黄芪祛疣汤对尖锐湿疣患者外周血Treg/Th17细胞免疫的影响
|
摘要
目的探讨黄芪祛疣汤治疗尖锐湿疣的疗效及对Treg/Th17细胞免疫的调节作用。方法纳入尖锐湿疣患者共120例作为研究对象,按随机数字表法分为对照组(60例)和治疗组(60例)。对照组采取CO_2激光术治疗;涂抹5%咪喹莫特乳膏于疣体部位,隔日1次,3次/周。治疗组在对照组基础上予黄芪祛疣汤内服治疗,1剂/d,2次/d。2组疗程均2个月。比较2组患者创面愈合时间、临床疗效及复发率。检测2组外周血Treg/Th17细胞及血清白细胞介素(IL)-6、IL-17、转化生子因子(TGF)-β水平。结果治疗组创面平均愈合时间为(11.04±1.34)d,显著低于对照组为(17.15±1.92)d(P<0.05)。治疗组患者总有效率为96.67%,显著高于对照组为81.67%(P<0.05)。随访3个月,治疗组复发率为8.33%,显著低于对照组为21.67%(χ~2=4.002,P<0.05)。治疗后,治疗组患者外周血Treg,Treg/Th17显著低于对照组,Th17显著高于对照组(P<0.01)。治疗组治疗后患者血清IL-6,IL-17水平显著高于对照组,TGF-β水平显著少于对照组(P<0.01)。结论在常规干预基础上,黄芪祛疣汤治疗尖锐湿疣可促进创面愈合,提高疗效,降低复发率,调节血中Treg/Th17细胞免疫可能与其疗效有关。
Objective In order to investigate the efficacy of Huangqi Quyou decoction in treating verruca acuminate and its regulation role of regulatory T cells(Treg)/T helper cell 17(Th17) cell immunity in peripheral blood. Methods One hundred and twenty cases with verruca acuminate were selected and randomly divided into treatment group and control group with 60 in each group according to random number table method. Control group was treated with CO_2 laser surgery and applied with5% miquimod cream(one time/every two days and three times a week). On basis of control group,treatment group was treated with Huangqi Quyou decoction one dose a day and two times a day. Two groups were observed for two months. Wound healing time,clinical efficacy and recurrence rate were compared between the two groups. Peripheral blood level of Treg/Th17 and serum levels of interleukin(IL)-6,IL-17,and transforming factor(TGF)-β were detected in both two groups. Results Wound healing time of treatment group was(11.04±1.34) d,which was obviously less than that of control group(17.15±1.92) d,(P<0.05). The efficacy of treatment group was 96.67%,which was higher than that of control group(81.67%,P<0.05). After three months of follow-up,the recurrence rate of the treatment group was 8.33%,which was significantly lower than that of the control group(21.67%;χ~2=4.002,P<0.05). Peripheral blood level of Treg and Treg/Th17 of treatment group were obviously lower,while Th17 was higher than control group after treatment(P<0.01). Serum levels of IL-6 and IL-17 of treatment group were higher after treatment,while TGF-β was lower than that of control group(P <0.01). Conclusion On the basis of conventional intervention,Huangqi Quyou decoction in treating verruca acuminate can promote wound healing,increase the efficacy,and reduce recurrence rate. The regulation of blood Treg/Th17 immunity may be related to the curative effect.
