2019 年第 11 期 第 14 卷

补肾活血方对不明原因复发性流产患者外周血中辅助性T细胞17/调节性T细胞平衡的影响

Effect of Bushen Huoxue prescription on helper T cell 17/regulatory T cell balance in peripheral blood of patients with unexplained recurrent spontaneous abortion

作者：冯晓玲贾丹李杨陈璐张杨

英文作者：

单位：150036哈尔滨，黑龙江中医药大学附属第一医院妇科二科（冯晓玲、陈璐、张杨）；150040哈尔滨，黑龙江中医药大学研究生院（贾丹、李杨）

英文单位：

关键词：不明原因复发性流产；补肾活血方；白细胞介素17A；白细胞介素35；辅助性T细胞17；调节性T细胞

英文关键词：

• 摘要：

• 【摘要】目的    探讨补肾活血方对不明原因复发性流产（URSA）患者外周血中辅助性T细胞17(Th17)/调节性T细胞(Treg)平衡的影响。方法    选取2016年2月至2017年2月于黑龙江中医药大学附属第一医院妇科就诊的URSA保胎患者61例作为研究对象，采用随机数字表法分为观察组和对照组，在研究过程中1例脱落患者未计入数据统计，每组各30例。观察组患者给予补肾活血方联合地屈孕酮口服治疗4周。对照组患者单独给予地屈孕酮口服治疗4周。治疗前以及治疗4周后采集2组患者空腹静脉血，酶联免疫吸附试验检测血清中白细胞介素(IL)17A和IL-35水平，并检测2组患者治疗前后血清雌二醇、孕酮和β-人绒毛膜促性腺激素(β-HCG)水平变化。结果    治疗前观察组和对照组IL-17A和IL-35水平比较差异均无统计学意义（均P＞0.05）。治疗后观察组和对照组IL-17A均较治疗前明显下降［（12±5）ng/L比（25±8）ng/L、（17±6）ng/L比（27±9）ng/L］，IL-35均较治疗前明显升高［（54±14）ng/L比（33±7）ng/L、（42±9）ng/L比（33±4）ng/L］，且观察组IL-17A明显低于对照组、IL-35明显高于对照组，差异均有统计学意义（均P＜0.01）。治疗前2组雌二醇、孕酮、β-HCG水平比较差异无统计学意义（P＞0.05），治疗后均较治疗前明显升高，且观察组明显高于对照组，差异均有统计学意义（均P＜0.01）。结论    补肾活血方可以下调肾虚血瘀型URSA患者外周血中IL-17A，并上调IL-35的含量，起到调节免疫及抑制炎性反应的作用；还能够明显升高URSA患者外周血雌二醇、孕酮、β-HCG的含量。

• 【Abstract】Objective    To investigate the effect of Bushen Huoxue prescription on helper T cell 17(Th17)/regulatory T cell(Treg) balance in peripheral blood of patients with unexplained recurrent spontaneous abortion(URSA). Methods    A total of 61 women with kidney deficiency and blood stasis type of URSA admitted to First Affiliated Hospital, Heilongjiang University of Chinese Medicine from February 2016 to February 2017 were randomly divided into observation group and control group, with 30 cases in each group and 1 case lost during the trail. The observation group was treated by Chinese medicine Bushen Huoxue prescription combined with dydrogesterone and the control group was treated by dydrogesterone alone. Fasting venous blood was taken before and after 4 weeks of treatment to test serum interleukin(IL)-17A and IL-35(enzyme linked immunosorbent assay), estradiol, progesterone and β-human chorionic gonadotropin(β-HCG). Results    There were no significant differences of serum levels of IL-17A, IL-35, estradiol, progesterone and β-HCG between groups before treatment（all P＞0.05）. After treatment, IL-17A decreased［（12±5）ng/L vs （25±8）ng/L, （17±6）ng/L vs （27±9）ng/L］ and IL-35 increased［（54±14）ng/L vs （33±7）ng/L, （42±9）ng/L vs （33±4）ng/L］ significantly compared to those before treatment in both groups; IL-17A level in observation group was lower and IL-35 level was higher than those in control group（all P＜0.01）. Levels of serum estradiol, progesterone and β-HCG significantly increased after treatment and the levels in observation group were significantly higher than those in control group（all P＜0.01）. Conclusion    Bushen Huoxue prescription can regulate immunity and suppress inflammation through down-regulating IL-17A and up-regulating IL-35 in patients with kidney deficiency and blood stasis type of URSA; it can also improve the contents of estradiol, progesterone and β-HCG in peripheral blood.