调脾胃升降温针法对溃疡性结肠炎患者Th17/Treg平衡及其细胞因子水平的影响

目的观察调脾胃升降温针法治疗溃疡性结肠炎的临床疗效及对患者外周血辅助T细胞17(Th17)与调节性T细胞(Treg)比例及相关细胞因子水平的影响。方法将2018年6月—2020年1月唐山市中医医院收治的溃疡性结肠炎脾虚证患者随机分为2组,对照组38例予美沙拉嗪肠溶片口服,观察组39例在对照组基础上加用调脾胃升降温针法治疗,2组疗程均为2个月。观察2组治疗前后Mayo评分,血清C反应蛋白(CRP)、白细胞介素-17(IL-17)、转化生长因子-β1(TGF-β1)水平及外周血单个核细胞中Th17和Treg细胞比例,分析Mayo分级与血清IL-17、TGF-β1水平及Th17和Treg细胞比例的关系,观察比较2组临床疗效及不良反应发生情况。结果治疗后观察组Mayo评分及血清CRP、IL-17水平和Th17细胞比例较对照组及治疗前明显下降(P均<0.05),血清TGF-β1、Treg细胞比例较对照组及治疗前明显升高(P均<0.05);IL-17、Th17细胞表达与Mayo分级呈显著正相关(P均<0.05),TGF-β1、Treg细胞表达与Mayo分级呈显著负相关(P均<0.05)。观察组总有效率为89.7%(35/39),对照组为73.7%(28/38),观察组总有效率明显高于对照组(P<0.05)。2组不良反应均较微。结论调脾胃升降温针法治疗溃疡性结肠炎疗效更好,机制可能与明显调节Th17/Treg平衡,使IL-17、TGF-β1水平趋向正常,从而减轻炎症反应有关。

Effect of warming acupuncture for regulating spleen and stomach on Th17/Treg balance and cytokine levels in patients with ulcerative colitis

Objective It is to observe the clinical efficacy of warming acupuncture for regulating spleen and stomach on ulcerative colitis and its influence on the ratio of peripheral blood helper T cell 17(Th17)and regulatory T cells(Treg)and the level of related cytokines.Methods 77 patients with ulcerative colitis with spleen deficiency syndrome admitted to Tangshan Hospital of Traditional Chinese Medicine from June 2018 to January 2020 were randomly divided into two groups.38 cases in the control group were treated with mesalazine enteric-coated tablets by oral administration,and 39 cases in the observation group were treated with warming acupuncture for regulating spleen and stomach based on the control group,and the course of treatment of both groups was 2 months.The Mayo scores,levels of serum C-reactive protein(CRP),interleukin-17(IL-17),transforming growth factor-β1(TGF-β1)and the proportion of Th17 and Treg in peripheral blood mononuclear cells were observed before and after treatment in the two groups.The relationship between Mayo classification and serum IL-17,TGF-β1 levels and the ratio of Th17 and Treg was analyzed,the clinical efficacy and occurrence of adverse reactions were observed and compared between the two groups.Results After treatment,the Mayo score,levels of serum CRP,IL-17 and Th17 cell ratio of the observation group were significantly lower than those of the control group and before treatment(P<0.05),and the level of serum TGF-β1 and Treg cell ratio were significantly higher than those of the control group and before treatment(P<0.05).IL-17,Th17 cell expression was significantly positively correlated with UC classification(P<0.05),TGF-β1,Treg cell expression was significantly negatively correlated with UC classification(P<0.05).The total effective rate of the observation group was 89.7%(35/39),and that of the control group was 73.7%(28/38),the total effective rate of the observation group was higher than that of the control group(P<0.05).The side effects were all slight in both groups.Conclusion Warming acupuncture for regulating spleen and stomach has a better curative effect on ulcerative colitis.The mechanism The mechanism may be related to the obvious regulation of Th17/Treg balance,so that the levels of IL-17 and TGF-β1 tend to be normal,thereby reducing inflammation.