清胰利胆颗粒联合床旁CRRT疗法对SAP患者炎性因子、免疫功能及外周血Foxp3、RORγt mRNA表达的影响

Effect of Qingyilidan Granule Combined with Bedside CRRT on Inflammatory Factors, Immune Function and the Expression of Foxp3 and RoR γt mRNA in Peripheral Blood of Patients with Severe Acute Pancreatitis

目的:探讨清胰利胆颗粒联合床旁连续性肾脏替代治疗(CRRT)对重症急性胰腺炎(SAP)患者炎性因子、免疫功能及外周血叉状头/翅膀状螺旋转录因子(Foxp3)、维甲酸相关孤独受体γt(RORγt)m RNA表达的影响。方法:选取2017年3月~2019年12月期间我院收治的SAP患者80例,根据随机数字表法分为对照组(n=40)和研究组(n=40),对照组患者予以床旁CRRT疗法治疗,研究组在对照组的基础上联合清胰利胆颗粒治疗,比较两组疗效、炎性因子、免疫功能、外周血Foxp3、RORγt mRNA相对表达量及不良反应。结果:研究组治疗后临床总有效率为87.50%(35/40),高于对照组患者的70.00%(28/40)(P<0.05)。研究组治疗后免疫球蛋白G(Ig G)、免疫球蛋白A(Ig A)、免疫球蛋白M(Ig M)、Foxp3 m RNA相对表达量较治疗前升高,且高于对照组(P<0.05)。两组治疗后白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、RORγt m RNA相对表达量较治疗前降低,且研究组低于对照组(P<0.05)。两组在治疗过程中均未出现严重不良反应。结论:清胰利胆颗粒联合床旁CRRT疗法治疗SAP,疗效显著,可有效改善患者炎性因子、免疫功能,其主要作用机制可能与外周血Foxp3、RORγt m RNA相对表达量有关。

Objective: To investigate the effect of qingyilidan granule combined with continuous renal replacement therapy(CRRT) on inflammatory factors, immune function and the relative expression of forked head/wing spiral transcription factor(Foxp3) and retinoic acid related lone receptor γt(ROR γT) m RNA in patients with severe acute pancreatitis(SAP). Methods: 80 SAP patients who were admitted to our hospital from March 2017 to December 2019 were selected, they were randomly divided into two groups: control group(n=40) and study group(n=40). Patients in the control group were treated with CRRT beside the bed. The study group was treated with Qingyi Lidan Granule on the basis of the control group. The efficacy, inflammatory factors, immune function, The relative expression of m RNA Foxp3, ror γt and adverse reactions of the two groups were compared. Results: The total clinical effective rate was87.50%(35/40) in the study group, which was higher than 70.00%(28/40) in the control group(P<0.05). The relative expression of immunoglobulin G(Ig G), immunoglobulin A(IGA), immunoglobulin M(Ig M), Foxp3 m RNA in the study group was higher than that in the control group(P<0.05). The relative expressions of Interleukin-6(IL-6), interleukin-8(IL-8), tumor necrosis factor-α(TNF-α) and ror γt m RNA in the two groups were lower than those in the control group(P<0.05). There were no adverse reactions in the two groups. Conclusion: Qingyilidan granule combined with bedside CRRT can effectively improve the inflammatory factors and immune function of patients with SAP, and its main mechanism may be related to the relative expression of Foxp3 and ror γ t m RNA in peripheral blood.