(P<0.05)。与同组治疗前比较,治疗后2 组关节压痛数、关节肿胀数、视觉模拟评分(VAS)、红细胞沉降率(ESR)、DAS28 评分、外周血Th17 细胞比例、血清IL-17含量均降低(P<0.05),Treg 细胞比例、IL-10 含量均升高(P<0.05)。与对照组治疗后比较,治疗组关节肿胀数、ESR、DAS28评分、外周血Th17 细胞比例、IL-17 含量均较低(P<0.05),Treg 细胞比例、IL-10 含量均较高(P<0.05)。结论:基于散寒除湿法立方的穴位贴敷能有效改善活动期寒湿痹阻型RA 患者的临床症状,纠正RA 患者体内Th17/Treg 细胞失衡状态。

    Abstract:

    Abstract:Objective:To observe the clinical effect of point application with prescriptions based on cold-dissipating and dampness-eliminating method for patients with rheumatoid arthritis(RA) with cold-dampness obstruction syndrome,and its effect on T helper cells 17(Th17)/regulatory T cells(Treg) balance. Methods:A total of 102 cases of RA patients were randomly divided into the control group and the treatment group. The control group was given methotrexate and leflunomide,and the treatment group was additionally given point application with Chinese medicine based on the treatment of the control group . Scores of Disease Activity Score 28(DAS28) and Chinese medicine syndrome scores before and after treatment were compared between the two groups. Flow cytometry was used to measure the proportion of the expression of Th17 and Treg cells in peripheral blood. Enzyme linked immunosorbent assay was used to determine levels of interleukin- 10(IL- 10) and interleukin- 17(IL- 17) in serum. Results: The total effective rate was 92.31% in the treatment group, higher than that of 76.00% in the control group(P<0.05). Compared with those in the same group before treatment,joint tenderness number, joint swelling number,scores of Visual Analogue Scale(VAS) and DAS28 of rheumatoid arthritis,erythrocyte sedimentation rate(ESR),the proportion of Th17 cells in peripheral blood,and the content of IL-17 in serum were decreased(P<0.05);the proportion of Treg cells and the content of IL- 10 were increased(P<0.05). Compared with those in the control group after treatment,joint swelling number,ESR,score of DAS28,the proportion of Th17 cells in peripheral blood,and the content of IL-17 in the treatment group were lower(P<0.05);the proportion of Treg cells and the content of IL-10 were higher(P< 0.05). Conclusion:For RA patients of cold- dampness obstruction type in active stage,point application with prescriptions based on cold-dissipating and dampness-eliminating method can effectively improve their clinical symptoms and rectify Th17/ Treg cell imbalance in the body.

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阮玲娟,陈春燕,莫娟芬.散寒除湿法对寒湿痹阻型类风湿关节炎患者Th17/Treg 细胞平衡的影响[J].新中医,2021,53(11):80-84

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  • 在线发布日期: 2021-06-10
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