The Effect Of Yishen Jiedu Compound Prescription On T Lymphocyte Subsets And Cytokines In Patients With Relapsing-remitting Multiple Sclerosis

Objective:This study selected Yishenjiedu compound as the prescription for the treatment of RRMS patients in remission period,and observed the recurrence of patients before and after treatment,EDSS scale score and Barthel index changes.Compared immunological indicatorsT lymphocyte subsets CD4+?CD8+?CD4+/CD8+,Th17,CD4+CD25+FOXP3Treg cells,IFN-?,IL-4,IL-17,TGF-?,immunoglobulin IgG,IgA,IgM?serum complement C3,C4 with before treatment.Through these indexes,the study evaluated the clinical efficacy of Yishenjiedu compound in the treatment of patients with RRMS in remission period,and observed the state of immune function,and analyzed the relationship between abnormal expression of immune cells and relapse.Finally,the possible mechanism of Yishenjiedu compound was elucidated in the treatment of RRMS and provided immunological basis for clinical application of Yishenjiedu compound.Method:According to McDonald 2010 MS western medicine diagnostic criteria,the RRMS patients who were admitted to the second affiliated Hospital of Guiyang College of traditional Chinese Medicine from September 2015 to February 2017 were collected(N=32,8 males,24 females).All the patients were treated with Yishenjiedu compound after entering the group,1 dose daily,3 times a day,1 year sustatined.Patients with acute recurrence during treatment were treated with methylprednisolone 1000mg shock therapy and gradually reduced.The current international extended disability score(EDSS)was used before and after treatment.The functional state of the activity of daily life was measured through measuring the score of the scale(Barthel index).The number of annual recurrence statistics was combined to evaluate the efficacy and the safety evaluation was made through observing adverse reactions(TESS Scale).After and before 1 years of treatment,The content changes of T lymphocyte subsets CD3+,CD4+,CD8+,Th17,CD4+CD25+FOXP3Treg cells were measured through FCM,the ELISA method was used to determine IFN-y and IL-4,IL-17,TGF-? level in the peripheral blood of the patients.The content changes of peripheral blood immunoglobulin IgG,IgA,IgM and complement C3,C4 were measured through immune scatter turbidity.Results:1.In terms of clinical efficacy:Yishenjiedu compound can reduce the clinical EDSS score,The difference between 6 months and 1 year after treatment have statistically significance compared with the day of entry(P<0.01).Compared 6 months with one year after treatment,the scores of EDSS have no statistically significance(P>0.05).The total effective rate in 6 months and 1 year after treatment were 60%and 63.33%,respectively.There was no significant difference in Barthel scores at different time before and after treatment with Yishenjiedu compound.Yishenjiedu compound can reduce the recurrence times and the annual recurrence of RRMS in remission period.There was significant difference between the time before and after treatment(P<0.01).2.The effect of lymphocyte subsets:The expression of CD4+,CD4+/CD8+in peripheral blood after treatment with Yishenjiedu compound was significantly lower than that before treatment(P<0.05,P<0.01).The expression of CD8+and CD4+CD25+FOXP3Treg cells significantly higher than that before treatment,and the difference was very statistically significant(P<0.01).The number of Th17 cells decreased significantly compared with before treatment(P<0.05).Th17/CD4+CD25+F OXP3 Treg cells significantly decreased with statistically difference(P<0.01)?3.In terms of intervention in cytokines:Compared with before treatment,YishenJiedu compound can reduce the expression of serum IFN-? and IL-17 cytokines,all of which have very significant differences(P<0.01).And Yishenjiedu increased serum IL-4 cytokines and the content of TGF-?(P<0.05andP<0.01),and the differences were statistically significant.4.The content level changes of serum complement C3,C4,immunoglobulin IgG,IgA,IgM had no statistical significance(P>0.05).Conclusion:1.Yishenjiedu compound can reduce the number of clinical recurrence and EDSS score of RRMS patients in remission period.None of obvious adverse reactions were appeared,which means clinical application is safe and effective.2.The abnormal expression of T lymphocyte subsets and the imbalance of cytokine network in peripheral blood of RRMS patients may be one of the important reasons for the recurrence of RRMS.3.YishenJiedu compound can regulate the imbalance of T lymphocytes,and can also reduce the expression of IFN-y and IL-17 in peripheral blood and increase the expression of IL-4,TGF-? to regulate T cell immune response network in patients with RRMS and the imbalance of cytokine network.Also the body immune disorders were improved,and immune tolerance was restored,it may be an important mechanism of kidney detoxification treatment of compound RRMS,recurrence times reducing.