黄芪复方对重症肌无力患者淋巴细胞亚群、免疫球蛋白及补体的影响

作者	单位
牛广华	辽宁中医药大学附属医院
孙旭	武警辽宁总队医院
张春明	辽宁中医药大学附属医院
张静生	辽宁中医药大学附属医院

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中文摘要:

目的探讨黄芪复方对重症肌无力(myasthenia gravis,MG)患者的细胞免疫调节机制及疗效。方法将60例患者随机分为2组,每组30例。治疗组服用黄芪复方;对照组服用泼尼松片,疗程3个月,观察症状改善情况及不良反应。两组患者治疗前后应用流式细胞仪检测外周血淋巴细胞亚群分布的变化情况;免疫比浊法测定外周血免疫球蛋白及补体的水平。结果经治疗12周后,治疗组临床总有效率为80%(24/30);对照组临床总有效率为83.3%(25/30),两组比较,差异无统计学意义。两组CD4+细胞、CD4+/CD8+比值均有明显下降,治疗组CD4+/CD8+比值与对照组比较,差异均有统计学意义(P<0.05)。治疗组治疗后CD8+细胞明显增加,与治疗前比较,差异有统计学意义(P<0.05),与对照组比较无明显变化(P>0.05)。MG患者血清IgM、IgA水平与健康组比较,差异有统计学意义(P<0.01),两组治疗后C3、C4水平有所升高,与治疗前比较,差异有统计学意义(P<0.05)。用药第2周对照组有5例出现一过性丙氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶(AST)中度增高;治疗组未出现不良反应。结论通过调节淋巴细胞亚群比例分布以及体液免疫功能等的变化,可能是黄芪复方发挥免疫调节作用机制之一。

英文摘要:

Objective To investigate the effect and mechanisms of Compound Astragalus Recipe(CAR) for regulating cellular immune in patients with myasthenia gravis(MG).Methods Sixty MG patients were equally assigned to two groups randomly,the test group administered with CAR and the control group with prednisone for 3 months.Changes of patients’ symptoms and adverse reactions were observed.The peripheral lymphocyte subsets distribution was examined by flow cytometry,and the levels of immunoglobulins and complements in the peripheral blood were measured by immuno-turbidimetry before and after treatment.Results The total effective rate in the test group after 12-week treatment reached 80%(24/30),while that of the control group reached 83.3%(25/30),difference between them showed no statistical significance(P>0.05).CD+4 and CD+4/CD+8 ratio were lowered significantly in both groups,but the decrement of CD+4/CD+8 ratio in the test group was more significant than that in the control group,showing significance between groups(P<0.05).While CD+8 in the test group after treatment was significantly increased as compared with that before treatment(P<0.05),but with no significant difference in comparing with that in the control group(P>0.05).Serum levels of IgM and IgA in MG patients were significantly higher than normal range(P<0.01).Levels of C3 and C4 were significantly increased in both groups after treatment(P<0.05).Moderate high level of ALT and AST revealed transiently at the 2nd week in 5 patients of the control group,while no adverse reaction was found in the test group.Conclusion One of the mechanisms for CAR in playing its immuno-modulate effect may be its regulation on lymphocyte subsets distribution and humoral immune function.

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