清火柔肝明目方治疗慢性葡萄膜炎临床研究

Clinical study on treatment of chronic uveitis with Qinghuo Rougan Mingmu formula

目的观察清火柔肝明目方治疗以白塞病(Behcet’s disease)、伏格特-小柳-原田(Vogt-Koyanagi-Harada syndrome,VKH)综合征为代表的慢性葡萄膜炎临床效果。方法选取本院2013年11月~2015年11月住院治疗的慢性葡萄膜炎患者,随机分为治疗组和对照组,共完成治疗、随访及辅助性T细胞17(Th17)、调节性T细胞(Treg细胞)检测93例,其中治疗组46例,68眼、对照组47例,70眼。对照组予以西医治疗,治疗组在对照组的基础上加用清火柔肝明目方加减治疗,比较两组患者的临床疗效;随访观察12个月;并收集两组患者治疗前后外周静脉血4 ml,流式细胞仪检测Th17、Treg细胞的表达。结果清火柔肝明目方治疗组治愈率明显优于对照组;清火柔肝明目方治疗组复发率明显低于对照组。慢性葡萄膜炎患者外周血中Th17细胞比例治疗后明显降低,与对照组比较,差异均具有统计学意义(P<0.05),Treg细胞比例治疗后明显升高,与对照组比较差异具有统计学意义(P<0.05)。结论清火柔肝明目方能提高慢性葡萄膜炎的治愈率、降低复发率,改善慢性葡萄膜炎患者免疫状态。

OBJECTIVE To observe the clinical effect of Qinghuo Rougan Mingmu formula on chronic uveitis manifested as Behcet＇s disease and VKH syndrome. METHODS Patients with chronic uveitis hospitalized from November 2013 to November 2015 were randomly divided into treatment group and control group. A total of 93 pa-tients finished all the trial containing 46 cases（68 eyes） of treatment group and 47 cases（70 eyes） of control group.The control group was treated by western medicine while the treatment group was managed by the same regime in ad-dition to Qinghuo Rougan Mingmu formula. All subjects were followed up for 12 months and 4ml peripheral blood was collected before and after therapy for expression of Th17 and Treg cells with flow cytometry. RESULTS After treatment, the cure rate of treatment group was obviously higher than that of the control group. The recurrence rate of treatment group was obviously lower than that of the control group. The percentage of Th17 cells in peripheral blood in treatment group was significantly lower than that of control group（P〈0.05）, and the percentage of Treg cells was significantly higher than that of control group, and the difference was statistically significant（ P〈0.05）. CONCLUSIONS Qinghuo Rougan Mingmu formula had obvious clinical effect. It significantly improved the cure rate, reduced the recurrence rate, and significantly improved the immune status of patients with chronic uveitis.