中药明目汤对白塞氏病葡萄膜炎患者T淋巴细胞亚群的影响

作者	单位
周婉瑜	中国中医研究院西苑医院北京100091
李越虹	中国中医研究院西苑医院北京100091
麻柔	中国中医研究院西苑医院北京100091
许勇钢	中国中医研究院西苑医院北京100091

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中文摘要:

目的 :探讨中药明目汤对白塞氏病葡萄膜炎患者T淋巴细胞亚群的影响。方法 :以中药明目汤联合环孢霉素A(CSA)和小剂量皮质类固醇 (联合中药组 14例 )与单纯CSA结合皮质类固醇 (单纯西药组 14例 )治疗白塞氏病葡萄膜炎相比较 ,观察两组患者治疗前后T淋巴细胞亚群的变化。结果 :两组患者葡萄膜炎复发时均有T淋巴细胞亚群的改变 ,TH 升高 ,TS 降低 ,TH/TS 升高 ,治疗 1个月后均为TH 降低 ,TS 升高 (P <0 0 5 ,P <0 0 1) ,TH/TS 降低 (均P <0 0 5 )。治疗后两组间比较差异无显著性。随诊 1年中强的松的用量 :联合中药组平均用量为 (9 2 9± 2 6 7)mg/d ;单纯西药组 (15 71± 8 5 2 )mg/d。两组患者强的松的平均用量比较差异有显著性 (P <0 0 5 )。两组患者葡萄膜炎 1年的复发频率比较差异有显著性 (P <0 0 5 )。结论 :从辨证的角度观察 ,湿热壅盛型白塞氏病患者存在显著的细胞免疫调节紊乱 ,中药明目汤有抗炎及调节细胞免疫功能的作用 ,为白塞氏病葡萄膜炎的有效治疗方法。

英文摘要:

Objective: To study the effect of Mingmu Decoction (MMD) on T lymphocyte subsets in patients with uveitis complicated by Behcet′s disease (U BD). Methods: Twenty eight patients with U BD were divided into two groups, 14 in the treated group were treated with MMD combined with cyclosporin A (CSA) and small dose of corticosterone, and 14 in the control group were treated with CSA and corticosterone, the changes of T lymphocyte subsets before and after treatment were observed. Results: Patients with relapsed uveitis in both groups showed changes of T lymphocyte subsets, including decrease of T S, increase of T H and T H/T S ratio. These parameters were all restored to some degree after treatment (P<0 01 or P<0 05). Comparison between the two groups showed the difference was insignificant. The daily dosage of prednisone consumed in one year of follow up in the treated groups was 9.29±2.67 mg, which was significantly lower as compared with that in the control groups (15.71±8.52 mg, P<0 05). Besides, the frequency of relapse of uveitis in the two groups were different significantly (P<0 05). Conclusion: From the viewpoint of Syndrome Differentiation, patients with Behcet′s disease has significant cellular immune regulation disorder. MMD, which has anti inflammatory and regulatory effects on cellular immunity, is an effective treatment of U BD.

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