CAJ | 학술논문

目的：观察复方甘草酸苷对过敏性紫癜（HSP）患儿外周血T辅助细胞功能的影响。方法选取急性期HSP患儿39例，随机分为复方甘草酸苷治疗组20例、糖皮质激素治疗组19例，选取22例健康儿童为正常对照组。复方甘草酸苷组在常规治疗基础上给予复方甘草酸苷（3~5岁80mg qd、5~8岁120mg qd、＞8岁160mg qd）治疗7~10d，糖皮质激素组在常规治疗基础上给予甲基强的松龙（1~2mg/（kg·d），bid）治疗7~10d。留取治疗前后血浆，采用双抗体夹心酶联免疫吸附（ELISA）法检测血浆干扰素-γ（IFN-γ）、白介素-4（IL-4）、白介素-17（IL-17）水平变化。结果（1）HSP组患儿治疗前血浆IL-4、IL-17水平明显高于正常对照组（P＜0.05，P＜0.01）， IFN-γ水平与正常对照组无显著性差异（P＞0.05）；治疗前复方甘草酸苷组与糖皮质激素组血浆IFN-γ、IL-4、IL-17水平均无显著性差异（均P＞0.05）。（2）复方甘草酸苷组治疗前后血浆IFN-γ水平变化无显著性差异（P＞0.05），而IL-4、IL-17水平治疗后显著降低（P＜0.01，P＜0.05）；糖皮质激素组用药后血浆IFN-γ、IL-4、IL-17水平均较治疗前均显著下降（P＜0.05，P＜0.01，P＜0.05）。（3）糖皮质激素组用药后血浆IFN-γ、IL-4、IL-17水平下降幅度均显著大于复方甘草酸苷组（P均＜0.05）。结论复方甘草酸苷可能通过抑制HSP患儿Th2、Th17细胞活化而发挥抗炎和免疫调节作用，但其作用强度不及糖皮质激素明显。
목적：관찰복방감초산감대과민성자전（HSP）환인외주혈T보조세포공능적영향。방법선취급성기HSP환인39례，수궤분위복방감초산감치료조20례、당피질격소치료조19례，선취22례건강인동위정상대조조。복방감초산감조재상규치료기출상급여복방감초산감（3~5세80mg qd、5~8세120mg qd、＞8세160mg qd）치료7~10d，당피질격소조재상규치료기출상급여갑기강적송룡（1~2mg/（kg·d），bid）치료7~10d。류취치료전후혈장，채용쌍항체협심매련면역흡부（ELISA）법검측혈장간우소-γ（IFN-γ）、백개소-4（IL-4）、백개소-17（IL-17）수평변화。결과（1）HSP조환인치료전혈장IL-4、IL-17수평명현고우정상대조조（P＜0.05，P＜0.01）， IFN-γ수평여정상대조조무현저성차이（P＞0.05）；치료전복방감초산감조여당피질격소조혈장IFN-γ、IL-4、IL-17수평균무현저성차이（균P＞0.05）。（2）복방감초산감조치료전후혈장IFN-γ수평변화무현저성차이（P＞0.05），이IL-4、IL-17수평치료후현저강저（P＜0.01，P＜0.05）；당피질격소조용약후혈장IFN-γ、IL-4、IL-17수평균교치료전균현저하강（P＜0.05，P＜0.01，P＜0.05）。（3）당피질격소조용약후혈장IFN-γ、IL-4、IL-17수평하강폭도균현저대우복방감초산감조（P균＜0.05）。결론복방감초산감가능통과억제HSP환인Th2、Th17세포활화이발휘항염화면역조절작용，단기작용강도불급당피질격소명현。
Objective To explore the influence of Compond Glycyrrhizin on helper T lymphocyte Cell in peripheral blood of children with Henoch-schonlein Purpura(HSP). Methods 39 HSP children were randomly divided into glycyrrhizin treatment group and glucocorticoid treatment group, and 22 healthy children were chosen as the control group.Glycyrrhizin treatment group on the basis of conventional treatment was given different doses of glycyrrhizin according to age (3y-5y 80mg per time,once a day;5y-8y 120mg per time, once a day; > 8y 160mg per time,once a day),for 7-10 days;Glucocorticoid treatment group on the basis of conventional treatment was given Methylprednisolone Na Succinate (1-2mg Per kilogram, per day,twice a day), for 7-10 days; Enzyme-linked immunosobent assay(ELISA) was used to determine the level changes of IFN-γ, IL-4 and IL-17 in the plasma. Results (1) The level of IL-4 and IL-17 of HSP group was significantly higher than that of the control group(P<0.05,P<0.01),and there were no significant differences in the level of IFN-γ between the two groups(P>0.05).There were no significant differences in the level of IFN-γ,IL-4 and IL-17 between two treatment groups before the treatment(P > 0.05).(2) There was no significant difference in the level of IFN-γ of glycyrrhizin group between before and after the treatment (P >0.05), while IL-4, IL-17 levels were significantly lower (P < 0.01,P < 0.05);The level of IFN-γ,IL-4 and IL-17 of glucocorticoid group were significantly decreased than that of before treatment (P <0.05,P<0.01,P<0.05).(3) In the glucocorticoid group the level of IFN-γ,IL-4,IL-17 in the plasma decline were significantly greater than the glycyrrhizin group (all P < 0.05) between before and after the treatment. Conclusion Glycyrrhizin has siginificant immunoloregulation function on HSP children,and play it's role possibly through inhibition of Th2,Th17 cell overactivation, downregulation the level of IL-4, IL-17 in plasma,but its role in immune regulation was not so evident than that of glucocorticoid.