玉屏风散加味方对肺气虚寒型变应性鼻炎患者的临床疗效 及IL-17A、TGF-β1表达的影响*
作者:
作者单位:

(1. 广州中医药大学附属中山医院,广东 中山 528400;2. 广州中医药大学第一附属医院,广东 广州 510405; 3. 广州中医药大学,广东 广州 510405)

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R276.1

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收稿日期: 2018 - 07- 27
*基金项目: 广东省自然科学基金项目(2017A030313626);中山市科技计划项目(2015B1052)
第一作者简介: 张丽娟(1982-),女,硕士,主治中医师,研究方向:中医耳鼻咽喉疾病的临床与基础研究。
△通信作者: 李得堂,E-mail:lidetang2002@163.com


Effect of Modified Yupingfeng San of Lung Deficiency-cold Type AR Patients with the Clinical Efficacy and IL-17A, TGF-β1 Expression
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(1. Zhongshan Hospital Affiliated To Guangzhou University of Chinese Medicine, ZhongShan 528400, China; 2. The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, China; 3. Guangzhou University of Chinese Medicine, Gua

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    摘要:

    目的探讨玉屏风散加味方对肺气虚寒型变应性鼻炎(allergic rhinitis,AR)患者的疗效,及外周血Th17/Treg细胞中特征因子IL-17A、TGF-β1表达的影响。方法选取肺气虚寒型AR患者19例,健康志愿者10例作对照,肺气虚寒型AR患者组进行分类及分度为4组:轻度间歇性、中-重度间歇性、轻度持续性及中-重度持续性,玉屏风散加味方治疗14 d,进行治疗前后量表评分,评价其临床疗效,及ELISA法检测治疗前后各组血清IL-17A、TGF-β1的表达。结果玉屏风散加味方治疗后,VAS、TNSS、TNNSS及RQLQ量表评分均显著低于治疗前(**P<0.01)。19例肺气虚寒型AR患者IL-17A及TGF-β1表达显著高于对照组(**P<0.01),不同分类与分度的肺气虚寒型AR患者,中-重度间歇性、轻度持续性及中-重度持续性AR组IL-17A及TGF-β1表达显著高于对照组(**P<0.01,*P<0.05),轻度间歇性AR组IL-17A表达明显高于对照组(*P<0.05),而轻度间歇性AR组TGF-β1表达与对照组无差别(P>0.05)。中-重度间歇性、轻度持续性及中-重度持续性AR组IL-17A及TGF-β1表达明显高于轻度间歇性AR(*P<0.05)。治疗后,IL-17A、TGF-β1表达均有下降,治疗组IL-17A及TGF-β1表达明显低于治疗前的AR组(*P<0.05,**P<0.01),具有统计学差异。结论肺气虚寒型AR患者,玉屏风散加味方治疗后,粘膜水肿、炎症和鼻痒、喷嚏、清水样鼻涕的症状明显改善,量表评分值显著降低,Th17/Treg免疫失衡有所改善,玉屏风散加味方对肺气虚寒型AR患者有确切的临床疗效及调节Th17/Treg免疫失衡的作用。

    Abstract:

    Objective To investigate the therapeutic effect of modified Yupingfeng San on Lung deficiency-cold type AR patients, and the influence of peripheral blood Th17/Treg cells characteristic factor IL-17A, TGF-β1 expression. Methods The selection of the treatment of 19 cases of lung deficiency-cold type AR patients, 10 healthy volunteers as control group, of patients with AR deficiency type classification and dividing into 4 groups: Mild intermittent AR、 Moderate to severe intermittent AR、 Mild persistent AR and Moderate to severe persistent AR, modified Yupingfeng San for the treatment of 14d, treatment before and after the score and to evaluate its clinical efficacy, the expression of serum IL-17A, TGF-β1 and ELISA were detected before and after treatment. Results The scores of VAS, TNSS, TNNSS and RQLQ were significantly lower than those before treatment after the treatment of modified Yupingfeng San(**P<0.01). 19 cases of lung deficiency-cold type AR patients IL-17A and TGF-β1 expression was significantly higher than the control group(**P<0.01), different classifications and grades of lung deficiency-cold type AR patients, moderate to severe intermittent, mild persistent and moderate severe persistent AR group IL-17A and TGF-β1 expression was significantly higher than the control group(**P<0.01, *P<0.05), mild intermittent group IL-17A expression was significantly higher than the control group(*P<0.05), and mild intermittent AR group TGF-β1 expression no difference the control group(*P>0.05). The expression of IL-17A and TGF-β1 in moderate to severe intermittent, mild persistence and moderate to severe persistent AR group was significantly higher than that of mild intermittent AR(*P<0.05). After treatment, the expression of IL-17A and TGF-β1 decreased. The expression of IL-17A and TGF-β1 in the treatment group was significantly lower than that in the AR group before treatment, with statistical difference(**P<0.01, *P<0.05). Conclusion Patients with lung deficiency-cold type AR, modified Yupingfeng San prescription treatment, mucosal edema, inflammation and nasal itching, sneezing, rhinorrhea symptoms improved, gauge score was significantly reduced, the immune imbalance of Th17/Treg improved effect of modified Yupingfeng San of lung deficiency-cold type AR patients have clinical curative effect and regulation the immune imbalance of Th17/Treg.

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