中药复方治疗复发性生殖器疱疹的临床观察及对血清Th17/Treg细胞的影响

Therapeutic Effect of Chinese Herbal Medicine Compound for Recurrent Genital Herpes and Its Effect on Serum Th17/Treg Cells

【目的】观察具有清热祛湿、补益气血作用的中药复方治疗复发性生殖器疱疹(RGH)的临床疗效,检测Th17细胞、Treg细胞在RGH患者外周血中的表达情况,并探讨两者在RGH中的发病机制。【方法】将60例RGH患者随机分为治疗组和对照组各30例。治疗组给予中药汤剂治疗,对照组给予阿昔洛韦片口服治疗,疗程均为6个月。观察2组临床疗效及患者外周血中Th17细胞、Treg细胞的比例。【结果】(1)治疗3个月、6个月后,治疗组的总有效率分别为53.33%、80.00%,对照组分别为23.33%、46.67%,治疗组的疗效均优于对照组,差异均有统计学意义(P<0.05)。(2)治疗后,2组外周血Th17细胞比例及Th17/Treg细胞比值均下降,外周血Treg细胞比例均升高,其中治疗组差异均有统计学意义(P<0.05),对照组差异尚无统计学意义(P>0.05);治疗后组间比较,治疗组对外周血Th17细胞比例和Th17/Treg细胞比值的下降作用及对Treg细胞比例的升高作用均优于对照组,差异均有统计学意义(P<0.05)。【结论】中药复方治疗RGH疗效优于西药阿昔洛韦,能够降低RGH患者Th17细胞水平,提高Treg细胞水平,从而使Th17/Treg细胞比值降低,提示清热祛湿、补益气血中药能够负向调节Th17/Treg细胞平衡,进而发挥抗炎和免疫调节的作用。

Objective To observe the clinical efficacy of heat-clearing, dampness-removing, and Qi-blood-tonifying Chinese herbal medicine compound for the treatment of recurrent genital herpes（RGH）, and to investigate the expression levels of Th17 cells and Treg cells in peripheral blood of patients with RGH as well as their role in the pathogenesis of RGH. Methods Sixty RGH patients were randomly divided into experimental group and control group, 30 cases in each group. The experimental group was treated with Chinese medicine decoction, and the control group was treated with Aciclovir tablets orally. The treatment course covered 6 months. The percentages of Th17 cells and Treg cells in the peripheral blood of the RGH patients were detected with flow cytometry. Results （1） After treatment for 3, 6 months, the total effective rate of the experimental group was 53.33%, 80.00%, and that of the control group was 23.33%, 46.67% respectively. There were significant difference between the two groups（P 〈 0.05）.（2） After treatment, the percentage of Th17 cells and the ratio ofTh17/Treg cells were decreased while the percentage of Treg cells was increased in the two groups, and the differences before and after treatment were significant in the experimental group（P〈0.05） while were insignificant in the control group （P 〉 0.05）. The inter-group comparison showed the decrease of Th17 cell percentage and Th17/Treg cell ratio as well as the increase of Treg cell percentage in the experimental group was superior to that in the control group, the differences being significant （P〈0.05）. Conclusion The curative effect of Chinese herbal compound for RGH is better than that of the control group. Chinese herbal medicine compound can decrease the level of Th17 cells, increase the level of Treg cells, thus to decrease the ratio of Th17/Treg cells, indicating that heat-clearing, dampness-removing, and Qi-blood-tonifying Chinese herbal medicine compound can correct the imbalance of Th17/Treg cells, and then plays a role in anti-inflammation and immune regulation.