易激灵2号方对大肠湿热型肠易激综合征T细胞亚群的影响

[目的]观察易激灵2号方对大肠湿热型腹泻型肠易激综合征（diarrheatypeirritablebowelsyndrome，IB孓D）患者T细胞亚群的影响，并探讨其作用机制。[方法]将174例大肠湿热型IBS-D患者随机分为两组，中药组采用易激灵2号方，煎取200ml，早晚分服；西药组采用马来酸曲美布汀片（商品名：舒丽启能）0．1g／次，枯草杆菌二联活菌肠溶胶囊（商品名：美常安）0．5g／次，3次／d，口服；同时设立正常组24名，两组疗程均为4周。采用流式细胞仪测定外周血CD3^＋。、CD4^＋和CD8^＋T淋巴细胞分布百分率。[结果]与正常组相比，大肠湿热型IBS-D患者CD4^＋细胞水平显著降低（P〈O．01），CD8^＋细胞水平显著升高（P〈O．05），CD4^＋／CD8^＋比值下降明显（P〈0．05）。中药组和西药组治疗后，CD4^＋。细胞水平较治疗前均明显升高（P〈O．01，P〈0．05），但中药组升高更为明显，组间差异有统计学意义（P〈0．05）；CD8^＋细胞水平较治疗前均有明显下降（P〈O．05），CD4^＋／CD8^＋比值均有明显升高（P〈0．05）。与西药组相比，中药组治疗后CD8^＋细胞水平和CD4’／CD8’比值有一定程度升高，但差异无统计学意义。[结论]以抑肝扶脾清热利湿立法的易激灵2号方很可能通过调节T细胞亚群的变化，达到消除或减轻IBS-D患者临床症状的效果。

Effect of soothing liver and invigorating spleen,clearing away heat and eliminating dampness on the express of T cell subsets in patients with irritable bowel syndrome of large intestine damp-heat

[Objective]To observe the effect of soothing liver and invigorating spleen, clearing-away heat and eliminating dampness on the express of T cell subsets in patients with irritable bowel syndrome of large intestine clamp-heat. [Methods]One hundred and seventy-four patients were assigned to 2 groups： Chi- nese medicine group was treated with Yijiling-2,decocted 200 ml,twice daily by oral administration; west- ern medicine group was treated with Trimebutine maleate tablets 0. 1 g and Meiehang＇an 0.5 g, 3 times dai- ly by oral administration. The therapeutic course was 4 weeks for all. The expression of CD3^＋ , CD4^＋ , CD8^＋ of T lymphocyte was analyzed by flow cytometry. [Results]The percentage of CD4＋ was significantly lower（P〈0. 01）, the percentage of CD8^＋ was significantly higher（P~0. 05）and the ratio of CD4^＋/CD8^＋ were significantly lower（P〈0. 05）in IBS-D patients than in the normal group. After treatment, the expres- sion of CD4^＋ and the ratio of CD4^＋/CD8^＋ were significantly higher in IBS-D patients of Chinese medicine group and western medicine group（P〈0. 01, P〈0. 05）, while the expression of CD8^＋ were significantly lower（P〈0.05）. But the expression of CD4^＋ in Chinese medicine group was significantly higher than that in the western medicine group（P〈0. 05）. [Conclusion]Soothing liver and invigorating spleen, clearing away heat and eliminating dampness might influence the T cell subsets thus eliminate or ameliorate symptoms of IBS patients.