蜂胶类黄酮对肺结核合并糖尿病的辅助治疗作用探讨

Auxiliary therapeutic effect of propolis flavonoid on pulmonary tuberculosis complicated by diabetes mellitus

目的探讨蜂胶类黄酮对肺结核合并糖尿病(PTB-DM)患者的辅助治疗作用及其免疫调节机制,为寻求安全有效的PTB-DM防治措施提供参考。方法以PTB-DM患者120人为对象,利用随机数字表随机分为A、B、C三组,每组40人,A、B组分别按1 000、2 000 mg/d剂量口服含蜂胶类黄酮的蜂胶软胶囊,C组口服不含蜂胶类黄酮的蜂胶基质软胶囊作为对照,观察6个月,比较各组疗效差异、试验前后WBC及分类、T淋巴细胞亚群CD3^+、CD4^+、CD8^+、CD4^+/CD8^+比值的差异。结果三组有效率差异有统计学意义(P=0.005),其中B组为94.6%、A组为76.9%、C组为64.1%;细胞免疫7项指标差异有统计学意义(P=0.000),其中WBC计数、中性粒细胞百分比为B组高于A与C组,淋巴细胞百分比为B组最高、A组其次、C组最低;T淋巴细胞:CD3^+、CD4^+为B组>A组>C组,CD8^+的组间差异无统计学意义(P>0.05),CD4^+/CD8^+比值为A与B组高于C组。结论蜂胶类黄酮对PTB-DM患者具有辅助治疗作用,可改善WBC及分类、T淋巴细胞亚群CD3^+、CD4^+、CD4^+/CD8^+比值等指标,增强细胞免疫水平具有作用,且有剂量差异。

Objective To explore the auxiliary therapeutic effect and immune regulating mechanism of propolis flavonoid in patients with pulmonary tuberculosis complicated by diabetes mellitus （PTB-DM）, and to provide references for seeking safe and effective PTB-DM prevention and control measures. Methods One hundred and twenty PTB-DM patients served as the objects, and were randomly divided into group A, group B and group C （each n=40） by the random digital table. The patients in group A and group B were assigned to take 1,000 mg/d and 2,000 mg/d propolis flavonoid soft capsule respectively. The patients in group C served as controls and received propolis soft capsule without flavonoid. After 6 months, the differences in curative effects, WBC count and classification, the levels of T lymphocyte subsets CD3＋, CD4＋, CD8＋ and the ratio of CD4＋/CD8＋ before and after the test were compared among the groups. Results The effective rates in group B, group A and group C were 94.6%, 76.9% and 64.1% respectively, showing statistically significant differences （P=0.005）. The 7 indexes of cellular immune function exhibited statistically significant differences （P=0.000）, of which WBC count and neutrophil percentage were higher in group B than in the group A and group C, and lymphocyte percentage and the levels of CD3＋ and CD4＋ were the highest in group B, followed by group A and group C. No statistically significant difference was found in the level of CD8＋ among the three groups （P〉0.05）. The ratio of CD4＋/CD8＋ was higher in group A and B than in group C. Conclusions Propolis flavonoid has auxiliary therapy effect in PTB-DM patients, and can improve WBC count and classification, the levels of T lymphocyte subsets CD3＋, CD4＋ and the ratio of CD4＋/CD8＋. It enhances cellular immunity in a dose-dependent manner.