自身抗体阳性RM患者外周血Th17细胞亚群的分布情况及中药的调节作用

发布时间：2018-03-26 18:06

  本文选题：免疫性复发性流产　切入点：消抗灵Ⅰ号　出处：《黑龙江中医药大学》2017年硕士论文

【摘要】：目的:探讨Th17细胞在复发性流产(recurrent miscarriage,RM)发生过程中的作用及临床验方对其具有的潜在调节作用,揭示免疫性RM的发生机制。为中药治疗自身抗体阳性RM患者提供新靶点和理论依据。为治疗提供有效免疫性RM中药产品。并对其临床疗效进行验证。方法:采用自身治疗前后对照法,收集所有的病例自2015年08月-2016年08月期间,就诊于黑龙江中医药大学附属第一医院妇科门诊的30例筛选符合纳入条件的自身抗体阳性RM患者。纳入的患者自身四项抗体(抗心磷脂抗体、抗精子抗体、抗卵巢抗体、抗子宫内膜抗体)中至少有一项阳性的30例患者设为疾病组,留取符合标准患者外周血,检测Th17细胞亚群比例,应用消抗灵Ⅰ号治疗,疗后30天如抗体转阴,再次留取患者静脉血检测Th17细胞比例,此后不再继续采血;如果抗体未转阴,间隔15天采血至抗体转阴。如果90天抗体仍未转阴,为治疗无效。观察对比疾病组的治疗前后中医症候积分等,以判定中药对于中医证候的临床疗效。健康志愿者为我院年龄匹配的正常女性30名作为对照。采用酶连免疫法检测抗体,应用流式细胞术检测Th17细胞的数量。结果:1、疾病组治疗前静脉血中Th17相关细胞因子CD4+IL-17A+比例表达水平高于健康组(P0.01),有统计学意义。2、疾病组自身治疗前后相比,CD4+IL-17A+细胞因子比例表达水平明显下降(P0.01),有显著差异及统计学意义。3、疾病组治疗后与健康组相比,外周静脉血中Th17相关细胞CD4+IL-17A+细胞因子比例表达水平无明显差异(P0.05)。4、疾病组治疗前后Th17相关细胞因子CD4+IL-17A+比例下降情况与不孕四项转阴情况存在明显的正相关性(r=0.863,P＜0.01)。5、经规律用药后,疾病组治疗前的临床伴随症状治疗后得到明显改善,中医症候积分明显下降。结论:研究中发现免疫性复发性流产(RM)患者外周静脉血中Th17细胞相关亚群比例显著高于健康组,说明Th17细胞在自身抗体阳性RM患者中具有的潜在调节作用。中药消抗灵Ⅰ号对治疗自身免疫性复发性流产患者外周血中Th17细胞比例下降有明显效果并对临床伴随症状有明显改善,是已病防变治疗滑胎脾肾两虚型的有效方剂。
[Abstract]:Objective: to investigate the role of Th17 cells in the pathogenesis of recurrent miscarriage and the potential regulatory effects of clinical prescriptions. To reveal the pathogenesis of immune RM, to provide new targets and theoretical basis for the treatment of autoantibody positive RM patients with Chinese medicine, and to provide effective immunological RM traditional medicine products for treatment, and to verify its clinical efficacy. Before and after self-treatment, Collecting all cases from August 2015 to August 2016, Thirty patients in gynecological outpatient clinic of the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine were screened for autoantibody positive RM patients who met the criteria of inclusion. The four autoantibodies (anti-cardiolipin antibody, anti-sperm antibody, anti-ovarian antibody) were included. 30 patients with at least one positive anti-endometrial antibody were selected as disease group. Peripheral blood samples were collected from patients who met the criteria. The proportion of Th17 cell subsets was detected. The patients were treated with Xiaokangling 鈪，

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