升降散对脓毒症患者Th1/Th2失衡及相关调节因子的干预

Intervenient study of Shengjiang San on Th1/Th2 imbalances and related regulatory factors in sepsis patients

目的研究中药升降散对脓毒症患者血清Th1/Th2失衡及相关调节因子T-bet、GATA-3的干预作用。方法将55例脓毒症患者随机分为常规组(27例)和升降散组(28例),另将健康志愿者9例设为对照组。常规组患者给予西医常规治疗,升降散组患者在西医常规治疗的基础上加用升降散100 m L,每日2次口服或鼻饲,对照组患者予口服安慰剂;3组的疗程均为3 d。比较治疗前后3组患者中医证候评分、白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)、血清Th1/Th2及其相关转录因子T-bet、GATA-3的水平。结果常规组与升降散组比较,治疗后中医证候评分、WBC、Th1/Th2和T-bet的差异均有统计学意义(P<0.05或P<0.01),2组患者治疗后CRP、PCT和GATA3的差异无统计学意义(P>0.05);2组与对照组比较,除GATA3外,其他各项指标差异均有统计学意义(P<0.01)。结论升降散可以改善脓毒症患者中医临床征候和炎症反应指标,对血清Th1/Th2失衡及其相关调节因子T-bet、GATA-3的水平具有干预作用。

Objective To investigate the intervention of Chinese herb Shengjiang San（SJS）for the imbalances of serum Th1/Th2 cells and related regulatory factors in sepsis patients.Methods Fifty-five sepsis patients were randomly divided into two groups：conventional treatment group of 27 cases and SJS group of 28 cases.Nine cases of healthy volunteers were enrolled as control group in the study.Cases of conventional group were treated with western medicine only and cases of SJS group were treated with both western medicine and Chinese herb SJS（100 m L twice one day）.The therapy course of both groups was 3 days.Score of Chinese medical syndromes,serum level of leukocyte count,C reactive protein（CRP）and procalcitonin（PCT）,serum T-bet,GATA-3,Th1Th2 cells in the proportion of whole CD4~＋ Th cells and Th1/Th2 ratio were compared respectively in each group before and after treatment.Results There were significant differences between SJS group and conventional group in score of Chinese medical syndromes,serum level of leukocyte count,T-bet,GATA-3,Th1Th2 cells in the proportion of whole CD4＋ Th cells and Th1/Th2 ratio（P〈0.05 or P〈0.01）.There were no significant differences between the two groups in serum level of CRP,PCT and GATA3.Compared with control group,there were significant differences in all indicators except GATA3 of the two groups（P〈0.01）.Conclusion Chinese herb Shengjiang San has an effective benefits to Chinese medical syndromes,inflammatory reaction,the imbalance of serum Th1/T2 and related regulatory factors（T-betGATA-3）in sepsis patients.