疏肝活血方对肝郁脾虚型原发性胆汁性肝硬化患者Th17/Treg细胞的调节作用

Regulating Effect of Shugan Huoxue Recipe on Th17/Treg Cell for Patients with Primary Biliary Cirrhosis with Liver-Qi Depression and Spleen Deficiency

目的:观察疏肝活血方治疗肝郁脾虚型原发性胆汁性肝硬化患者的临床治疗效果及其对患者外周血Th17/Treg细胞的调节作用。方法:将178例原发性胆汁性肝硬化患者,随机分为2组,对照组87例,观察组91例。对照组患者口服熊去氧胆酸胶囊10mg/次,10mg/(kg·d)),每日早、晚2次餐后服用;观察组患者在对照组治疗的基础上给予疏肝活血方治疗,每日1剂,3周为1疗程,连续治疗6个月。观察治疗前后2组患者肝功能指标、肝纤化指标及外周血Th17和Treg,血清白细胞介素(IL-17)。比较2组患者治疗6个疗程后的临床分级评分及临床疗效。结果:治疗后2组患者的肝功能指标、肝纤化指标的表达均明显降低(P<0.05),观察组Th17细胞及IL-17水平的降低程度较对照组更为明显(P<0.05),Treg细胞的升高程度也较对照组更加显著(P<0.05);观察组患者各项临床分级评分显著低于对照组(P<0.05);观察组的治疗总有效率为82.4%,疗效明显优于对照组的66.7%(P<0.05)。结论:疏肝活血方治疗肝郁脾虚型原发性胆汁性肝硬化具有良好的临床疗效,其治疗机制可能与调节机体Th17/Treg细胞相关。

Objective: To investigate the clinical therapeutic effect of regulating effect of Shugan Huoxue Decoction in the treatment of liver stagnation and spleen deficiency syndrome in patients with primary biliary cirrhosis and peripheral blood of patients with Th17/Treg cells. Methods: 178 cases of patients with primary biliary cirrhosis,were randomly divided into 2 groups,87 cases in controlled group,91 cases in observation group. The controlled group was treated with Ursodeoxycholic Acid Capules10 mg/time,10 mg/(kg·d)),daily early,late 2 times after meal; Patients in the observation group based on the treatment in the controlled group treated with Shugan Huoxue Recipe,1 dose daily,3 weeks as 1 course of treatment,continuous treatment for6 months to observe the treatment. Before and after the treatment 2 groups of patients with liver function,liver fibrosis index and peripheral blood Th17 and Treg,serum interleukin(IL-17). The 2 groups were compared after 6 courses of clinical grading and clinical curative effect. Results: The liver function index of the 2 groups of patients after treatment,the indexes of liver fibrosis the table was significantly decreased(P<0. 05),the observation group of Th17 cells and IL-17 level decreased more obviously than that in the controlled group(P < 0. 05),increased the level of Treg cells was more significant than the control group(P < 0. 05);Group of patients with the clinical grading score was significantly lower than the controlled group(P< 0. 05); The total effective rate of the observation group was 82. 4%,significantly better than the controlled group 66. 7%(P < 0. 05). Conclusion: Using Shugan Huoxue Decoction in the treatment of liver stagnation and spleen deficiency syndrome of primary biliary cirrhosis has good clinical curative effect,the treatment mechanism may be related to regulating the Th17/Treg cells.