滋水清肝饮加减方对2型糖尿病患者正性共刺激分子ICOS/ICOSL、OX40/OX40L免疫调节作用的影响

Effect of Zishui Qinggan Yin in Treatment of Type 2 Diabetes Mellitus in Positive Co-stimulatory Molecules ICOS/ICOSL and OX40/OX40L on Immune Regulation Effect

目的:研究滋水清肝饮加减方对2型糖尿病患者正性共刺激分子ICOS/ICOSL、OX40/OX40L的免疫调节作用的影响。方法:随机抽取2016年1月—2017年3月本院收治的90例2型糖尿病患者,依据治疗措施差异分作两组,各45例,对照组施予甘精胰岛素治疗,于此基础,观察组施予滋水清肝饮加减方治疗,比较两组正性共刺激分子ICOS/ICOSL、OX40/OX40L。结果:治疗后,(1)在B细胞上,观察组ICOS/ICOSL表达(0.71±0.04)%,OX40/OX40L(6.05±0.83)%,分别比对照组的(2.11±0.37)%及(11.58±2.10)%低,差异有统计学意义(P<0.05);(2)在CD4+T细胞上,观察组ICOS/ICOSL表达(0.61±0.01)%,OX40/OX40L(0.30±0.03)%,分别比对照组的(1.60±0.17)%及(1.13±0.20)%低,差异有统计学意义(P<0.05);(3)对于合并大血管病变者,观察组B细胞、CD4+T细胞上的ICOS/ICOSL、OX40/OX40L表达均比对照组低,差异有统计学意义(P<0.05);(4)观察组血糖及总胆固醇(Total Cholesterol,TC)、糖化血清蛋白(Glucosylated serum protein,GSP)水平均比对照组低,差异有统计学意义(P<0.05)。结论:于2型糖尿病患者中施予滋水清肝饮加减方治疗有助于改善正性共刺激分子ICOS/ICOSL、OX40/OX40L的免疫调节作用,促进合并大血管病变者转归,值得推广。

Objective:To research the effect of Zishui Qinggan Yin in treatment of type 2 diabetes mellitus in positive co-stimulatory molecules ICOS/ICOSL and OX40/OX40 L on immune regulation effect.Methods:We randomly selected 90 type 2 Diabetes mellitus patients from January 2016 to March 2017.On the basis of treatment differences,the patients were divided into two groups,45 patients in each.The control group was treated with Glargine Insulin.On this basis,the observation group was treated with Zishui Qinggan Yin.The positive co-stimulatory molecules ICOS/ICOSL and OX40/OX40 L of two groups were compared.Results:After treatment:(1)On B cells,the expression level of ICOS/ICOSL in observation group was(0.71±0.04)%and the expression level of OX40/OX40 L was(6.05±0.83)%,which were lower than those of the control group[(2.11±0.37)%and(11.58±2.10)%]respectively,and the differences were statistically significant(P<0.05).(2)On CD4+T cells,the expression level of ICOS/ICOSL in observation group was(0.61±0.01)%and the expression level of OX40/OX40 L was(0.30±0.03)%,which were lower than those of the control group[(1.60±0.17)%and(1.13±0.20)%]respectively,and the differences were statistically significant(P<0.05).(3)For patients combined with macrovascular disease,the expression levels of ICOS/ICOSL and OX40/OX40 L on B cells and CD4+T cells in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).(4)The level of blood glucose,total cholesterol(TC)and glucosylated serum protein(GSP)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion:Zishui Qinggan Yin in treatment of type 2 diabetes mellitus is helpful for the positive co-stimulatory molecules ICOS/ICOSL and OX40/OX40 L on immune regulation effect and can improve the prognosis of patients combined with macrovascular disease.It is worthy of promotion.