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目的:探讨白芍煎剂对系统性红斑狼疮样患者Th17/Treg细胞的影响。方法:选取我院皮肤性病科收治的系统性红斑狼疮患者92例,随机数字表达法分为2组,其中对照组46例,予糖皮质激素、免疫抑制剂、静脉注射大剂量免疫球蛋白及对症治疗等常规治疗,1周为1个疗程,治疗4个疗程;实验组46例,在常规治疗的基础上加用白芍煎剂,200 m L日2次口服,1周为1个疗程,治疗4个疗程。健康组46例,为来我院健康体检患者。采用免疫组化法检测3组患者治疗前后皮损组织中辅助性T细胞17(Th17)细胞及调节性T细胞(Treg)各占CD4+T细胞分数和治疗Th17/Treg水平。结果:1治疗前,SLE患者皮损组织中Th17细胞占CD4+T细胞比例及Th17/Treg水平明显高于健康组;而Treg细胞占CD4+T细胞比例却明显低于健康组,差异有统计学意义(P<0.05);2治疗后实验组皮损组织中Th17细胞占CD4+T细胞比例及Th17/Treg水平明显低于对照组,但较健康组明显升高,差异有统计学意义(P<0.05);3治疗后实验组患者皮损组织中Treg细胞占CD4+T细胞比例明显高于对照组,但较健康组明显降低,差异有统计学意义(P<0.05)。结论:Th17/Treg细胞平衡失调在系统性红斑狼疮的发生、发展过程中起着重要作用;白芍煎剂能够明显改善系统性红斑狼疮患者组织中Th17/Treg细胞平衡,恢复正常的免疫系统功能,提高临床疗效,对临床具有指导意义,值得临床推广。
Objective: To investigate the effect of peony root decoction on Th17 / Treg cells in patients with systemic lupus erythematosus. Methods: A total of 92 patients with systemic lupus erythematosus (SLE) admitted to Department of Dermatology of our hospital were divided into two groups randomly. The control group consisted of 46 patients with glucocorticoid, immunosuppressive agents, intravenous injection of high-dose immunoglobulin and Symptomatic treatment and other conventional treatment, 1 week for a course of treatment for 4 courses of treatment; experimental group 46 cases, on the basis of conventional treatment with peony root decoction, 200 m L 2 times orally, 1 week for a course of treatment , Treatment of 4 courses. 46 cases of health group, to come to our hospital healthy physical examination patients. Immunohistochemical method was used to detect the percentage of T helper 17 (Th17) and regulatory T cells (Treg) in CD4 + T cells and the level of Th17 / Treg in skin lesions of the three groups before and after treatment. Results: Before treatment, the proportion of Th17 cells to CD4 + T cells and the level of Th17 / Treg in skin lesions of SLE patients were significantly higher than those in healthy controls, while the proportion of Tregs to CD4 + T cells was significantly lower than that in healthy controls (P <0.05). After treatment, the percentage of Th17 cells in CD4 + T cells and the level of Th17 / Treg in the experimental group were significantly lower than those in the control group, but significantly higher than those in the healthy group (P <0.05) P <0.05) .3 The percentage of Treg cells in CD4 (superscript +) T cells in the experimental group was significantly higher than that in the control group (P <0.05), but the difference was statistically significant (P <0.05). Conclusion: The imbalance of Th17 / Treg cells plays an important role in the pathogenesis and development of systemic lupus erythematosus. Decoction of peony can significantly improve the balance of Th17 / Treg cells and normal immune system in patients with systemic lupus erythematosus , Improve clinical efficacy, clinical significance, it is worth clinical promotion.