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目的:探讨中药升降散对脓毒症患者Th17/Treg失衡及相关调节因子RORγt和foxp3的干预作用。方法:将55例脓毒症患者随机分为西医组(27例)和升降散组(28例),另设健康志愿者9例为对照组。西医组患者给予西医常规治疗,并加用安慰剂100ml/次,2次/d,口服或鼻饲;升降散组患者在西医常规治疗的基础上加用升降散100ml/次,2次/d,口服或鼻饲;对照组患者给予口服安慰剂100ml/次,2次/d;疗程均为3d。比较治疗前后3组患者中医证候积分、血白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)、Th17/Treg及其特异性转录因子RORγt、foxp3的水平。结果:西医组与升降散组比较,治疗后中医证候积分、WBC、Th17/Treg、RORγt和foxp3差异均有统计学意义(P<0.05或P<0.01),2组患者治疗后CRP和PCT的差异无统计学意义;2组与对照组比较,治疗前后各项指标差异均有显著统计学意义(P<0.01)。结论:升降散可改善脓毒症患者中医证候积分、降低血白细胞水平,对Th17/Treg失衡及相关调节因子RORγt和foxp3具有干预作用。
Objective: To investigate the effects of Sheng Jiang San on the imbalance of Th17 / Treg and related regulators RORγt and foxp3 in septic patients. Methods: 55 patients with sepsis were randomly divided into Western medicine group (27 cases) and Shengjiang powder group (28 cases), and another 9 healthy volunteers as control group. Western medicine group were given conventional Western medicine treatment, plus placebo 100ml / time, 2 times / d, oral or nasal feeding; patients with ascending and descending scattered in Western medicine on the basis of conventional treatment plus ascending and descending 100ml / times, 2 times / Oral or nasal feeding; the control group of patients given oral placebo 100ml / time, 2 times / d; course of treatment were 3d. The TCM syndrome scores, WBC, C-reactive protein (CRP), procalcitonin (PCT), Th17 / Treg and its specific transcription factors RORγt and foxp3 were compared between the three groups before and after treatment. Results: After treatment, the difference of TCM syndrome score, WBC, Th17 / Treg, RORγt and foxp3 between the two groups were statistically significant (P <0.05 or P <0.01) There was no statistically significant difference between the two groups before and after treatment (P <0.01). Conclusion: Shengmai San can improve TCM syndrome score and blood leukocyte level in patients with sepsis and interfere with the imbalance of Th17 / Treg and related regulators RORγt and foxp3.