大柴胡汤对轻症急性胰腺炎患者Th17/Treg免疫平衡和血清水通道蛋白的影响

摘要 目的：观察大柴胡汤对轻症急性胰腺炎（MAP）患者辅助性T细胞17 /调节性T细胞（Th17/Treg）免疫平衡和血清水通道蛋白（AQP）的影响。方法：按照随机数字表法，将天津中医药大学第一附属医院2020年4月~2022年4月期间收治的95例MAP患者分为对照组（西医基础治疗，47例）和研究组（对照组基础上接受大柴胡汤治疗，48例）。对比两组中医证候积分、Th17/Treg免疫平衡、AQP1、AQP5、AQP6和实验室指标。结果：两组治疗7 d后两胁胀痛，矢气则舒，右中上腹痛，恶心呕吐，抑郁易怒，嗳气呃逆，大便不畅评分均下降，且研究组低于对照组（P<0.05）。两组治疗7 d后Treg细胞比例升高，Th17细胞比例、Th17/Treg下降，且研究组的改善幅度大于对照组（P<0.05）。两组治疗7 d后AQP1、AQP5、AQP6升高，且研究组高于对照组（P<0.05）。两组治疗7 d后淀粉酶（AMY）、脂肪酶（LIP）、C反应蛋白（CRP）下降，且研究组低于对照组（P<0.05）。结论：大柴胡汤治疗MAP疗效确切，可以缓解患者的临床症状，有效改善MAP患者Th17/Treg免疫平衡和血清AQP1、AQP5、AQP6水平。

Effect of Dachaihu Decoction on Th17/Treg Immune Balance and Serum Aquaporin in Patients with Mild Acute Pancreatitis

ABSTRACT Objective: To observe the effect of Dachaihu decoction on helper T cell 17/regulatory T cell (Th17/Treg) immune balance and serum aquaporin (AQP) in patients with mild acute pancreatitis (MAP). Methods: According to the random number table method, 95 patients with MAP who were admitted to The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from April 2020 to April 2022 were divided into control group (treated with basic western medicine, 47 cases) and study group (treated with Dachaihu decoction on the basis of the control group, 48 cases). The traditional Chinese medicine syndrome scores, Th17/Treg immune balance, AQP1, AQP5, AQP6 and laboratory indicators were compared between the two groups. Results: The scores of pain and swelling in both flanks, relief from sagittal qi, right upper and middle abdominal pain, nausea and vomiting, depression and irritability, belching and hiccup, and obstructed bowel movements decreased in the two groups 7 d after treatment, and the study group was lower than that in the control group (P<0.05). The ratio of Treg cells increased and the ratio of Th17 cells, Th17 / Treg decreased after 7 d of treatment in both groups, and the improvement in the study group was greater than that in the control group (P<0.05). The AQP1, AQP5, and AQP6 increased in the two groups 7d after treatment, and the study group was higher than that in the control group (P<0.05). The amylase (AMY), lipase (LIP), and C-reactive protein (CRP) decreased in the two groups 7d after treatment, and the study group was lower than that in the control group (P<0.05). Conclusion: Dachaihu decoction can effectively improve Th17 to Treg immune balance and serum AQP levels in patients with MAP, promote the improvement of clinical symptoms in patients, and which has good clinical application value.