Objective In order to investigate the efficacy of Huangqi Quyou decoction in treating verruca acuminate and its regulation role of regulatory T cells(Treg)/T helper cell 17(Th17) cell immunity in peripheral blood. Methods One hundred and twenty cases with verruca acuminate were selected and randomly divided into treatment group and control group with 60 in each group according to random number table method. Control group was treated with CO_2 laser surgery and applied with5% miquimod cream(one time/every two days and three times a week). On basis of control group,treatment group was treated with Huangqi Quyou decoction one dose a day and two times a day. Two groups were observed for two months. Wound healing time,clinical efficacy and recurrence rate were compared between the two groups. Peripheral blood level of Treg/Th17 and serum levels of interleukin(IL)-6,IL-17,and transforming factor(TGF)-β were detected in both two groups. Results Wound healing time of treatment group was(11.04±1.34) d,which was obviously less than that of control group(17.15±1.92) d,(P<0.05). The efficacy of treatment group was 96.67%,which was higher than that of control group(81.67%,P<0.05). After three months of follow-up,the recurrence rate of the treatment group was 8.33%,which was significantly lower than that of the control group(21.67%;χ~2=4.002,P<0.05). Peripheral blood level of Treg and Treg/Th17 of treatment group were obviously lower,while Th17 was higher than control group after treatment(P<0.01). Serum levels of IL-6 and IL-17 of treatment group were higher after treatment,while TGF-β was lower than that of control group(P <0.01). Conclusion On the basis of conventional intervention,Huangqi Quyou decoction in treating verruca acuminate can promote wound healing,increase the efficacy,and reduce recurrence rate. The regulation of blood Treg/Th17 immunity may be related to the curative effect.
引文
[1]杨雪松,付彧,房庆华,等.斑蝥素联合α-2β干扰素治疗尖锐湿疣疗效观察[J].中国性科学,2018,27(5):120-123.
[2]邓勇,蒋亚辉,万焰,等.微波联合光动力预防男性尖锐湿疣复发的临床研究[J].中国性科学,2018,27(5):117-120.
[3]莫怀民,林锐辉,谢小兰.复方马齿苋片对尖锐湿疣患者免疫功能的影响[J].中国实验方剂学杂志,2013,19(3):276-278.
[4]林建华,梁月英.复发性尖锐湿疣患者细胞免疫、体液免疫功能评价及其与皮损组织中相关分子表达的关系[J].海南医学院学报,2015,21(12):1 737-1 740.
[5]陈华,熊琦,陈永艳.尖锐湿疣患者外周血Treg/Th17细胞平衡及相关转录因子的表达[J].中国感染控制杂志,2017,16(12):1120-1 125.
[6]中华医学会皮肤性病学分会性病学组,中国医师协会皮肤科分会性病亚专业委员会.尖锐湿疣临床诊疗与防治指南(一)[J].中国艾滋病性病,2015,21(2):172-174.
[7]中华医学会皮肤性病学分会性病学组.尖锐湿疣治疗专家共识(2017)[J].临床皮肤科杂志,2018,47(2):125-127.
[8]D'Hauwers K,Depuydt C,Bogers JP,et al.Urine versus brushed in human papillomavirus screening:study in both genders[J].Asian JAndrol,2007,9:705-710.
[9]刘国艳,庞云燕,栾青霞,等.自拟扶正祛疣汤联合CO2激光治疗尖锐湿疣的疗效[J].中国中西医结合皮肤性病学杂志,2014,13(1):34-36.
[10]徐华香,习长青,王莉丽.中药联合CO2激光治疗尖锐湿疣与IL-2的相关性研究[J].中国中西医结合皮肤性病学杂志,2018,17(3):237-240.
[11]陈卫丰.局部44℃温热治疗尖锐湿疣的效果及对外周血CD4+CD25+Foxp3+调节性T细胞及相关因子的影响[J].中国医药导报,2015,12(26):107-110.
[12]Nedoszytko B,Lange M,Soko?owska-Wojdy?o M,et al.The role of regulatory T cells and genes involved in their differentiation in pathogenesis of selected inflammatory and neoplastic skin diseases.PartⅡ:The Treg role in skin diseases pathogenesis[J].Postepy Dermatol Alergol,2017,34:405-417.
[13]Lee GR.The Balance of Th17 versus Treg Cells in Autoimmunity[J].Int J Mol Sci,2018,19:E730.
[14]陈华,熊琦,陈永艳.尖锐湿疣患者外周血Treg/Th17细胞平衡及相关转录因子的表达[J].中国感染控制杂志,2017,16(12):1 120-1 125.
[15]戴超,李向培.系统性红斑狼疮Th17细胞分子调控机制研究进展[J].安徽医药2016,20(5):817-820.
