泻痢康胶囊治疗脾肾阳虚证艾滋病腹泻及对IL-17等的影响研究

发布时间：2018-03-22 17:34

本文选题：艾滋病相关腹泻　切入点：脾肾阳虚证　出处：《河南中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:以脾肾阳虚证艾滋病相关腹泻患者为研究对象,通过随机、对照的研究方法进行泻痢康胶囊干预治疗研究,评价泻痢康胶囊对脾肾阳虚证艾滋病腹泻患者临床疗效及其对炎症细胞因子IL-17、IL-6等的影响。方法:纳入脾肾阳虚证艾滋病腹泻患者60例,随机分为泻痢康胶囊治疗组及思密达颗粒对照组,治疗4周,每周进行一次随访,记录病人主症、次症、舌脉的信息,观察治疗前后腹泻相关临床症状积分变化,同时留取治疗前后外周血,进行IL-17、IL-6等细胞因子检测,评价泻痢康胶囊对外周血IL-17相关细胞因子的影响。结果:研究共纳入脾肾阳虚证艾滋病腹泻患者60例,治疗过程中脱落6例,其中治疗组2例,对照组4例,完成试验54人。治疗组临床有效率为66.7%,对照组43.3%,组间比较差异有统计学意义(P0.05)。腹泻次数症状积分均呈下降趋势,治疗组组内比较t=2.321,P=0.024;组间比较F=3.372,P=0.0410.05。治疗组外周血IL-17由治疗前的(1361.43±1676.57)pg/ml上升为(1662.09±1964.34)pg/ml,治疗前后比较差异有统计学意义,对照组由治疗前的(1097.50±1087.49)pg/ml下降为(794.19±727.54)pg/ml,组间采用协方差分析,两组比较差异有统计学意义。治疗组患者IL-6及IL-23分别由治疗前的(13.38±37.41)pg/ml、(11.58±11.24)pg/ml上升为(99.09±113.13)pg/ml、(66.10±41.12)pg/ml,组间比较差异显著。治疗组IL-21采用配对样本Wilcoxon检验,治疗前后p=0.018,差异有统计学意义。结论:(1)脾肾阳虚证艾滋病腹泻患者感邪日久,疾病过程中兼有寒湿、痰饮、瘀血等病因,也存在化热的病机转变。(2)脾肾阳虚证艾滋病腹泻患者CD4+T淋巴细胞均值较高但其腹泻的发生率并未明显降低。(3)泻痢康胶囊治疗脾肾阳虚证艾滋病腹泻疗效优于思密达颗粒。可明显减少腹泻患者大便次数。(4)泻痢康胶囊可提升脾肾阳虚证艾滋病患者外周血IL-17、IL-6、IL-23水平。诱导初始T细胞向Th17细胞分化,促进Th17细胞的发育及增殖,减轻肠道免疫炎症反应。脾肾阳虚证艾滋病患者IL-21检出率低,泻痢康胶囊可提升患者外周血IL-21水平。
[Abstract]:Objective: to study the intervention therapy of Xielikang capsule in patients with AIDS-related diarrhea due to deficiency of spleen and kidney yang. Objective: to evaluate the clinical effect of Xielikang capsule on patients with AIDS diarrhea due to deficiency of spleen and kidney yang and its effect on the inflammatory cytokines IL-17 and IL-6. Methods: 60 patients with AIDS diarrhea due to deficiency of spleen and kidney yang were included in this study. They were randomly divided into Xielikang capsule treatment group and Simida granule control group. The patients were followed up once a week for 4 weeks to record the information of main symptoms, secondary symptoms and tongue veins, and to observe the changes of clinical symptom scores related to diarrhea before and after treatment. At the same time, the peripheral blood was collected before and after treatment, and the cytokines such as IL-17 and IL-6 were detected to evaluate the effect of Xielikang capsule on the cytokines associated with IL-17 in peripheral blood. Results: 60 patients with diarrhea due to the deficiency of spleen and kidney yang were included in the study. In the course of treatment, 6 cases dropped out, including 2 cases in the treatment group, 4 cases in the control group, 54 cases completed the test. The clinical effective rate of the treatment group was 66.7%, and that of the control group was 43.3%. The difference between the two groups was statistically significant (P 0.05). In the treatment group, the IL-17 of peripheral blood increased from 1361.43 卤1676.57)pg/ml to 1662.09 卤1964.34 PG / ml, and the control group decreased from 1097.50 卤1087.49)pg/ml to 794.19 卤727.54 渭 g / ml. The IL-6 and IL-23 in the treatment group increased from 13.38 卤37.41g / ml 11.58 卤11.24)pg/ml to 99.09 卤113.13pgml / ml 66.10 卤41.12g / ml, respectively. The IL-21 of the treatment group was tested by paired sample Wilcoxon. Before and after treatment, the difference was statistically significant. Conclusion: 1) Spleen-Kidney Yang deficiency Syndrome patients with AIDS diarrhea feel evil for a long time, and there are cold and dampness, phlegm and blood stasis in the course of the disease. There is also pathogenesis transformation of heat. 2) the mean value of CD4 T lymphocytes in patients with diarrhea of spleen and kidney yang deficiency is higher but the incidence of diarrhea is not significantly reduced.) Xielikang capsule is better than Si in treating AIDS diarrhea due to deficiency of spleen and kidney yang. Meida granule. It can obviously reduce the defecation times of diarrhea patients.) Xielikang capsule can increase the level of IL-17, IL-6, IL-6 and IL-23 in peripheral blood of AIDS patients with deficiency of spleen and kidney yang, and induce the initial T cells to differentiate into Th17 cells. Promoting the development and proliferation of Th17 cells and alleviating the intestinal immune inflammation. The detection rate of IL-21 was low in the patients with deficiency of spleen and kidney yang. Xielikang capsule could enhance the level of IL-21 in peripheral blood of the patients.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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