滋水涵木通络法治疗肝肾不足型斑秃疗效及Th17/Treg相关机制研究

Study of clinical efficacy of Zishui Hanmu Tongluo method on liver and kidney deficiency patients with alopecia areata and mechanisms associated with Th17/Treg

[目的]观察滋水涵木通络法治疗肝肾不足型斑秃的临床疗效,并探讨与Treg/Th17相关的作用机制。[方法] 66例肝肾不足型斑秃患者口服滋水涵木通络方剂,每日1次,持续12周。记录患者治疗前后患处毛发积分以评价治疗效果,并采集正常人及患者外周血,荧光定量聚合酶链式反应(PCR)法测定其中维甲酸相关核孤儿受体γt(RORγt)和叉头框蛋白(Foxp3)mRNA水平,酶联反应吸附(ELISA)法测定白介素(IL)-17A和转化生长因子-β1(TGF-β1)含量。[结果]患者治疗前后的积分分别为(11.85±2.08)分和(3.30±0.94)分,两者比较有统计学差异(P<0.01)。经治疗,多数患者脱发区长出新生毛发,总有效率为96.97%。与健康人相比,患者治疗前RORγt mRNA水平明显升高;而Foxp3 mRNA水平明显降低(P<0.01);患者血清中IL-17A水平显著升高;而TGF-β1水平明显下降(P<0.01)。经治疗,上述各指标均改善,与治疗前相比有统计学差异(P<0.01)。[结论]"滋水涵木通络"法治疗斑秃能调节患者体内Th17/Treg细胞的功能,减轻局部炎症损伤,起到保护毛囊、抑制脱发的作用。

[Objective] In this study, the clinical efficacy of Zishui Hanmu Tongluo method on liver and kidney deficiency patients with alopecia areata and mechanisms associated with Th17/Treg were investigated.[Methods] Altogether 66 liver and kidney deficiency patients with alopecia areata were enrolled and received "Zishui Hanmu Tongluo" method orally once daily for 12 weeks. The pre-and post-treatment scores of hair loss in the affected areas were recorded to evaluate the therapeutic effect. The peripheral blood of normol controls and patients with alopecia areata were collected, then the m RNA expression levels of RORγt and Foxp3 were determined by fluorescence quantitative PCR and the concentrations of IL-17 A and TGF-β1 were measured by ELISA.[Results] The pre-and posttreatment scores of the patients were(11.85±2.08) and(3.30±0.94) respectively, and there were obvious differences between them(P<0.001). After treatment, the affected areas grow new hair in majority of patients, and the effective rate was 96.97%. When compared with the normal controls, the pre-treatment mRNA level of RORγt were increased significantly, whereas Foxp3 m RNA were decreased(P<0.001). The concentration of IL-17 A in serum was significantly higher than that in normal controls, while TGF-β1 was significantly decreased(P<0.01). After treatment, the levels of above indicators changed to the opposite direction, showing significant differences when compared with that of pre-treatment(P<0.01).[Conclusion] The function of Th17 cells was enhanced, whereas the function of Tregs was decreased in patients with alopecia areate. An imbalance of immune functions existed in the bodies of patients."Zishui Chanyu Tongluo"method could regulate the functions of Th17/Treg cells in patients with alopecia areata, reduce local inflammatory injury, protect hair follicle and inhibit hair loss.