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目的探讨槐杞黄颗粒对过敏性紫癜(HSP)儿童Th17/Treg失衡的影响及其对HSP复发、肾损伤的作用。方法选取HSP患儿63例分为常规治疗组和槐杞黄组,两组均给予常规治疗,槐杞黄组加用槐杞黄颗粒口服治疗。收集患者一般情况,检测所有患儿治疗前及治疗2周后Th17细胞(CD3+CD8-IL-17+细胞)、Treg细胞(CD4+CD25+CD127+细胞)及细胞因子IL-17、TGF-β1水平。随访记录各组患儿紫癜复发次数。结果常规治疗组及槐杞黄治疗组两组治疗后与治疗前比较Th17、IL-17、TGF-β1水平均有下降,Treg水平有升高,差异有统计学意义(P<0.05);两组治疗后Treg及TGF-β1水平比较差异无统计学意义(P>0.05);但槐杞黄组治疗后的Th17及IL-17水平低于常规治疗组治疗后水平,差异有统计学意义(P<0.05)。槐杞黄组较常规治疗组复发率少,差异有统计学意义(10.3%vs.33.3%,χ2=4.023,P=0.045),肾损伤率差异无统计学意义(14.7%vs.27.6%;χ2=1.585,P=0.208)。结论槐杞黄辅助常规治疗能调节HSP患儿Th17/Treg失衡,尤其是抑制Th17细胞的分化及其相关因子IL-17;槐杞黄辅助治疗能减少HSP的复发,不能减少肾损伤的发生率。
Objective To investigate the effect of Huai Qi Huang granules on the imbalance of Th17 / Treg in children with Henoch-Schonlein Purpura (HSP) and its effect on HSP recurrence and renal injury. Methods 63 children with HSP were divided into conventional treatment group and Huai Qi Huang group, both groups were given routine treatment, Huai Qi Huang group plus Huai Qi Huang granules oral treatment. The general condition of the patients was collected. The levels of Th17 cells (CD3 + CD8-IL-17 + cells), Treg cells (CD4 + CD25 + CD127 + cells) and cytokines IL-17, TGF- Level. Follow-up records of children with purpura relapse frequency. Results The levels of Th17, IL-17 and TGF-β1 in both the conventional treatment group and the Huai Qi Huang treatment group were significantly lower than those before treatment (P <0.05) There was no significant difference in the levels of Treg and TGF-β1 between the two groups after treatment (P> 0.05). However, the levels of Th17 and IL-17 in the Huaqihuang group were lower than those in the conventional treatment group, with significant difference P <0.05). The Huaiqi Huang group had less recurrence rate than the conventional treatment group (10.3% vs.33.3%, χ2 = 4.023, P = 0.045). There was no significant difference in the rate of renal injury between the two groups (14.7% vs.27.6%; χ2 = 1.585, P = 0.208). Conclusion Huaiqi Huang adjuvant therapy regulates the imbalance of Th17 / Treg in children with HSP, especially the differentiation of Th17 cells and the related factor IL-17. Huaiqi Huang adjuvant therapy can reduce the recurrence of HSP and can not reduce the incidence of renal injury .