| Objective:To investigate the therapeutic effect of Chai Huang Qing Yi Huo Xue granules on patients with severe acute pancreatitis(Severe Acute Pancreatitis,SAP)and its effect on r elated factors of Treg and Th17 cells,and further explore the mechanism of Chai Huang Qing Yi Huo Xue granules in the treatment of SAP,from an immunological point of view.It may provide a new scientific basis for the treatment of SAP immune dysfunction.Methods:62 SAP inpatients admitted from July 2016 to January 2018 in the Affiliated Chinese Medicine Hospital of Southwest Medical University were divided into two groups,according to randomized,controlled and single-blind principle: 32 cases of Chai Huang Qing Yi Huo Xue Granules group(group CH),which was dealt with basic treatments and Chai Huang Qing Yi Huo Xue Granules;30 cases of Qing Yi Li Dan Granules group(group QY),which was dealt with basic treatments and Qing Yi Li Dan Granules.Observe the symptoms and signs of SAP patients and the fluctuation of C-reactive protein,for clinical valence evaluation.On the 1st day of hospitalization(on the admission day),the 3rd day,the 7th day,Collect the peripheral venous blood of severe acute pancreatitis patients added to 6ml.Real-time quantitative polymerase chain reaction(RT-q PCR)was used to calculate the relative expression levels of mRNA of Fork head box protein P3(Foxp3)and Retinoid-related orphan nuclear receptor ?t(ROR?t),which is specific transcription factors of regulatory T cells(Tregs)and T helper cell 17(Th17)in peripheral blood mononuclear cells(PBMCs).By using Enzyme Linked Immune-Immune-Sorbent A-Ssay(Elisa),measured the levels of cytokine TNF-?,IL-17 and IL-10.Use SPSS19.0 statistical software for statistical analysis of the data.Results:1.Including 62 cases of standard cases,CH group of 32 cases,2 cases fall off.2.Symptoms,signs,and CRP levels in patients with SAP with treatment(1)Symptoms,signs and CRP levels on the 1st day in SAP patients were not statistically different(P>0.05);(2)Symptoms and signs score of CH group and QY group on the 3rd day of hospitalization were lower than those on the 1st day,there was significant difference(P<0.05);CRP levels in CH group and QY group on the 3rd day were higher than those on the 1st day,and there was no significant difference(P>0.05);Symptoms and signs score and CRP level of CH group and QY group on the 7th day of hospitalization were respectively lower than those on the 1st day(P<0.05);(3)The symptoms,signs and CRP levels of CH group on the 3rd day were not statistically different from those of QY group(P>0.05);Symptoms,signs levels in CH group were significantly different from those in QY group on the 7th day(P<0.05);CRP levels in CH group were not statistically different from those of QY group on the 7th day(P>0.05).3.Study on relative expression of Foxp3 mRNA and ROR?t mRNA in patients with SAP with treatment(1)There was no significant difference in the relative expression levels of Foxp3 mRNA and ROR?t mRNA on the 1st day after hospitalization in SAP patients(P>0.05);(2)The relative expression level of Foxp3 mRNA in CH group and QY group on the 3rd day was higher than that on the 1st day,there is a statistical difference between these(P<0.05);The relative expression level of Foxp3 mRNA in CH group and QY group on the 7th day was higher than that on the 1st day,there is a statistical difference between these(P<0.05);(3)The relative expression of ROR?t mRNA on the 3rd day in CH group and QY group was lower than that on the 1st day,there is a statistical difference between these(P<0.05);On the 7th day,the relative expression of ROR?t mRNA in CH group and QY group was lower than that on the 1st day,there is a statistical difference between these(P<0.05);(4)On the 3rd day,the relative expression level of Foxp3 mRNA in CH group was not significantly different from that in QY group(P>0.05);the relative expression of Foxp3 in CH group on the 7th day was not significantly different from that of QY group(P>0.05);Compared with QY group,the relative expression of ROR?t mRNA in CH group on the 3rd day was significantly different(P<0.05);Compared with the QY group,the relative expression of ROR?t mRNA in CH group on the 7th day was significantly different(P<0.05).4.The levels of TNF-?,IL-17 and IL-10 in SAP patients with treatment(1)There was no significant difference in the levels of TNF-?,IL-17 and IL-10 on the 1st day after hospitalization in SAP patients(P>0.05);(2)The levels of TNF-? in CH group and QY group on the 3rd day were lower than those on the 1st day,there is a statistical difference between these(P<0.05);the levels of TNF-? in CH group and QY group On the 7th day were lower than those on the 1st day,there is a statistical difference between these(P<0.05).There was no significant difference in TNF-? level between CH group and QY group on the 3rd day(P>0.05);Compared with QY group,there was no significant difference in TNF-? level with CH group on the 7th day(P>0.05);(3)The level of IL-17 in CH group and QY group on the 3rd day was lower than that on the 1st day,there is a statistical difference between these(P<0.05);The levels of IL-17 in CH group and QY group on the 7th day were lower than those on the 1st day,there is a statistical difference between these(P<0.05);The levels of IL-17 in CH group was significantly higher than that in QY group on the 3rd day(P<0.05);Compared with QY group,the levels of IL-17 in CH group on the 7th day had a statistical difference(P<0.05);(4)On the 3rd day,the levels of IL-10 in CH group and QY group was higher than that on the 1st day,there is a statistical difference between these(P<0.05);the level of IL-10 in CH group and QY group on the 7th day was higher than that on the 1st day,there is a statistical difference between these(P<0.05);There was no significant difference in IL-10 level between CH group and QY group on the 3rd day(P>0.05).Compared with QY group,there was no significant difference in IL-10 level with CH group on the 7th day(P>0.05).Conclusion:(1)Intra-hospital preparation of Chai Huang Qing Yi Huo Xue Granules can reduce CRP,TNF-? levels,improve the symptoms and signs of SAP patients,to promote patient recovery.(2)The mechanism of Huang Qing Yi Huo Xue Granules in treating SAP: It is possible to regulate the immune over-response / immunosuppressive response and promote the recovery of immune homeostasis by enhancing the expression of Foxp3 transcription factor and decreasing the expression of ROR?t transcription factor.(3)Foxp3 and ROR?t transcription factor mechanism of action may be through the regulation of proinflammatory cytokines IL-17 and anti-inflammatory factor IL-10.However,due to the relatively insufficient sample size in the study and other factors,the mechanism of action of Foxp3 and ROR?t transcription factors needs further study. |
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