莲蓣消瘿汤对桥本甲状腺炎患者外周血中CD4^(+)CD45RO^(+)记忆性T细胞的影响

Effect of Lianyu Xiaoying Decoction(莲蓣消瘿汤) on CD4^(+)CD45RO^(+) Memory T Cell in Peripheral Blood of Patients with Hashimoto Thyroiditis with Normal Thyroid Function

目的:观察莲蓣消瘿汤对甲状腺功能正常的桥本甲状腺炎(HT)患者外周血CD4^(+)CD45RO^(+)记忆性T细胞水平的影响。方法:将132例甲状腺功能正常的HT肝郁脾虚证患者随机分为中药组(莲蓣消瘿汤)、西药组(硒酵母)、中药联合西药组(联合组),每组44例,治疗12周,治疗前后通过化学发光免疫分析法检测血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)、甲状腺过氧化物酶抗体(TPO-Ab)、甲状腺球蛋白抗体(Tg Ab)浓度,酶联免疫吸附法(ELISA)测定血清白细胞介素-17(IL-17)、干扰素-γ(IFN-γ)的表达量,流式细胞技术测定CD4^(+)CD45RO^(+)记忆性T细胞在外周血单个核细胞(PBMC)中的百分比。结果:联合组、中药组、西药组患者治疗后TPO-Ab、Tg Ab低于治疗前(P<0.05),联合组、中药组患者治疗后IL-17、IFN-γ、CD4^(+)CD45RO^(+)记忆性T细胞在PBMC中百分比均低于治疗前(P<0.01);治疗后组间比较,联合组患者血清TPO-Ab、Tg Ab、IL-17、IFN-γ水平明显低于中药组、西药组(P<0.05),中药组患者血清TPO-Ab、Tg Ab、IL-17、IFN-γ水平低于西药组(P<0.05),联合组、中药组患者CD4^(+)CD45RO^(+)记忆性T细胞在PBMC中百分比均低于西药组(P<0.01),中药组患者治疗后CD4^(+)CD45RO^(+)记忆性T细胞在PBMC中百分比与联合组比较,差异无统计学意义(P>0.05)。结论:莲蓣消瘿汤能降低甲状腺功能正常的HT患者血清TPO-Ab、Tg Ab滴度及血清IL-17、IFN-γ水平,并降低CD4^(+)CD45RO^(+)记忆性T细胞在PBMC中百分比,调节机体免疫功能,改善桥本甲状腺炎。

Objective:To observe the effect and clinical significance of Lianyu Xiaoying(LYXY)Decoction on peripheral blood CD4^(+)CD45RO^(+) memory T cell levels in Hashimoto Thyroiditis(HT)with normal thyroid function.Methods:Totally 132 patients with HT were randomly divided into Chinese medicine group(LYXYDecoction),western medicine group(Selenious yeast)and combination group,44 cases in each group.Treatment lasted 12 weeks.The concentration of FT3,FT4,TSH,TPO-Ab and TG-Ab were detected by chemiluminescence immunoassay.The expression level of IL-17 and IFN-γ were determined by enzyme-linked immunosorbent assay(ELISA),and the level of CD4^(+)CD45RO^(+) memory T cells in the PBMC was determined by flow cytometry.Results:Comparing with before treatment,the combination group,Chinese medicine group and western medicine group showed lower TPO-Ab and TG-Ab after treatment(P<0.05);the combination group and Chinese medicine group showed lower serum IL-17,IFN-γ and CD4^(+)CD45RO^(+) memory T cells in PBMC after treatment(P<0.01).After treatment,the combination group showed lower levels of TPO-Ab,TG-Ab,serum IL-17 and serum IFN-γ than Chinese medicine group and western medicine group(P<0.05);And Chinese medicine group showed lower TPO-Ab,TG-Ab,serum IL-17 and serum IFN-γ levels than western medicine group(P<0.05);the combination group and Chinese medicine group showed lower proportion of CD4^(+)CD45RO^(+) memory T cells in PBMC than western medicine group(P<0.01).After treatment,there was no statistical difference in CD4^(+)CD45RO^(+) memory Tcells in PBMC between the combination group and Chinese medicine group(P>0.05).Conclusion:LYXY Decoction could notably decrease the titer of TPO-Ab and TG-Ab,the level of serum IL-17,serum IFN-γ and CD4^(+)CD45RO^(+) memory T cells in PBMC of patients with Hashimoto thyroiditis with normal thyroid function,regulate the body’s immune function and improve Hashimoto thyroiditis.