莲蓣消瘿汤对桥本甲状腺炎患者外周血TREM2的影响及相关临床意义

Effect of Lianyu Xiaoying Decoction on TREM2 in Peripheral Blood of Patients with HT and Its Clinical Significance

目的:观察莲蓣消瘿汤对甲状腺功能正常桥本甲状腺炎患者外周血TREM2水平的影响及临床意义。方法:选取符合纳入标准的甲状腺功能正常的桥本甲状腺患者132例,采用随机、对照、平行的实验设计方法,将其分为汤药组(莲蓣消瘿汤)、西药组(硒酵母)和联合组(莲蓣消瘿汤联合硒酵母),治疗12周。通过化学发光免疫分析法检测治疗前后FT3、FT4、TSH、TPO-Ab、TG-Ab浓度,酶联免疫吸附法(ELISA)测定IL-17、IFN-γ的表达量,流式细胞技术测定髓样细胞触发受体2(TREM2)在外周血单个核细胞(peripheral blood mononuclear cell,PBMC)中的水平。结果:联合组、汤药组和西药组3组TPO-Ab、TG-Ab均低于治疗前(P<0.01,P<0.05),联合组、汤药组IL-17、IFN-γ低于治疗前(P<0.05),联合组、汤药组TREM2在PBMC比例高于治疗前(P<0.05)。治疗后联合组TPO-Ab、TG-Ab、血清IL-17、IFN-γ水平明显低于汤药组和西药组(P<0.05,P<0.01),汤药组TPO-Ab、TG-Ab、血清IL-17、IFN-γ水平低于西药组(P<0.05,P<0.01);联合组TREM2在PBMC比例明显高于汤药组和西药组(P<0.05),汤药组TREM2在PBMC比例高于西药组(P<0.05)。结论:莲蓣消瘿汤降低甲状腺功能正常桥本甲状腺炎患者血清TPO-Ab、TG-Ab滴度,血清IL-17、IFN-γ水平,升高TREM2在外周血单个核细胞(PBMC)中的比例,调节机体免疫功能,改善桥本甲状腺炎。

Objective:To observe the effect of Lianyu Xiaoying Decoction on TREM2 in peripheral blood of patients with Hashimoto thyroiditis(HT)with normal thyroid function and its clinical significance.Methods:132 cases of HT with normal thyroid function,which met the inclusion criteria,were randomly divided into the decoction group(Lianyu Xiaoying Decoction),the western medicine group(Selenious yeast)and the combination group(Lianyu Xiaoying Decoction+Selenious yeast).After 12 weeks of the treatment,the concentrations of FT3,FT4,TSH,TPO-Ab and TG-Ab were detected by chemiluminescence immunoassay(CLIA),the expressions of IL-17 and IFN-γwere determined by enzyme-linked immunosorbent assay(ELISA),and the level of TREM2 in the peripheral blood mononuclear cell(PBMC)was determined by flow cytometry.Results:The levels of TPO-Ab and TG-Ab were lower after the treatment than those before the treatment in the three groups(P<0.05).The levels of IL-17 and IFN-γwere lower and the proportion of TREM2 in PBMC was higher after the treatment than those before the treatment in the combination group and the decoction group(P<0.05).In terms of the levels of TPO-Ab,TG-Ab,IL-17 and IFN-γafter the treatment,they were significantly lower in the combination group than those in the decoction group and western medicine group(P<0.05);also they were lower in the decoction group than those in the western medicine group(P<0.05).The proportion of TREM2 in PBMC was significantly higher in the combination group than that in the decoction group and the western medicine group after the treatment(P<0.05);also the decoction group was higher than the western medicine group(P<0.05).Conclusion:Lianyu Xiaoying Decoction can notably decrease the levels of TPO-Ab,TG-Ab,IL-17 and IFN-γ,as well as increase the proportion of TREM2 in PBMC in the treatment of Hashimoto thyroiditis with normal thyroid function.The therapy can regulate immune function to improve HT.