杞菊地黄丸对肝肾阴虚证孕妇血清IFN-γ及IL-4水平的影响

Effect of Qiju Dihuang Pill on Serum Levels of IFN-γ and IL-4 in Pregnant Women of Gan-Shen Yin Deficiency Syndrome

目的探讨杞菊地黄丸对肝肾阴虚证孕妇证型转化的影响，以及细胞因子水平失衡与中医肝肾阴虚证间的关系。方法采用随机对照的研究方法，将163例孕12～16周，经辨证分型为肝肾阴虚证的孕妇随机分为口服杞菊地黄丸治疗组（试验组，86例）和空白对照组（对照组，77例），比较两组孕妇治疗前后中医证型的转归以及血清细胞因子γ干扰素（interferon-γ，IFN-γ） 和细胞因子白细胞介素4（interleukin-4，IL-4）水平变化。结果（1）试验组治疗后47.7%（41/486）转化为正常证型，在随访的相同时间段内，对照组11.7%（9/77）转化为正常证型，两组比较差异有统计学意义（P〈0.05）。（2）试验组治疗后外周血细胞因子IFN-γ和IFN-γ/ IL-4比值水平较治疗前明显降低（P〈0.01），且显著低于对照组，差异有统计学意义（P〈0.01）；试验组IL-4水平较治疗前升高，且高于对照组，但差异无统计学意义。结论肝肾阴虚证孕妇外周血中存在细胞因子IFN-γ及IL-4比例失衡，杞菊地黄丸可能通过影响细胞因子IFN-γ水平发挥免疫调节作用。

Objective To observe the effect of Qiju Dihuang Pill （QDP） on changes of Chinese medical syndrome types in pregnant women of Gan-Shen yin deficiency syndrome （GSYDS）, and to explore the correlation between imbalanced cytokine levels and GSYDS. Methods This was a random controlled trail. A total of 163 pregnant women of GSYDS at 12 -16 gestational weeks were randomly allocated into the experimental group （86 cases） and the control group （77 cases）. Patients in the experimental group took QDP for 2 -4 weeks. Changes of Chinese medical syndrome types and serum interferon-γ （IFN-γ） and interleukin-4 （IL-4） levels were observed and compared between the two groups before and after treatment. Results （1） Totally 41 patients （47.7%） in the experimental group were transformed to normal Chinese medical syndrome type. In the same period of the follow-ups, 9 patients （11.7%） in the control group were transformed to normal Chinese medical syndrome type, showing statistical difference （P 〈0.05）. （2） In the experimental group, the serum level of IFN-γ and the ratio of IFN-γ/IL-4 in the peripheral blood were obviously lower after treatment than before treatment （P 〈0.01 ）, and obviously lower than those in the control group （P 〈0.01 ）. The level of IL-4 after treatment in the experimental group was higher than that before treatment, and also higher than that in the control group, but with no statistical difference. Conclusions These results indicated that there was imbalanced IFN-γ/IL-4 ratio in the peripheral blood of pregnant women of GSYDS. QDP might play a role in immunoregulation by affecting the IFN- γ/level.