凉血活血方敷贴治疗湿热蕴结型急性痛风性关节炎的疗效及对Th17/Treg细胞平衡的影响

Efficacy of Liangxue Huoxue Recipe Application in the Treatment of Acute Gouty Arthritis of Dampness-Heat Accumulation Type and Its Effect on Th17/Treg Cell Balance

目的:探讨凉血活血方敷贴治疗湿热蕴结型急性痛风性关节炎的临床疗效及对辅助型T细胞17/调节型T细胞(Th17/Treg)平衡的影响。方法:选取2019年6月至2021年3月于该院住院治疗的80例急性痛风性关节炎患者纳入研究,采用随机数字表法分为观察组和对照组(每组40例),对照组患者采取基础治疗方案,观察组患者在基础治疗方案上采用凉血活血方敷贴进行治疗。对比两组患者疗程结束后的疗效情况,治疗前后中医症状积分,CD4^(+)T淋巴细胞的Th17(CD3^(+)CD4^(+)IL-17^(+))、Treg(CD4^(+)CD25^(+)CD127^(+))细胞百分比和Th17/Treg比值,以及血尿酸(UA)、血沉(ESR)、转化生长因子-β1(TGF-β1)、白细胞介素-17(IL-17)和C反应蛋白(CRP)水平。结果:治疗后,两组患者中医症状积分均显著降低,且观察组患者改善更明显,差异均有统计学意义(P<0.05)。观察组患者治疗总有效率为97.50%(39/40),对照组为85.00%(34/40),两组的差异有统计学意义(χ^(2)=3.914,P<0.05)。治疗后,两组患者Th17细胞百分比和Th17/Treg比值均显著降低,且观察组患者改善更明显,差异均有统计学意义(P<0.05);两组患者Treg细胞百分比显著升高,且观察组患者改善更明显,差异均有统计学意义(P<0.05)。治疗后,两组患者UA、ESR、IL-17和CRP水平均显著降低,且观察组患者改善更明显,差异均有统计学意义(P<0.05);两组患者TGF-β1水平显著升高,且观察组患者改善更明显,差异均有统计学意义(P<0.05)。结论:凉血活血方敷贴可有效改善湿热蕴结型急性痛风性关节炎患者的UA水平,减轻机体炎症反应,并调节Th17/Treg细胞平衡。

OBJECTIVE:To probe into the clinical efficacy of Liangxue Huoxue recipe application in the treatment of acute gouty arthritis of dampness-heat accumulation type and its effect on T helper cells 17/T regulatory cells(Th17/Treg)cell balance.METHODS:A total of 80 patients with acute gouty arthritis admitted into the hospital from Jun.2019 to Mar.2021 were extracted to be divided into the observation group and the control group via the random number table method(with 40 cases in each group).The control group was treated with basic treatment regimen,while the observation group received Liangxue Huoxue formula application based on the basic treatment regimen.Clinical efficacy,traditional Chinese medicine symptom scores,Th17(CD3^(+)CD4^(+)IL-17^(+)),Treg(CD4^(+)CD25^(+)CD127^(+))cell percentage and Th17/Treg ratio of CD4^(+)T lymphocytes,serum uric acid(UA),erythrocyte sedimentation rate(ESR),transforming growth factor-β1(TGF-β1),interleukin-17(IL-17)and C-reactive protein(CRP)levels before and after treatment of two groups were compared.RESULTS:After treatment,the traditional Chinese medicine symptom scores of two groups decreased significantly,and the improvement in the observation group was more significant,and the differences were statistically significant(P<0.05).The total effective rate of the observation group was 97.50%(39/40),and that of the control group was 85.00%(34/40),the difference was statistically significant(χ^(2)=3.914,P<0.05).After treatment,the Th17 cell percentage and Th17/Treg ratio in two groups decreased significantly,and the improvement in the observation group was more significant,the differences were statistically significant(P<0.05);the Treg cell percentage in two groups increased significantly,and the improvement in the observation group was more significant,the differences were statistically significant(P<0.05).After treatment,the levels of UA,ESR,IL-17 and CRP in two groups decreased significantly,and the improvement in the observation group was more significant,with statistically significant differences(P<0.05);the level of TGF-β1 in two groups increased significantly,and the improvement in the observation group was more significant,with statistically significant differences(P<0.05).CONCLUSIONS:Liangxue Huoxue recipe application can effectively improve the UA level of patients with acute gouty arthritis of dampness-heat accumulation type,reduce the inflammatory response,and regulate the balance of Th17/Treg cells.