益气和营法调控肉芽肿性乳腺炎IL-6、IL-1β、IFN-γ免疫失衡机制

Regulating the Immune Imbalance Iechanism of IL-6 and IL-1β、IFN-γ in Granulomatous Mastitis by Yiqi Heying Method

目的基于既往工作基础研究肉芽肿性乳腺炎组织中IL-6、IL-1β、IFN-γ的免疫失衡表达,探讨益气和营法联合激素治疗肉芽肿性乳腺炎的疗效及对局部组织内免疫失衡状态的调节机制。方法收集肿块期肉芽肿性乳腺炎患者126例,随机分为两组,治疗组66例予以激素联合益气和营中药方加减治疗,对照组60例予以纯激素治疗。检测治疗前后炎性组织中IL-6、IL-1β、IFN-γ的表达情况,对比治疗前后乳房炎症肿块缩小范围、患处皮色及疼痛程度等临床症状改善情况,分析益气和营法治疗肉芽肿性乳腺炎的临床疗效及免疫失衡机制。结果(1)肉芽肿炎症组织内可见以病变小叶为中心的小灶性坏死,及大量CD4+T淋巴细胞、单核样细胞、浆细胞、多核巨细胞浸润,IL-6、IL-1β表达升高,而IFN-γ表达降低;治疗前后对比,两组患者治疗后免疫失衡状态改善,IL-6、IL-1β表达均明显下降,IFN-γ表达明显上升,有统计学差异(P<0.01)。(2)治疗后两组患者的乳房肿块缩小范围评分、患处皮色评分、疼痛评分较治疗前均明显降低,评分均有统计学差异(P<0.05)。结论(1)GM炎性组织中IL-6、IL-1β、IFN-γ的水平处于失衡状态,免疫失衡引起过强的免疫应答,导致一系列的免疫炎症反应。(2)治疗组可更有效的缩小肿块大小、改善乳房皮色、缓解乳房疼痛,显示益气和营法治疗肿块期GM具有明显优势。(3)益气和营法可通过调节局部组织的IL-6、IL-1β、IFN-γ免疫失衡状态,达到治疗GM的效果。本研究为肉芽肿性乳腺炎肿块期的治疗提供实验基础和临床依据。

Objective To study the immune imbalance expression of IL-6,IL-1βand IFN-γin granulomatous mastitis tissues based on previous work,and to explore the efficacy of yiqi heying method combined with hormone therapy in the treatment of granulomatous mastitis and the regulation mechanism of immune imbalance in local tissues.Methods A total of 126 patients with granulomatous mastitis in mass stage were collected and randomly divided into two groups.66patients in the treatment group were treated with hormone combined yiqi heying method,and 60 patients in the control group were treated with hormone alone.The expressions of IL-6,IL-1βand IFN-γin inflammatory tissues before and after treatment were detected,and the improvement of clinical symptoms such as reduced range of breast inflammatory masses,skin color and pain degree were compared before and after treatment,and the clinical efficacy and immune imbalance mechanism of yiqi heying method in the treatment of granulomatous mastitis were analyzed.Results(1)There was small focal necrosis centered on the lobule in the inflammatory tissue of granuloma,and a large number of CD4+T lymphocytes,mononuclear cells,plasma cells and multinuclear giant cells were infiltrated.The expression of IL-6 and IL-1βincreased,while the expression of IFN-γdecreased.Compared with before and after treatment,the immune imbalance of 2 groups was improved,the expression of IL-6 and IL-1βwas significantly decreased,and the expression of IFN-γwas significantly increased,with statistical differences(P<0.01).(2)After treatment,the breast mass reduction scale score,skin color score and pain score in 2 groups were significantly lower than those before treatment,with statistical differences(P<0.05).Conclusion(1)The levels of IL-6 and IL-1β、IFN-γin GM inflammatory tissue are unbalanced,and the immune imbalance leads to a strong immune response,leading to a series of immune inflammatory reactions.(2)The treatment group can reduce the size of the lump,improve the skin color of the breast and relieve the breast pain more effectively,indicating that the treatment of GM in the lump stage by yiqi heying method has obvious advantages.(3)Yiqi heying method can achieve the effect of GM treatment by regulating the immune imbalance of IL-6and IL-1β、IFN-γin local tissues.This study provides experimental basis and clinical basis for the treatment of granulomatous mastitis at mass stage.