鼻敏煎治疗变应性鼻炎及对Treg/Th17免疫平衡的影响

Effect of Bimin Decoction on allergic rhinitis and immune balance of Th1/Th2 in lung qi weak and cold pattern patients

目的观察鼻敏煎治疗肺气虚寒型变应性鼻炎的临床疗效及对Treg/Th17转录因子、炎性因子的影响。方法选取2016年2月~2018年4月北京中医医院耳鼻咽喉科确诊的152例常年性变应性鼻炎患者随机分为治疗组和对照组,各76例。治疗组予以鼻敏煎治疗,对照组给予丙酸氟替卡松鼻喷剂喷鼻和氯雷他定片口服,两组均治疗30天。评价两组治疗前、后临床症状评分和生活质量评分,检测治疗前后Foxp3、RORC mRNA的相对表达量及外周血TGF-β和IL-17水平。结果治疗组总有效率为96.05%,对照组为92.11%,两组比较,差异无统计学意义(P=0.494);治疗后两组临床症状评分比较,差异无统计学意义(P=0.607);治疗后两组RQLQ总评分比较,差异有统计学意义(P<0.01);治疗后两组Foxp3 mRNA相对表达量较治疗前明显增高(P<0.01),RORC mRNA相对表达量及较治疗前明显降低(P<0.01);治疗后两组外周血TGF-β水平较治疗前明显增高(P<0.01),外周血IL-17水平治疗前明显降低(P<0.01)。结论鼻敏煎治疗肺气虚寒型常年性变应性鼻炎患者具有很好的改善鼻部和全身症状的作用,调节Treg/Th17细胞失衡,改善体内免疫平衡状态。

OBJECTIVE To observe the clinical efficacy of Bimin Decoction on perennial allergic rhinitis（PAR） of lung qi weak and cold pattern patients and its effects on Treg/Th17 transcription factors and inflammatory cytokines. METHODS One hundred and fifty two patinets with PAR diagnosed in the Department of Otolaryngology in Beijing Hospital of Traditional Chinese Medicine from February 2016 to April 2018 were randomized into take Bimin Decoction（experimental group） or Flixonase nasal spray and Clarityne tablets for 30 days, with 76 cases in each group. The symptom score and quality of life score（RQLQ） were assessed before and after intervention. The relative expression of Foxp3 and RORC mRNA and the level of TGF-β and IL-17 in peripheral blood were also measured. RESULTS The total effective rate of the experimental group was 96.05% and the control group was 92.11%, no statistically significant difference was observed（P=0.494）. The total symptom score between the two groups showed no marked difference（P=0.607）.However the total score of RQLQ between the two groups was significantly different（P〈0.01）. The relative expression of Foxp3 mRNA of both groups was significantly higher than that before intervention（P〈0.01）, and the relative expression of RORC mRNA was significantly lower than that before（P〈0.01）. The level of TGF-β in peripheral blood was notable higher than that before intervention（P〈0.01）in both groups, and the level of IL-17 decreased significantly（P〈0.01） after intervention. No significant difference was found between groups in the levels of Foxp3 and RORC mRNA and the TGF-（3 and IL-17 in peripheral blood（P〉0.05）. CONCLUSION Bimin Decoction could regulate imbalance of T regulatory and Th17 cells to help relieve PAR symptoms and improve rhinitis-related life quality and the state of immune balance.