一贯煎加减对干燥综合征阴虚肝郁证患者外周血B淋巴细胞的影响

Effect of Yiguanjian Decoction on peripheral blood B lymphocytes in patients with sicca syndrome with syndrome of Yin Deficiency and Liver stagnation

目的观察一贯煎加减对干燥综合征阴虚肝郁证患者B淋巴细胞的影响,探讨其可能作用机制。方法将2018年5月—2019年4月南京中医药大学附属医院诊治的60例女性干燥综合征阴虚肝郁证患者随机分为2组,对照组30例采用西药硫酸羟氯喹治疗,观察组30例采用中药复方一贯煎加减治疗,2组均连续治疗12周;另选择20例健康体检者作为正常组。观察对照组、观察组治疗前后及正常组外周血B淋巴细胞活化、分化、增殖、凋亡及Tfh细胞比率情况。结果治疗前,观察组和对照组外周血B淋巴细胞活化率、增殖率、凋亡率及Tfh细胞比率均明显高于正常组(P均<0.05),B淋巴细胞分化率显著低于正常组(P均<0.05);与治疗前比较,治疗后观察组和对照组外周血B淋巴细胞活化率、增殖率、凋亡率及Tfh细胞比率均显著降低,细胞分化率显著升高,差异均有统计学意义(P均<0.05);但观察组和对照组外周血B淋巴细胞上述指标组间比较差异均无统计学意义(P均>0.05)。结论一贯煎加减方与硫酸羟氯喹对干燥综合征阴虚肝郁证患者B淋巴细胞异常均有一定调节作用,二者治疗干燥综合征的作用机制类似。

Objective It is to observe the effect of Yiguanjian Decoction on B lymphocytes in patients with sicca syndrome(SS)with syndrome of Yin deficiency and liver stagnation,and to explore its possible mechanism.Methods 60 female patients with SS with syndrome of Yin deficiency and liver stagnation diagnosed and treated in the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from May 2018 to April 2019 were randomly divided into 2 groups.The control group(n=30)was treated with hydroxychloroquine sulfate,the observation group(n=30)were treated with Yiguanjian Decoction,and both groups were treated continuously for 12 weeks;another 20 healthy subjects were selected as the normal group.The activation,differentiation,proliferation,apoptosis and Tfh cell ratio of peripheral blood B lymphocytes in the control group,observation group before and after treatment,and in the normal group were observed.Results Before treatment,the activation rate,proliferation rate,apoptosis rate and Tfh cell ratio of peripheral blood B lymphocytes in the observation group and the control group were significantly higher than those in the normal group(all P<0.05),and the differentiation rate of B lymphocytes was significantly lower than that in the normal group(P<0.05);compared with before treatment,the activation rate,proliferation rate,apoptosis rate and Tfh cell ratio of the observation group and the control group were significantly reduced,and the cell differentiation rate was significantly increased after treatment,all the differences were statistically significant(all P<0.05),but there was no statistically significant difference in the above-mentioned indicators of peripheral blood B lymphocytes between the observation group and the control group(all P>0.05).Conclusion Both Yiguanjian Decoction and hydroxychloroquine sulfate have a certain regulatory effect on the abnormality of B lymphocytes in patients with SS with Yin-deficiency and liver-stagnation,and their mechanism of action in treating SS is similar.