丹参联合生脉注射液通过IL-23/IL-17轴调节脓毒症患者Treg/Th17失衡作用机制研究

Study on the Mechanism of Salvia Miltiorrhiza Combined with Shengmai Injection to Regulate Treg/Th17 Imbalance in Sepsis Patients through IL-23/IL-17 Axis

目的观察丹参联合生脉注射液通过IL-23/IL-17轴调节脓毒症患者Treg/Th17失衡的作用机制。方法选取2018年1月—2019年12月收入西南医科大学附属中医医院重症医学科的30例脓毒症患者,随机分为治疗组和对照组,每组15例。2组患者均采用西医集束式治疗方案,治疗组加用丹参联合生脉注射液,疗程为7 d。比较2组的序贯器官衰竭估计(Sequential organ failure assessment,SOFA)评分、急性生理学与慢性健康状况评分系统Ⅱ(Acute physiology and chronic health evaluation scoring systemⅡ,APACHEⅡ)评分,流式细胞仪检测Treg和Th17水平及其细胞比,ELISA法检测IL-23、IL-17水平。结果2组患者治疗后的SOFA评分、APACHEII评分、Th17、IL-23及IL-17水平低于治疗前,治疗组患者治疗后的APACHEII评分、IL-23及IL-17水平低于对照组,差异均有统计学意义(P<0.05);治疗后,治疗组的Treg高于治疗前,对照组的Treg低于治疗前,2组的Th17低于治疗前,2组的Treg/Th17高于治疗前,治疗组患者治疗后的Treg、Treg/Th17高于对照组,差异均有统计学意义(P<0.05)。结论丹参联合生脉注射液能够通过抑制IL-23/IL-17轴改善脓毒症患者Treg/Th17失衡从而发挥辅助增强抗炎反应的作用机制。

Objective To observe the effect of Salvia Miltiorrhiza combined with Shengmai injection on regulating Treg/Th17 imbalance in sepsis patients through IL-23/IL-17 axis.Methods A total of 30 sepsis patients who met the diagnostic criteria from January 2018 to December 2019 in the department of intensive medicine of Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University were divided into treatment group and control group,with 15 cases in each group.Both groups of patients were treated with western medicine cluster therapy.The treatment group added Salvia Miltiorrhiza combined Shengmai injection.The course of treatment was 7 days.The sequential organ failure assessment(SOFA)score,acute physiology and chronic health evaluation scoring systemⅡ(APACHEII)score before and after treatment was calculated,flow cytometry was used to detect Treg and Th17 cell ratio,and ELISA method was used to detect IL-23,IL-17.Results The SOFA score,APACHEII score,IL-23 and IL-17 of the two groups were lower than before treatment.After treatment,the treatment group was more significantly reduced than the control group APACHEII score,IL-23 and IL-17,and the difference was statistically significant(P<0.05).The proportion of Th17 in the two groups was significantly reduced,and the Treg/Th17 was significantly increased,and the difference was statistically significant(P<0.05).the proportion of Treg in the treatment group was significantly increased,and the proportion of Treg in the control group was significantly decreased,and the difference was statistically significance(P<0.05).Compared with the control group,the percentage of Th17 decreased more in the treatment group,and the percentage of Treg and Treg/Th17 increased more significantly.The difference was statistically significant(P<0.05).Conclusion Salvia miltiorrhiza combined with Shengmai injection can improve the imbalance of Treg/Th17 in patients with sepsis by inhibiting the IL-23/IL-17 axis to play an auxiliary role in enhancing the anti-inflammatory response.