| 来洁,王安妮,朱梦洁,等.消瘀泄浊饮对慢性肾脏病2～4期患者Th17/Treg细胞免疫平衡的影响[J].浙江中医药大学学报,2021,45(7):761-764, 791. |
| 消瘀泄浊饮对慢性肾脏病2～4期患者Th17/Treg细胞免疫平衡的影响 |
| The Effect of Xiaoyu Xiezhuo Decoction on Th17/Treg Cell Immune Balance in Patients with Chronic Kidney Disease Stage 2～4 |
| DOI：10.16466/j.issn1005-5509.2021.07.014 |
| 中文关键词: 消瘀泄浊饮 慢性肾脏病 气虚夹瘀 Th17细胞 Treg细胞，CD+4T细胞 免疫平衡 24h尿蛋白定量 |
| 英文关键词: Xiaoyu Xiezhuo Decoction chronic kidney disease Qi deficiency and blood stasis Th17 Treg CD+4T immune balance 24 hour urinary protein quantity |
| 基金项目:浙江省自然科学基金项目(LY16H270007) |
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| 中文摘要: |
| [目的]观察消瘀泄浊饮对慢性肾脏病(chronic kidney disease，CKD)2～4期患者辅助性T细胞17(T helper cell 17，Th17)/调节性T细胞(regulatory cells，Treg)免疫平衡的影响。[方法]选取CKD 2～4期气虚夹瘀型患者共80例，随机分为两组:对照组40例，仅予基础治疗；治疗组40例，除基础治疗外加用中药汤剂消瘀泄浊饮治疗，1剂/d，分早晚两次服用。治疗12周后，比较两组治疗前后外周血Th17、Treg细胞占CD+4T细胞的比例和相关指标变化情况，对比总结其临床疗效。[结果]治疗组治疗后，Th17、血肌酐(serum creatinine，Scr)、血尿素氮(blood urea nitrogen，BUN)、24h尿蛋白定量(24 hour urinary protein quantity，24UPr)水平较治疗前明显下降(P＜0.01)，血低密度脂蛋白胆固醇(low density lipoprotein cholesterin，LDL-C)水平较治疗前下降(P＜0.05)，白蛋白(albumin，ALB)水平较治疗前明显升高(P＜0.01)，Treg水平较治疗前升高(P＜0.05)。治疗后治疗组Th17、Scr、BUN水平低于对照组(P＜0.05)。治疗组总体疗效评价中总有效率42.5%，明显高于对照组(P＜0.01)。[结论]消瘀泄浊饮配合复方α-酮酸片等基础治疗，能够提高CKD 2～4期气虚夹瘀型患者Treg细胞水平，降低Th17细胞水平，恢复Th17/Treg免疫平衡状态，同时能够改善肾功能，延缓CKD病情进展。 |
| 英文摘要: |
| [Objective] To observe the effect of Xiaoyu Xiezhuo Decoction on T helper cell 17(Th17)/regulatory cells(Treg) cell immune balance in patients with chronic kidney disease(CKD) in stage 2～4.[Methods] A total of 80 patients with CKD stage 2～4 Qi deficiency and blood stasis syndrome were selected and randomly divided into two groups: 40 cases in control group， the patients were only given basic treatment; 40 cases in treatment group were treated with Xiaoyu Xiezhuo Decoction in addition to basic treatment， 1 dose per day， once in the morning and once in the evening. After 12 weeks of treatment， the ratio of Th17 and Treg cells in peripheral blood to CD+4 T cells and changes in related indicators were compared between the two groups before and after treatment， and the clinical efficacy was compared.[Results] After treatment， the levels of Th17，serum creatinine(Scr)， blood urea nitrogen(BUN) and 24 hour urinary protein quantity(24UPr) in treatment group were significantly lower than before treatment(P＜0.01)， the level of low density lipoprotein cholesterin(LDL-C) was lower than before treatment(P＜0.05)， and the level of albumin(ALB) was significantly higher than before treatment(P＜0.01)，the level of Treg was higher than before treatment(P＜0.05). After treatment， the ratio of Th17， and the levels of Scr and BUN in treatment group were lower than those in control group(P＜0.05). The total effective rate of treatment group was 42.5%， significantly higher than that of control group(P＜0.01).[Conclusion] Xiaoyu Xiezhuo Decoction combined with compound α-ketoacid tablets and other basic treatment of patients with CKD stage 2～4 Qi deficiency and blood stasis syndrome can increase the level of Treg cells， reduce the level of Th17 cells， and restore the immune imbalance of Th17/Treg， and protect the kidney function， delay the progress of CKD. |
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