胎元饮合寿胎丸加减联合主动免疫治疗不明原因复发性流产患者的疗效及其对辅助性T淋巴细胞17/调节性T淋巴细胞免疫失衡的影响

宋晓捷; 周艳艳; 赵莉娜

doi:10.13422/j.cnki.syfjx.20181318

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胎元饮合寿胎丸加减联合主动免疫治疗不明原因复发性流产患者的疗效及其对辅助性T淋巴细胞17/调节性T淋巴细胞免疫失衡的影响

临床 | 更新时间：2024-01-04

- 胎元饮合寿胎丸加减联合主动免疫治疗不明原因复发性流产患者的疗效及其对辅助性T淋巴细胞17/调节性T淋巴细胞免疫失衡的影响
- Efficacy of Taiyuanyin and Shoutaiwan Combined with Active Immunotherapy for Unexplained Recurrent Abortion and Effect on Immune Imbalance of 17/Regulatory T Lymphocytes in Helper T Lymphocytes
- 中国实验方剂学杂志 2018年24卷第18期页码：164-169
- 作者机构：
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  河南省科技厅项目（162102310186）
- DOI：10.13422/j.cnki.syfjx.20181318
  中图分类号： R271.9
- 纸质出版日期：2018
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宋晓捷, 周艳艳, 赵莉娜. 胎元饮合寿胎丸加减联合主动免疫治疗不明原因复发性流产患者的疗效及其对辅助性T淋巴细胞17/调节性T淋巴细胞免疫失衡的影响[J]. 中国实验方剂学杂志, 2018,24(18):164-169.

SONG Xiao-jie, ZHOU Yan-yan, ZHAO Li-na. Efficacy of Taiyuanyin and Shoutaiwan Combined with Active Immunotherapy for Unexplained Recurrent Abortion and Effect on Immune Imbalance of 17/Regulatory T Lymphocytes in Helper T Lymphocytes[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(18): 164-169.
宋晓捷, 周艳艳, 赵莉娜. 胎元饮合寿胎丸加减联合主动免疫治疗不明原因复发性流产患者的疗效及其对辅助性T淋巴细胞17/调节性T淋巴细胞免疫失衡的影响[J]. 中国实验方剂学杂志, 2018,24(18):164-169. DOI： 10.13422/j.cnki.syfjx.20181318.

SONG Xiao-jie, ZHOU Yan-yan, ZHAO Li-na. Efficacy of Taiyuanyin and Shoutaiwan Combined with Active Immunotherapy for Unexplained Recurrent Abortion and Effect on Immune Imbalance of 17/Regulatory T Lymphocytes in Helper T Lymphocytes[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(18): 164-169. DOI： 10.13422/j.cnki.syfjx.20181318.

摘要

目的：探讨胎元饮合寿胎丸加减治疗不明原因复发性流产患者的临床效果及其机制。方法：选择2015年1月至2016年3月收治的96例不明原因复发性流产（URSA）患者，根据随机数表法分为对照组和观察组，每组48例。对照组给予主动免疫治疗，观察组采用胎元饮合寿胎丸加减联合主动免疫治疗。比较两组的妊娠成功率及妊娠结局。测定并比较两组外周血Th17细胞，Treg细胞，炎症因子白细胞介素（IL）-4，IL-10，IL-17，Th17，Treg转录因子维甲酸相关孤核受体γt （RORγt），FoxP3 mRNA表达水平。比较两组治疗中不良反应发生情况。结果：对照组再次妊娠率95.8%，与观察组的97.9%比较差异无统计学意义。观察组的妊娠成功率93.8%（45/48），明显高于对照组的77.1%（37/48）（P<0.05）。观察组的足月分娩比例为95.6%，明显高于对照组的81.1%（P<0.05）。治疗后两组的Th17/CD4+，Th17/Treg较本组治疗前明显降低，Treg/CD4+较本组治疗前明显升高（P<0.05），且观察组的变化程度较对照组更加明显（P<0.05）。治疗后两组的IL-4，IL-10水平均较本组治疗前上升，IL-17水平降低（P<0.05）；治疗后观察组IL-4，IL-10水平较对照组高，IL-17水平较对照组低（P<0.05）。治疗后两组RORγt mRNA表达水平较本组治疗前降低，FoxP3 mRNA表达水平较本组治疗前升高（P<0.05）；观察组FoxP3，RORγt mRNA变化水平较对照组更加明显（P<0.05）。所有患者均无明显不良反应发生。结论：采用胎元饮合寿胎丸加减联合主动免疫治疗不明原因复发性流产疗效确切，其机制可能通过调节炎性因子水平，改善Th17/Treg的免疫失衡状态，进而改善妊娠结局，降低流产率，且安全性较高，治疗成本低，值得临床推广应用。

Abstract

Objective: To investigate the clinical efficacy and mechanism of Taiyuanyin and Shoutaiwan in patients with recurrent recurrent spontaneous abortion. Method: A total of 96 patients with recurrent recurrent spontaneous abortion (URSA) from January 2015 to March 2016 in our hospital were selected and divided into control group and observation group according to the random number table method

48 cases in each group. The control group received active immunotherapy

and the observation group was treated with Taiyuanyin and Shoutaiwan combined with active immunotherapy. The pregnancy success rate and pregnancy outcome were compared between these two groups. The mRNA expression levels of Th17 cells

Treg cells

inflammatory factors interleukin (IL)-4

IL-10

IL-17

Th17

Treg transcription factor RORγt and FoxP3 were measured and compared between two groups. The incidence of adverse reactions was also compared. Result: The repregnancy rate was 95.8%in control group and 97.9%in observation group

with no statistical difference between two groups. The success rate of pregnancy was 93.8%(45/48) in observation group

significantly higher than 77.1%(37/48) in control group (P<0.05). The percentage of term delivery was 95.6%in observation group

significantly higher than 81.1%in control group (P <0.05). The ratios of Th17/CD4+ and Th17/Treg after treatment were significantly decreased in both groups

and Treg/CD4+was significantly increased (P<0.05)

and the changes in observation group were more obvious than those in control group (P<0.05). After treatment

the levels of IL-4 and IL-10 were increased in both groups

and the level of IL-17 was decreased (P<0.05). After treatment

the levels of IL-4 and IL-10 in observation group were higher than those in control group

and the level of IL-17 was lower than that in control group (P<0.05). The expression level of RORγt mRNA was reduced and the expression level of FoxP3 mRNA was increased after treatment in both groups (P<0.05)

and the changes in observation group were more obvious than those in control group (P<0.05). No adverse reactions were found in any patient. Conclusion: Taiyuanyin and Shoutaiwan combined with active immunotherapy for unexplained recurrent spontaneous abortion has clear efficacy. It can improve the imbalance of Th17/Treg by regulating the level of inflammatory factors

thus improving the outcome of pregnancy and reducing the abortion rate. In addition

it has high safety and low cost

worthy of clinical application.

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