滋肾润肺平喘汤治疗哮喘缓解期疗效及对儿童Th17/Treg影响研究

目的:观察儿童哮喘缓解期口服滋肾润肺平喘汤对辅助性T细胞17/调节T细胞(Th17/Treg)及临床疗效的影响.方法:选取86例哮喘患儿纳入此项研究,按随机法划分为西药组与联合组,西药组给予布地奈德福莫特罗粉吸入治疗,联合组在西药组治疗的同时联合给予滋肾润肺平喘汤口服;1个治疗后,评估全部患儿疗效,观察疗程前后中医症候...

Effect of Zishen Runfei Pingchuan decoction on Th17/Treg and its clinical curative effect in children with asthma in remission stage

Objective:To observe the effect of Zishen Runfei Pingchuan decoction on the T cells 17/Regulatory T cells(Th17/Treg)and its clinical curative effect in children with asthma in remission stage.Methods:The objects of study were 86 children with asthma,and enrolled children were divided into western medicine group and combined group according to the randomization method.Children in western medicine group were given Budesonide and formoterol powder for inhalation,and those in the combined group were provided with Zishen Runfei Pingchuan decoction simultaneously on the basis of therapeutic approach in western medicine group.After 1 course of treatment,the curative effect of all the children was evaluated,and the changes of traditional Chinese medicine(TCM)syndrome score,lung function,Th17 count,Treg count,Th17/Treg and serum factors including interleukin-17(IL-17),interleukin-10(IL-10)and transforming growth factor-β(TGF-β)levels were observed before and after the treatment of all the children.Furthermore,the incidence of adverse reactions during treatment was counted.The children were followed up for 6 months to compare the frequency of asthma attacks.Results:After one course of treatment,the main symptoms of the children in the two groups were wheezing rales in the throat,asthma,chilly sensation and the cold limbs,while the secondary symptoms included cough,expectoration,growth retardation,pale complexion;all the above scores were lower than those before the course of treatment in the two groups(all P<0.05),and scores in the combined group were all lower than the western medicine group(all P<0.05).FEV 1,FEV 1/FVC and PEF of the two groups were all improved compared with those before treatment during intra-group comparison(all P<0.05),and those of the combined group were higher than those of the western medicine group(all P<0.05).Th17 count in both groups were decreased(all P<0.05)while Treg count increased(P<0.05)in both groups,and Th17/Treg count were both decreased(all P<0.05)compared with that before treatment during intra-group comparison.Furthermore,Th17 count in the combined group was higher than that in the western medicine group(P<0.05),while Treg count and Th17/Treg count were both higher than that in the western medicine group(all P<0.05).The serum levels of IL-17 and TGF-βwithin both groups were improved after treatment compared with those before treatment(all P<0.05),and the combined group was superior to the western medicine group(all P<0.05).No serious adverse reactions were observed during treatment in both groups.Follow-up for 6 months showed that the frequency and duration of asthma attacks in the two groups were both lower than that before the course of treatment during intra-group comparison,and the combined group was lower than that in the western medicine group(P<0.05).Conclusion:Zishen Ru nfei Pingchuan decoction can help to improve the expression levels of Th17 and Treg-related serum factors in children with asthma,which plays a role in assisting the regulation of Th17/Treg balance and reducing the frequency of asthma attacks.