补虚化瘀法调控Th17紊乱治疗肝性骨营养不良的临床观察

The clinical observation of the Supplement deficiency dissipation blood stasis for the regulation Th17 imbalance in treating Hepatic osteodystrophy

目的:证实补虚化瘀法方可通过调节Th17的平衡,改善气虚血瘀证的肝性骨营养不良。方法:将肝性骨营养不良患者随机分为治疗组(15例)、对照组(15例)。治疗组给予补虚化瘀方药,对照组给予仙灵骨葆胶囊。治疗3个月后比较两组患者钙磷代谢指标、骨代谢指标、骨密度、中医证候积分情况及外周血中IL-17表达。结果:①骨代谢指标:治疗后治疗组β-CTX指标高于对照组(P<0.05);治疗组、对照组治疗后1,25-(OH)2D 3指标均高于治疗前(P<0.05)。②骨密度:治疗组患者治疗后骨密度情况优于治疗前(P<0.05)。③中医证候积分:治疗组、对照组治疗前中医证候积分均高于治疗后(P<0.01)。④IL-17:治疗组治疗后IL-17浓度低于治疗前,与对照组治疗后,比较有统计学意义(P<0.05)。结论:补虚化瘀方系“从肝论治”,能调控Th17紊乱,有效改善患者临床症状与生化指标,提高生存质量,值得临床推广。

Objective:To observe the effect of the Supplement deficiency dissipation blood stasis for the regulation Th17 imbalance in treating Hepatic osteodystrophy.Methods:The patients of HOD were randomly divided into the treatment group and control group,15 cases in each group.The treatment group were treated with the Supplement deficiency dissipation blood stasis recipe.The control group were treated with“xian ling gu bao”capsule.After 3 months,indicators of liver function,metabolism of calcium phosphate,bone metabolism,bone mineral density,the Chinese medical score and IL-17 expression in peripheral blood of the both groups were measured.Results:(1)The bone metabolism index:Theβ-CTX index was higher than the control group after treatment in treatment group(P<0.05);The 1,25-(OH)2D3 index of the treatment group before treatment was higher than the group after treatment(P<0.05).(2)The bone mineral density:The treatment group after treatment was better than the before treatment(P<0.05).(3)The Chinese medical score:The treatment group before treatment was higher than the after treatment(P<0.01).The control group before treatment was higher than the after treatment(P<0.01).(4)The concentration of IL-17:The control group after treatment was higher than the treatment group(P<0.05);The treatment group after treatment was higher than the before treatment(P<0.05).Conclusion:The Supplement deficiency dissipation blood stasis recipe was the same as“The theory of liver treatment”,and can regulate Th17 immune imbalance,to improve patients’clinical symptoms,biochemical indicators,improve the quality of survival and worth clinical promotion.