雷公藤多甙治疗自体血清皮肤试验阳性的慢性特发性荨麻疹

Studies on the Treatment of Tripterygii Tororum (GTT) for Chronic Idopathic Urticaria

目的研究雷公藤多甙(GTT)对自体血清皮肤试验(ASST)阳性的慢性特发性荨麻疹(CIU)血清总IgE及Th1/Th2细胞因子的调节作用,以探讨GTT治疗CIU的作用机制。方法 210例CIU患者内有118例ASST阳性,并将其随机分为治疗组与对照组,各59例,治疗组给予GTT联合地氯雷他定片治疗,而对照组给予地氯雷他定片。两组治疗前后分别采用ELISA法检测血清总IgE,IL-2,IFN-γ,IL-4。结果 CIU患者ASST阳性率为56.19%。治疗组治疗后14d及28d有效率均高于对照组(P<0.05)。治疗组、对照组治疗后14d及28d血清总IgE水平均低于治疗前(P<0.05),治疗组与对照组治疗后28dIL-4水平低于治疗前及治疗后14d(P<0.05),而治疗后14dIL-4水平低于治疗前,但差异无统计学意义(P>0.05),治疗组与对照组治疗后IL-2,IFN-γ水平升高,但与治疗前比较差异无统计学意义(P>0.05)。结论 GTT有利于ASST阳性CIU患者降低血清总IgE,纠正体内Th1/Th2细胞因子失衡状态,这可能是GTT治疗CIU的重要作用机制。GTT治疗CIU效果缓慢,有一定的副作用。

Objective To investigate the modulatory effect of glucosidorum tripterygii tororum（GTr） on serum total IgE and Th1/Th2 cytokine of chronic idopathic urticaria（CIU） patients with positive autologous serum skin test （ASST）, and further to investigate the mechanism of GTT for CIU. Methods ASST detection were performed in 210 CIU patients, and 118 CIU patients among others ASST were positive. The positive ASST CIU groups assigned to treatment and control group at random. The treatment group patients were treated with GTT and Desloratadine, and the control group patients were treated with Desloratadine. The level of total serum IgE, IL-2, IL4, IFN-3, had been measured by ELISA in 210 patients with CIU before and after treatment. Results The positive rate were 56.19% in the research on CIU. The efficient rate of treatment group was higher than control group in positive ASST CIU patients at the time of both the 14th and the 28th day （both P 〈0.05 ）. The 14th and the 28th day, the level of serum total IgE in positive ASST CIU patients was lower than before treatment（P 〈 0.05 ）. The level of IL-4 on the 28th day were lower than those before treatment and the 14th days as well （P 〈 0.05 ）, but there was not significant difference beween the 14th days and before（ P 〉 0.05 ）. There was not significant difference on the level of IL-2 and IFN-γ（ P 〉 0.05 ）. Conclusion GTT was helped possive ASST CIU patients to reduce the level of serum IgE and correct the imbalance state of Th1/Th2 cytkines, which may be the mechanism of GTF effecting on CIU. The effect of GTT was torpidity on CIU, with some side effect.