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1.广西国际壮医医院,南宁 530000
2.金秀瑶族自治县瑶医医院,广西 来宾 545708
3.广西中医药大学,南宁 530000
罗秋香,医师,从事瑶医药防治常见疾病的临床研究,E-mail:114486349qq@com
* 尤剑鹏,医学博士,教授,从事瑶医药基础与临床研究,E-mail:yjp2816600@163.com
收稿日期:2020-07-06,
网络出版日期:2020-08-25,
纸质出版日期:2021-02-20
移动端阅览
罗秋香,梁琼平,尤剑鹏等.清疹方对慢性荨麻疹细胞免疫功能的调节作用[J].中国实验方剂学杂志,2021,27(04):95-100.
LUO Qiu-xiang,LIANG Qiong-ping,YOU Jian-peng,et al.Regulatory Effect of Qingzhenfang on Cellular Immune Function of Patients with Chronic Urticaria[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(04):95-100.
罗秋香,梁琼平,尤剑鹏等.清疹方对慢性荨麻疹细胞免疫功能的调节作用[J].中国实验方剂学杂志,2021,27(04):95-100. DOI: 10.13422/j.cnki.syfjx.20201133.
LUO Qiu-xiang,LIANG Qiong-ping,YOU Jian-peng,et al.Regulatory Effect of Qingzhenfang on Cellular Immune Function of Patients with Chronic Urticaria[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(04):95-100. DOI: 10.13422/j.cnki.syfjx.20201133.
目的
2
观察瑶医清疹方对慢性荨麻疹(浆朋比)的临床疗效及对细胞免疫功能的影响作用。
方法
2
按随机数字表法,将132例患者分为对照组和观察组各66例。对照组脱落、失访和剔除共6例,最后完成60例;观察组最后完成62例。两组均口服依巴斯汀片,10~20 mg/次,1次/d。对照组口服皮敏消胶囊,4粒/次,3次/d;观察组内服清疹方,1剂/d。两组疗程均为治疗8周。于治疗前、治疗后2,4,8周分别进行7 d荨麻疹活动度评分(USA7)和皮损情况评分(TSS);进行治疗前后慢性荨麻疹生活质量量表(CU-Q2oL)和风湿热内蕴证评分;对USA7
<
7分者进行3个月随访,记录复发情况;检测治疗前后补体3,4(C3,C4),CD4
+
和CD8
+
细胞,计算Th17,Treg细胞在CD4
+
细胞中的比例,并计算CD4
+
/CD8
+
和Th17/Treg;检测治疗前后外周血白细胞介素-10(IL-10),IL-17,IL-23和IL-35水平;进行安全性评价。
结果
2
在治疗后2,4和8周,观察组USA7评分和TSS评分均低于同期对照组(
P
<
0.01);观察组CU-Q2oL和风湿热内蕴证评分均低于对照组(
P
<
0.01);观察组C3,C4和IL-35水平均高于对照组(
P
<
0.01);观察组CD4
+
,Treg细胞和CD4
+
/CD8
+
均高于对照组(
P
<
0.01),观察组IL-10,IL-17,IL-23,CD8
+
,Th17细胞和Th17/Treg均低于对照组(
P
<
0.01);观察组复发率为25.58%(11/43)低于对照组的复发率为48.48%(16/33)(
<math id="M1"><msup><mrow><mi>χ</mi></mrow><mrow><mn mathvariant="normal">2</mn></mrow></msup></math>
http://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=22538793&type=
http://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=22538791&type=
2.96333337
3.13266659
=4.276,
P
<
0.05);观察组临床疗效优于对照组(
Z
=2.021,
P
<
0.05)。
结论
2
采用清疹方治疗慢性荨麻疹,可控制病情程度,提高生活质量,有着较好的临床疗效,并可减少复发,还能升高C3,C4水平,调节细胞免疫功能,减轻免疫炎症应答,值得临床进一步的研究与使用。
Objective
2
To observe the clinical efficacy of Qingzhenfang for plasmoby (chronic urticaria), and to investigate its effect on cellular immune function.
Method
2
One hundred and thirty-two cases patients were divided into control group and observation group evenly according to random number table. The 60 patients in control group finished the study because of 6 cases of dropout, loss of follow-up and withdrawal, and 62 patients in observation group finished the study. Patients in both groups got Yiebastine tablets, 10-20 mg/time, 1 time/day. Patients in control group additionally got Piminxiao capsule, 4 grains/time, 3 times/day, while patients in observation additionally got Qingzhenfang, 1 dose/day. The treatment continued for 8 weeks in both groups. Before the treatment, and at the second, fourth, and eighth week after treatment, scores of urticaria activity for 7 days (USA7) and total symptom score (TSS) were graded. Before and after treatment, scores of chronic urticaria quality of life scale (CU-Q2oL) and syndrome of rheumatic fever were graded. A follow-up of 3 months was conducted for the patients whose score of USA7 was less than 7 to record the recurrence. Complement 3 and 4 (C3, C4), CD4
+
, CD8
+
cells were detected, and Th17/ CD4
+
and Treg/ CD4
+
, CD4
+
/CD8
+
and Th17/Treg were calculated. Levels of peripheral blood interleukin-10 (IL-10), IL-17 and IL-23 were detected, and safety was evaluated after the treatment.
Result
2
At the second, fourth and eighth week after the treatment, scores of USA7, TSS, CU-Q2oL and syndrome of rheumatic fever in observation group were lower than those in the control group (
P
<
0.01). Levels of C3, C4, CD4
+
, Treg, CD4
+
/CD8
+
and IL-35 in observation group were higher than those levels detected in control group (
P
<
0.01), while levels of CD8
+
, Th17, Th17/Treg, IL-10, IL-17 and IL-23 were lower than those in the control group (
P
<
0.01). Recurrence rate was 25.58% (11/43) in observation group, lower than 48.48% (16/33) in control group (
<math id="M2"><msup><mrow><mi>χ</mi></mrow><mrow><mn mathvariant="normal">2</mn></mrow></msup></math>
http://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=22538798&type=
http://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=22538796&type=
3.30199981
3.64066648
=4.276,
P
<
0.05), and the clinical efficacy in observation group was superior to that in control group (
Z
=2.021,
P
<
0.05).
Conclusion
2
Yaoyi Qingzhenfang can control the degree of disease and improve the quality of life for patients with chronic urticaria, with superior clinical efficacy. In addition, it can reduce recurrence rate, increase the levels of C3, C4, regulate cellular immune function, and reduce immune inflammatory response, so it is worthy of further clinical research and use.
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