Wu Guo-lin, Wu Na-yuan, Li Tian-yi, Fan Yong-sheng, Yu Guo-you, Lu Wen-wen
The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, China.
Zhejiang University of Chinese Medicine, Hangzhou, 310053, China.
Chin J Integr Med. 2015 Oct;21(10):778-83. doi: 10.1007/s11655-015-2323-y. Epub 2015 Nov 3.
To investigate the effect of Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood on the reproductive endocrine-immune network and its mechanisms in patients with primary Sjogren's syndrome (pSS).
Seventy pSS patients were randomly assigned to two groups using a randomized digital table: the integrative therapy group (36 cases) and the control group (34 cases). Thirty healthy subjects were taken as a normal group. The control group was treated with hydroxychloroquine sulfate tablets alone, and the integrative therapy group was treated by Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with hydroxychloroquine sulfate tablets. The treatment course was 6 months for both groups. Before and after treatment, serum estradiol (E2), testosterone (T), luteinizing hormone (LH), prolactin (PRL) by radioimmunoassay and immunoglobulin (IgG) by immunodiffusion, erythrocyte sedimentation rate (ESR) by Westergren, interferon-γ (IFN-γ) and interleukin-4 (IL-4) by enzyme linked immunosorbent assay were determined.
E2 and T levels in all patients were lower than those of normal subjects before treatment (P<0.05) and were increased significantly after 6-month treatment (P<0.05). ESR, FSH, LH, IgG, IFN - γ, IL - 4 and ratios of E2/T, and IFN -γ/IL in the patients were higher than those of normal subjects before the treatments (P<0.05), and were reduced significantly after the treatments (P<0.05). The T and IFN - γ levels and E2/T ratio in the patients treated with integrative therapy were reduced significantly compared with the control group (P<0.05). However, the PRL levels before and after treatment were not significantly changed in the two groups (P>0.05). The ratios of E2/T and IFN -γ/IL-4, and levels of IgG and ESR were positively correlated before and after treatment (P<0.05).
The ratios of E2/T and IFN -γ/IL-4 might be used as indicators of pSS activity. Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with Western medicine could improve the therapeutic effect by regulating the reproductive endocrine-immune network in pSS patients.
探讨滋阴益气活血中药对原发性干燥综合征(pSS)患者生殖内分泌 - 免疫网络的影响及其作用机制。
采用随机数字表法将70例pSS患者随机分为两组:中西医结合治疗组(36例)和对照组(34例)。选取30例健康受试者作为正常组。对照组单纯给予硫酸羟氯喹片治疗,中西医结合治疗组在硫酸羟氯喹片治疗基础上加用滋阴益气活血中药治疗。两组疗程均为6个月。治疗前后采用放射免疫法检测血清雌二醇(E2)、睾酮(T)、黄体生成素(LH)、催乳素(PRL),免疫扩散法检测免疫球蛋白(IgG),魏氏法检测红细胞沉降率(ESR),酶联免疫吸附法检测干扰素 -γ(IFN -γ)和白细胞介素 -4(IL -4)。
所有患者治疗前E2和T水平均低于正常受试者(P<0.05),治疗6个月后显著升高(P<0.05)。患者治疗前ESR、卵泡刺激素(FSH)、LH、IgG、IFN -γ、IL -4及E2/T、IFN -γ/IL -4比值均高于正常受试者(P<0.05),治疗后显著降低(P<0.05)。中西医结合治疗组患者的T、IFN -γ水平及E2/T比值较对照组显著降低(P<0.05)。然而,两组治疗前后PRL水平无明显变化(P>0.05)。治疗前后E2/T、IFN -γ/IL -4比值及IgG、ESR水平呈正相关(P<0.05)。
E2/T、IFN -γ/IL -4比值可能作为pSS活动的指标。滋阴益气活血中药联合西药可通过调节pSS患者生殖内分泌 - 免疫网络提高治疗效果。