柴黄清胰活血颗粒对重症急性胰腺炎患者辅助性T细胞17及其相关因子的调节作用

Regulation effects of the Chaihuang Qingyi Huoxue granule on Th17 and the related factors in patients with severe acute pancreatitis

目的:探究柴黄清胰活血颗粒对重症急性胰腺炎患者辅助性T细胞17(T helper cell 17,Th17)及其相关因子及预后的影响。方法:收集2016年7月-2018年1月在西南医科大学附属中医医院脾胃风湿免疫病科住院的重症急性胰腺炎患者62例,将其随机分为对照组(A组,30例)、试验组(B组,32例),其中B组在常规治疗的基础上予以柴黄清胰活血颗粒管胃及灌肠治疗,A组在常规治疗基础上予以清胰利胆颗粒管胃及灌肠治疗。观察两组患者分别在第1、3、7天症状、体征评分,并采用RT-q PCR技术检测RORγt mRNA的相对表达量,运用酶联免疫吸附测定(ELISA)法检测细胞因子白细胞介素-17(Interlerkin-17,IL-17)及肿瘤坏死因子(Tumor Necrosis Factor-α,TNF-α)水平。结果:两组第3、7天症状及体征评分均低于第1天,且第7天低于第3天,差异均有统计学意义(P<0.05)。A组患者第7天的症状、体征评分高于B组,其差异有统计学意义(P<0.05)。两组第3、7天RORγt mRNA的相对表达量均低于第1天,且第7天低于第3天,差异均有统计学意义(P<0.05)。A组患者第3、7天的RORγt mRNA的相对表达量均高于B组,其差异有统计学意义(P<0.05)。两组第3、7天IL-17水平均低于第1天,且第7天低于第3天,差异均有统计学意义(P<0.05)。A组患者第3、7天的外周血中IL-17水平均高于B组,其差异有统计学意义(P<0.05)。两组第3、7天TNF-α水平均低于第1天,且第7天低于第3天,差异均有统计学意义(P<0.05)。A组患者第3、7天的外周血中TNF-α水平均高于B组,其差异无统计学意义(P>0.05)。结论:柴黄清胰活血颗粒可改善SAP患者的症状、体征,促进患者恢复,可减少重症急性胰腺炎患者RORγt mRNA相对表达量,降低IL-17及TNF-α水平。

Objective:To observe the effect of the Chaihuang Qingyi Huoxue granule(柴黄清胰活血颗粒)on Th17 and the related factors in patients with severe acute pancreatitis.Methods:62 cases were enrolled and randomly divided into A group(30 cases)and B group(32 cases).The patients in the B group were given tube feeding or oral administration and enema with the Chaihuang Qingyi Huoxue granule,and the patients in the A group were given tube feeding or oral administration and enema with the Qingyi Lidan granule(清胰利胆颗粒).Results:The scores of symptoms and signs in groups on the 3 rd day and the 7 th day were lower than those on the 1 st day,and the scores on the 7 th day were lower than those on the 3 rd day(P<0.05).The score on the 7 th day in the A group was higher than that in the B group(P<0.05).The expression of RORγt m RNA in the groups on the 3 rd and the 7 th day was lower than that on the 1 st day(P<0.05).The expression of RORγt m RNA in the A group was higher than that in the B group on the 3 rd and the 7 th day(P<0.05).The expression of IL-17 in the groups on the 3 rd and the 7 th day was lower than that on the 1 st day(P<0.05).The expression of IL-17 in the A group was higher than that in the B group on the 3 rd and 7 th day(P<0.05).The expression of TNF-αin the groups on the 3 rd and the 7 th day was lower than that on the 1 st day(P<0.05).The expression of TNF-αin the A group was higher than that in the B group on the 3 rd and the 7 th day,but the difference was not statistically significant(P>0.05).Conclusion:The Chaihuang Qingyi Huoxue granule can improve the symptoms and signs of patients with severe acute pancreatitis,promote the recovery of the patients and reduce the expression of RORγt m RNA,and decrease IL-17 and TNF-α.