黄芪桂枝汤对反复呼吸道感染患儿Th1/Th2平衡及血清miR-155、miR-146a的影响

Effects of Huangqi Guizhi Decoction on Th1/Th2 Balance and Serum miR-155 and miR-146a in Children with RRTI

目的:探讨黄芪桂枝汤对反复呼吸道感染(RRTI)患儿Th1/Th2平衡及血清微小RNA-155(miR-155)、微小RNA-146a(miR-146a)的影响。方法:选取符合纳入标准的67例反复呼吸道感染患儿依据随机数字表随机分为对照组33例与观察组34例。对照组予以常规西药治疗,观察组在常规西药治疗的基础上予以黄芪桂枝汤。两组均治疗3个月,随访6个月。对比两组患儿治疗前后中医症状积分(胸闷咳喘、咯痰量多、倦怠乏力、腹胀纳呆)、Th1细胞、Th2细胞、Th1/Th2比值及miR-155、miR-146a、白细胞介素-4(IL-4)、白细胞介素-10(IL-10)、和白细胞介素-12(IL-12)水平,并比较临床疗效。结果:观察组总有效率(92.12%,32/34)高于对照组(72.73%,24/33)(P<0.05)。治疗前,两组患儿胸闷咳喘、咯痰量多、倦怠乏力、腹胀纳呆等中医症状积分以及Th1细胞、Th2细胞、Th1/Th2、miR-155、miR-146a、IL-4、IL-10、IL-12水平比较,差异无统计学意义(P>0.05);治疗后,两组患儿中医症状积分、Th2细胞、Th1/Th2、IL-4、IL-10、IL-12水平低于治疗前(P<0.05),miR-155、miR-146a、Th1细胞水平高于治疗前(P<0.05),且观察组上述观察指标均优于对照组(P<0.05)。结论:黄芪桂枝汤治疗反复呼吸道感染效果显著,通过调节Th1/Th2平衡及血清miR-155、miR-146a表达,改善患儿的临床症状。

Objective:To investigate the effects of Huangqi Guizhi Decoction on Th1/Th2 balance and serum miR-155 and miR-146a in children with recurrent respiratory tract infection(RRTI).Methods:A total of 67 children with RRTI were randomly divided into the control group(n=33)and the observation group(n=34).The control group was treated with conventional western medication;on which basis,the observation group was also treated with Huangqi Huizhi Decoction.Both groups were treated for 3 months,and were followed up for 6 months.The scores of TCM symptoms(chest tightness,cough and asthma,heavy expectoration,fatigue,abdominal distention and indigestion),the levels of Th1 cell,Th2 cell,Th1/Th2 ratio and miR-155,miR-146a,IL-4,IL-10 and IL-12 were compared between before and after the treatment in the two groups.Clinical efficacy was also compared between the two groups.Results:The total effective rate was 92.12%(32/34)in the observation group,which was significantly higher than 72.73%(24/33)in the control group(P<0.05).There were no statistical differences in the scores of TCM symptoms and the levels of Th1 cell,Th2 cell,Th1/Th2,miR-155,miR-146a,IL-4,IL-10 and IL-12 between the two groups before the treatment(P>0.05).The scores of TCM symptoms and the levels of Th2 cell,Th1/Th2,IL-4,IL-10 and IL-12 were lower(P<0.05),and the levels of miR-155,miR-146a and TH1 cell were higher after the treatment than those before the treatment in the two groups(P<0.05);of which the improvements in the observation group were more significant than those in the control group(P<0.05).Conclusion:Huangqi Guizhi Decoction has a significant therapeutic effect on RRTI,it can improve clinical symptoms by regulating the Th1/Th2 balance and the serum expressions of miR-155 and miR-146a.