龙胆泻肝汤对分泌性中耳炎血清炎性因子、相关蛋白及免疫功能的影响

Effect of Longdan Xiegantang on Serum Inflammatory Factors,Related Proteins and Immune Function in Patients with Secretory Otitis Media

目的:探究龙胆泻肝汤对肝胆湿热型分泌性中耳炎(SOM)的血清炎性因子、相关蛋白及免疫功能的影响。方法:随机将2017年7月至2018年5月河南省中医院收治的76例肝胆湿热型SOM患者分为两组患者,各38例,对照组采用曲安奈德和氨溴索进行治疗,在对照组的基础上,观察组给予龙胆泻肝汤水煎服。于治疗前后,观察两组患者的免疫球蛋白(Ig) A,Ig G,Ig M,CD3^+,CD4^+,CD8^+,NK,白细胞介素-1β(IL-1β),IL-5,IL-8,肿瘤坏死因子-α(TNF-α),血小板活化因子(PAF),降钙素原(PCT),水通道蛋白-1(AQP-1),AQP-4,纤维连接蛋白(Fn),可溶性白细胞介素-2受体(SIL-2R)水平,并观察两组患者的疗效、不良反应。结果:(1)疗效,治疗后观察组治疗总有效率为92. 11%,高于对照组的76. 32%(Z=2. 108,P <0. 05)。(2)血清炎性介质,观察组治疗后TNF-α,PAF,PCT,IL-1β,IL-8水平低于对照组(P <0. 05)。(3)血清相关蛋白,观察组治疗后SIL-2R水平低于对照组(P <0. 05),观察组治疗后AQP-1,AQP-4,Fn水平高于对照组(P <0. 05)。(4)细胞及体液免疫功能,观察组治疗后CD8^+,Ig A,Ig G,Ig M低于对照组(P <0. 05),CD3^+,CD4^+,CD4^+/CD8^+,NK高于对照组(P <0. 05)。(5)不良反应,两组患者发生率分别为7. 89%,10. 53%,组间差异无统计学意义。结论:龙胆泻肝汤治疗肝胆湿热型SOM效果显著,能恢复症状,抑制炎症反应,激活细胞和体液免疫功能系统,降低AQP-1,SIL-2R等蛋白分泌,提高AQP-4,Fn蛋白分泌。

Objective: To explore the effect of Longdan Xiegantang on serum inflammatory factors,related proteins and immune function in patients of secretory otitis media( SOM) with liver and gallbladder wetnessheat Syndrome. Method: Totally 76 cases of SOM with liver and gallbladder wetness-heat syndrome admitted to our hospital from July 2017 to May 2018 were randomly divided into two groups,with 38 cases in each group. Control group was treated with triamcinolone acetonide and ambroxol. In addition to the therapy of control group,observation group was also treated with Longdan Xiegantang. Immunoglobulin( Ig) A,IgG,IgM,CD3^+,CD4^+,CD8^+and NK,interleukin-1 beta( IL-1β),IL-5,IL-8,tumor necrosis factor-α( TNF-α),platelet activating factor( PAF),calcitonin( PCT) and water channel protein-1( AQP-1),AQP-4,fiber link protein( Fn) and soluble interleukin-2 receptor( SIL-2 R) levels of two groups were observed before and after treatment. Curative effect and adverse reaction were observed. Result:(1) Curative effect,after treatment,the total effective rate of observation group was 92. 11%,which was higher than 76. 32% of control group,with statistically significant differences( Z = 2. 108,P < 0. 05).(2) Serum inflammatory medium,TNF-α,PAF,PCT,IL-1β and IL-8 in observation group were lower than those in control group after treatment( P < 0. 05).(3)Serum related proteins,in observation group,levels of SIL-2 R were lower than those of control group( P < 0. 05),while the levels of AQP-1,AQP-4 and Fn were higher than those of control group( P < 0. 05).(4)Cellular and humoral immunity,CD8^+,IgA,Ig G and IgM of observation group were lower than those of control group( P < 0. 05),while CD3^+,CD4^+,CD4^+/CD8^+and NK were higher than those of control group( P < 0. 05).(5) Adverse reactions,the incidence rates of the two groups were 7. 89% and 10. 53%,respectively,with no statistically significant difference between two groups. Conclusion: Longdan Xiegantang has a remarkable effect in treating patients of secretory otitis media with liver and gallbladder wetness-heat syndrome,and can restore symptoms,inhibit inflammatory response,activate cell and humeral immune system,reduce the secretion of AQP-1,SIL-2 R and other proteins,and increase the secretion of AQP-4 and Fn proteins.