枸杞联合激素治疗急性前葡萄膜炎的疗效及其对相关细胞因子的影响

Effect of lyceum barbarum combined with corticosteroids on the treatment of acute anterior uveitis and its impact on related cytokines

目的观察比较枸杞联合激素与单纯激素治疗急性前葡萄膜炎（AAU）的临床疗效,探讨枸杞辅助治疗急性前葡萄膜炎的机制。方法确诊AAU患者随机分为单纯糖皮质激素治疗组（激素治疗组）、枸杞联合激素治疗组（联合治疗组）,并选体检健康人群作对照（健康人群组）。结果联合治疗组治疗前期（1周）有效率为86%,激素治疗组为62%;治疗后期（2周）联合治疗组有效率为98%,激素治疗组为80%,2组总有效率比较差异有统计学意义（P〈0.05）。联合治疗组及激素治疗组IL-10、TNF-α、IFN-γ、IL-23在AAU发作期显著高于健康人群组（P〈0.01）,治疗后均显著降低（P〈0.01）。IL-10在治疗前均显著高于健康人群组（P〈0.01）,治疗后激素治疗组较治疗前升高（P〈0.05）,而联合治疗组呈一定程度下降（P〈0.05）。IFN-γ在治疗后2组均高于健康人群组（P〈0.05）。结论 AAU患者急性发作期IFN-γ、TNF-α、IL-10、IL-23水平显著高于治疗后及其他健康体检者,而枸杞联合激素进行治疗,IFN-γ、IL-23水平均下降显著,效果明显,值得推广。

Objective To observe and compare the effect of lyceum barbarum combined with corticosteroids and corticosteroids alone on the treatment of acute anterior uveitis（ AAU）,to explore the mechanism of lyceum barbarum could auxiliary treat AAU. Methods 60 cases with AAU were randomly divided into lyceum barbarum combined with corticosteroids treatment group（ combination therapy group）,simple corticosteroids treatment group（ cortisol treatment group） and health control group. Health control group consists of healthy volunteers. Results The efficient rate of the combination therapy group in the early treatment stage（ 1 week） was 86%,the cortisol treatment group was 62%. In the late stage treatment（ 2 weeks）the efficient rate was 98% and 80% in the cortisol treatment group. The total efficiency rate in the two groups was significant difference（ P 〈0. 05）. The level of IL-10、TNF-α、IFN-γ and IL-23 in the combination therapy group and cortisol treatment group were significantly higher than those in healthy control group in AAU attack period（ P〈 0. 01）,the levels of these cytokines were significantly decreased after treatment（ P〈 0. 01）. IL-10 was significantly higher in patients before treatment than that in healthy control group（ P〈 0. 01）,IL-10 in cortisol treatment group was increased than that before treatment,IL-10 in combination therapy group was decreased after treatment than that before treatment（ P〈 0. 05）. The level of IFN-γ in the combination therapy group and cortisol treatment group were higher than that in healthy control group after treatment（ P〈 0. 05）. Conclusion The levels of IFN-γ,IL-10,TNF-α,IL-23 in acute attack stage in AAU patients were significantly higher than those after treatment and other people with physical examination,while the treatment of lyceum barbarum combined with hormone,IFN-γ and IL-23 levels decreased significantly,the effect was obvious,which is worthy of promotion.