自拟止泻方通过调节Th17细胞功能治疗小儿迁延性腹泻的临床观察

Clinical Observation on Self-Made Antidiarrheal Decoction in Treating Pediatric Protracted Diarrhea by Regulating Th17 Cell Function

目的:观察自拟止泻方对小儿迁延性腹泻的临床疗效以及其部分调节机制的研究。方法:将本院2010年3月至2013年3月100例延性腹泻的患儿纳入研究,对照组50例患儿接受内科常规治疗,观察组50例在对照组治疗基础上加用自拟止泻方,观察2组患儿均以10 d为1个疗程,疗程结束后观察2组患儿临床症状的变化,同时采用流式细胞术检测外周血中Th17细胞表达水平,ELISA检测患者血清中IL-6、IL-17、IL-23的蛋白表达水平。结果:1)2组患儿体温恢复时间、呕吐停止时间比较差异无统计学意义(P>0.05),但是观察组患儿腹泻停止时间短于对照组(P<0.05);2)治疗后2组患儿血清中IL-6、IL-17、IL-23水平低于治疗前(P<0.05),治疗1个疗程后观察组患者IL-17、IL-6、IL-23水平下降趋势较对照组患儿明显(P<0.01);3)随访3个月后发现,观察组患儿的体重增长明显高于对照组患儿(P<0.05)。结论:迁延性腹泻患儿存在Th17细胞表达增加,功能亢进,自拟止泻方可以明显下调Th17细胞表达频数及功能,该效应可能是自拟止泻方从机体免疫方面改善迁延性腹泻的作用机制之一。

Objective： To observe the clinical curative effect of self-made antidiarrheal decoction in the treatment of pediatric protracted diarrhea and some of its regulatory mechanism. Methods： One hundred cases of pediatric protracted diarrhea treated in our hospital during March 2010 to March 2013 were included in the study. Fifty cases in the control group accepted medical conventional treatment,and the other 50 cases in the observation group received self-made antidiarrheal decoction apart from the same treatment of the control group.The treatment course of both groups was 10 days. The symptoms changes of children in the two groups after treatment was observed. Simultaneously flow cytometry was used to test peripheral blood expression level of Th17 cells,and ELISA was used to detect the protein expression level of IL-6,IL-17,IL-23 in the serum of patients. Results： 1） Temperature recovery time,vomiting stop time of the two groups were with no statistical differences（ P〉0. 05）,but the diarrhea stop time of the observation group was shorter than that of the control group（ P〈0. 05）. 2） after treatment,serum IL-6,IL-17,IL-23 levels in children in the two groups with lower than those before treatment（ P〈0. 05）,and after one period of treatment,IL-17,IL-6,IL-23 levels of the observation group declined significantly than those of the control group（ P〈0. 01）. 3） after the 3 months follow-up,childrens weight gain of the observation group was obviously more than that of the control group（ P〈0. 05）. Conclusion： Children with protracted diarrhea have increased expression of Thl7 cells and hyperfunction,and self-made antidiarrheal decoction can obviously down-regulate frequency and function of Thl7 cells expression which may be one of the mechanisms of self-made antidiarrheal decoction improving protracted diarrhea in the aspects of the bodys immune ability.