| Objective:1.By comparing the expression levels of CD4+CD25+CD127-,CD8+CD28-regulatory T cells in peripheral blood of TD and non-TD,explore the correlation beyween CD4+CD25+CD127-,CD8+CD28-regulatory T cells and TD,clarifie the immune status of children with TD.2.By studying the changes of peripheral blood CD4+CD25+CD127",CD8+CD28-levels in children with TD before and after treatment with Jingxinzhitong ddecoction,clarifie the role of Jingxin Zhitong decoction on cell and immunity level and further find a breakthrough point in the treatment of TD.Method:1.Collected 3 to 18-year-old TD patients who met the pediatric clinic of Guang’anmen Hospital from August 2018 to August 2019,and divided into TD group,non-TD group.2.Detect and observe the similarities and differences of the levels of CD4+CD25+CD127-、CD8+CD28-regulatory T cells in peripheral blood of children with TD and non-TD,and Observe the changes in the levels of CD4+CD25+CD127-,CD8+CD28" Treg cells in children with TD before and after treatment with Jingxin Zhitong decoction.3.CRF table(case report form)records:①general information of children with TD,②the disease YGTSS scores of children in the TD group before and after treatment ③laboratory related Indicators(CD8+CD28-,CD4+CD25+CD127-,routine urine test,liver and kidney function test before and after treatment in the TD group;CD4+CD25+CD127-,CD8+CD28-,liver and kidney function test of non-TD group),④record any bad record.4.SPSS 24.0 statistical software was used to analyze the data,the measurement data was tested with parameters,and the count data was tested with non-parameters.The difference test uses independent t-test,Mann-Whitney U test,one-way variance,Kruskal-Wallis H,chi-square test and other analysis methods;correlation analysis uses Pearson correlation,Kendalls tau-b rank correlation;influence factor analysis uses regression analysis,Discriminant analysis.Result:1.Correlation between CD4+CD25+CD127-,CD8+CD28-Treg cells and TD1.1 This test into a TD group 65 examples,the non-TD group 30 cases.1.2 The overall level of CD4+CD25+CD127-Treg cells in the TD group was not significantly different,P=0.550(P>0.05);but in different age groups and TCM syndrome groups,it was more abnormal than the non-TD group and had statistical significance(P<0.05).Specifically,in the aged less than 8 years old group and the Feipiqixu,Yinxufengdong TCM syndrome group,the level of CD4+CD25+CD127-in the TD group is lower than in the non-TD group.In the aged older than 11 group and the Xinganrechi group,the CD4+CD25+CD127-level in the TD group is higher than in the non-TD group.1.3 The CD4+CD25+CD127-in the non-TD group has a significant linear effect on age.The linear regression equation is Y=-0.207 X+10.40.This linear relationship was not shown in the TD group.1.4 TD group of CD8+CD28-the overall level of the Treg cells is higher than the TD groups,statistically significant differences,P=0.042(P<0.05).Specifically,in the girls of TD group,aged less than 8 years old,older than 11 group,the moderate and severe group,TS group and Yinxufengdong TCM syndrome group,the CD8+CD28-level higher than in the non-TD group.1.5 The CD4+CD25+CD127-of boys and girls in the TD group is statistically different,and the abnormality of CD8+CD28-is also mainly manifested in the girl group,that is,the expression capacity of Treg cells between boys and girls is different.1.6 By using CD4+CD25+CD127-,CD8+CD28-Treg cells to identify the TCM syndrome,the accuracy of the total prediction is 73.8%,of which the accurate prediction rate of Xinganrechi syndrome is as high as 83.9%.1.7 Both in the TD group and the non-TD group,there was no correlation between CD4+CD25+CD127-,CD8+CD28-,CD4+,CD8+and CD3+.Shows that the relationship between TD’s Treg cells and surrounding immune cells is relatively stable,indicating that the abnormality of TD’s immune function is the overall abnormality of the immune system.2 Effect of Jingxinzhitong ddecoction on TDThe total effective rate of Jingxinzhitong decoction for 12 weeks was 90.8%.There was no significant difference in efficacy between different gender groups,age groups,and syndrome groups(P>0.05),and there was a significant difference between mild and severe groups.P=0.021<0.05.3.Effect of Jingxinzhitong ddecoction on CD4+CD25+CD127-,CD8+CD28-Treg cells3.1 After 12 weeks of treatment with Jingxin Zhitong Recipe,the levels of CD4+CD25+CD127-,CD8+CD28-Treg cells approached the non-TD group after treatment.The levels in each group were lower than those in non-TD group(P<0.05),except the levels of CD4+CD25+CD127-Treg cells in Yinxufengdong group were loewer than those in non-TD group(P<0.05)and the levels of CD8+CD28-Treg cells in TD girl group were higher than non-TD group(P<0.05).3.2 The change rate of CD4+CD25+CD127-,CD8+CD28-has a positive correlation with the YGTSS reduction rate.Conclusion:1.TD children have abnormalities in the immune system and the overall immune system is abnormal,not limited to certain types of cell abnormalities.Abnormal immune function can show reduced immune tolerance and enhanced immune suppression.lt is speculated that the immune cross reaction and/or inflammation caused by abnormal immune function damages the central nervous system,which is one of the causes of TD.2.Boys and girls’ different ability to express "Treg cells" may be one of the reasons for the different incidence of TD boys and girls.3 TCM syndrome is the most significant factor that affects the difference between Treg cells in TD group and non-TD group.CD4+CD25+CD127-,CD8+CD28-can be used as micro-differentiation indicators of the TCM syndrome.4.In this trial,the total effective rate of the meditation stopper formula was 90.8%,and its efficacy was not affected by gender,age,and syndrome type.For severe TD,its total effective rate was 78.6%.The Jingxinzhitong decoction is safe and effective in treating TD,and has small limitations,and can be used for all TD patients.5.The effect of Jingxinzhitong decoction is consistent with the rate of change before and after treatment of CD4+CD25+CD127-,CD8+CD28-,that is,the Jingxinzhitong decoction has a corrective effect on Treg cells when treating TD children.Especially for bidirectional abnormal CD4+CD25+CD127-,it can perform the corresponding two-way adjustment. |
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