[16]吴万桂,杨剑,张杰.克罗恩病患者外周血Th17、Treg比例变化及其临床意义[J].山东医药,2018,58(24):64-66.
[17]徐小容,陈永艳.尖锐湿疣患者外周血IL-17、IL-23、IL-10和TGF-β表达水平[J].中国艾滋病性病,2018,24(7):711-713.
[18]杨钧,付锐,潘付堂.5%咪喹莫特乳膏联合CO2激光治疗在女性尖锐湿疣中的应用[J].中国性科学,2018,27(5):126-129.
[2]邓勇,蒋亚辉,万焰,等.微波联合光动力预防男性尖锐湿疣复发的临床研究[J].中国性科学,2018,27(5):117-120.
[3]莫怀民,林锐辉,谢小兰.复方马齿苋片对尖锐湿疣患者免疫功能的影响[J].中国实验方剂学杂志,2013,19(3):276-278.
[4]林建华,梁月英.复发性尖锐湿疣患者细胞免疫、体液免疫功能评价及其与皮损组织中相关分子表达的关系[J].海南医学院学报,2015,21(12):1 737-1 740.
[5]陈华,熊琦,陈永艳.尖锐湿疣患者外周血Treg/Th17细胞平衡及相关转录因子的表达[J].中国感染控制杂志,2017,16(12):1120-1 125.
[6]中华医学会皮肤性病学分会性病学组,中国医师协会皮肤科分会性病亚专业委员会.尖锐湿疣临床诊疗与防治指南(一)[J].中国艾滋病性病,2015,21(2):172-174.
[7]中华医学会皮肤性病学分会性病学组.尖锐湿疣治疗专家共识(2017)[J].临床皮肤科杂志,2018,47(2):125-127.
[8]D'Hauwers K,Depuydt C,Bogers JP,et al.Urine versus brushed in human papillomavirus screening:study in both genders[J].Asian JAndrol,2007,9:705-710.
[9]刘国艳,庞云燕,栾青霞,等.自拟扶正祛疣汤联合CO2激光治疗尖锐湿疣的疗效[J].中国中西医结合皮肤性病学杂志,2014,13(1):34-36.
[10]徐华香,习长青,王莉丽.中药联合CO2激光治疗尖锐湿疣与IL-2的相关性研究[J].中国中西医结合皮肤性病学杂志,2018,17(3):237-240.
[11]陈卫丰.局部44℃温热治疗尖锐湿疣的效果及对外周血CD4+CD25+Foxp3+调节性T细胞及相关因子的影响[J].中国医药导报,2015,12(26):107-110.
[12]Nedoszytko B,Lange M,Soko?owska-Wojdy?o M,et al.The role of regulatory T cells and genes involved in their differentiation in pathogenesis of selected inflammatory and neoplastic skin diseases.PartⅡ:The Treg role in skin diseases pathogenesis[J].Postepy Dermatol Alergol,2017,34:405-417.
[13]Lee GR.The Balance of Th17 versus Treg Cells in Autoimmunity[J].Int J Mol Sci,2018,19:E730.
[14]陈华,熊琦,陈永艳.尖锐湿疣患者外周血Treg/Th17细胞平衡及相关转录因子的表达[J].中国感染控制杂志,2017,16(12):1 120-1 125.
[15]戴超,李向培.系统性红斑狼疮Th17细胞分子调控机制研究进展[J].安徽医药2016,20(5):817-820.
[16]吴万桂,杨剑,张杰.克罗恩病患者外周血Th17、Treg比例变化及其临床意义[J].山东医药,2018,58(24):64-66.
[17]徐小容,陈永艳.尖锐湿疣患者外周血IL-17、IL-23、IL-10和TGF-β表达水平[J].中国艾滋病性病,2018,24(7):711-713.
[18]杨钧,付锐,潘付堂.5%咪喹莫特乳膏联合CO2激光治疗在女性尖锐湿疣中的应用[J].中国性科学,2018,27(5):126-129.