刘氏菖郁汤对缺血性脑卒中风痰阻络证患者Th17/Treg免疫平衡的影响

目的观察刘氏菖郁汤对缺血性脑卒中风痰阻络证患者辅助性T细胞17(Th17)与调节性T细胞(Treg)及其相关细胞因子的影响,并评价其改善神经功能缺损的疗效。方法将88例缺血性脑卒中风痰阻络证患者随机分为对照组(44例)和刘氏菖郁汤组(44例)。对照组按缺血性脑卒中相关指南进行基础治疗,刘氏菖郁汤组在此基础上加用刘氏菖郁汤,干预期为10 d。比较2组患者治疗前后美国国立卫生研究院卒中量表(NIHSS)评分,Treg、Th17数量以及白细胞介素(IL)-6、IL-10、转化生长因子(TGF)-β含量的变化。结果治疗后,刘氏菖郁汤组NIHSS评分低于对照组,差异有统计学意义(P<0.01),神经功能缺损改善有效率为65.9%(29/44),明显高于对照组36.4%(16/44),P<0.05];刘氏菖郁汤组Treg数量高于对照组(P<0.05),且刘氏菖郁汤组Treg数量上升,对照组Treg数量下降,差异有统计学意义(P<0.05);刘氏菖郁汤组IL-6水平低于对照组(P<0.05),2组IL-10、TGF-β均升高,差异有统计学意义(P<0.05);Th17/Treg比值降幅有大于对照组的趋势。结论刘氏菖郁汤能有效改善缺血性脑卒中风痰阻络证患者神经功能缺损,其机制可能与抑制IL-6的升高,提高IL-10、TGF-β含量,增加Treg数量,调整Th17/Treg平衡状态,减轻炎症反应有关。

Effect of Liu’s Chang Yu Decoction on Th17/Treg Immune Balance in Patients with Wind-phlegm Obstructing Channel Syndrome of Ischemic Stroke

Objective To observe the effect of Liu’s Chang Yu decoction on Treg,Th17 and related cytokines in patients with wind-phlegm obstructing channel syndrome of ischemic stroke, and to evaluate its efficacy on improving neurological dysfunction.Methods88 cases of ischemic stroke patients with wind-phlegm blocking channel syndrome were divided into control group 44 cases,Liu’s Chang Yu decoction group 44 cases according to random digital table. The basic treatment of the control group was carried out according to the guidelines for ischemic stroke,and the Liu’s Chang yu decoction was added to the Liu’s Chang Yu decoction group for 10 days. The changes of NIHSS, numbers of Treg, and Th17 and IL-6, IL-10, TGF-β contents before and after treatment were compared between the two groups.ResultsAfter treatment,the NIHSS score of Liu’s Chang Yu decoction group was lower than that of the control group,the difference was statistically significant(P<0.01). The effective rate of the Liu’s Chang Yu decoction group in neurological deficits improvement was 65.9%(29/44), which was significantly higher than that of the control group36.4%(16/44),P<0.05];the number of Tregs in Liu’s Chang Yu decoction group was higher than that in the control group(P<0.05). The number of Tregs in the Liu’s Chang Yu decoction group increased,while that in the control group decreased and the difference was statistically significant(P<0.05).The level of IL-6 in the Liu’s Chang Yu decoction group was lower than that of the control group(P<0.05),the levels of IL-10 and TGF-β in the two groups were increased,and the difference were statistically significant(P<0.05);the Th17/Treg ratio has a tendency to decrease large than the control group.Conclusion Liu’s Chang Yu decoction can effectively improve the neurological deficit in patients with wind-phlegm obstructing channel syndrome in stroke. The mechanism may be related to inhibiting the increase of IL-6,increasing the contents of IL-10 and TGF-β,increasing the number of Tregs,adjusting the balance of Th17/Treg,and reducing inflammation.