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目的观察解毒化瘀颗粒在ACLF治疗中对Th17细胞介导的免疫应答的干预效应及临床疗效。方法采用开放性、区组随机、平行对照临床实验方法,随机分为治疗组(解毒化瘀颗粒+西医基础综合)和对照组(西医基础综合治疗),采用全自动生化检测系统检测血清ALT、TBIL、PTA等相关生化指标,流式细胞仪分析患者IL-17~+细胞的数量,与采集的外周血中的CD_4~+细胞比较,得到Th17细胞频率的变化情况,评价解毒化瘀颗粒在治疗ACLF中对Th17细胞介导的免疫应答的干预作用。结果治疗组患者的肝功能及凝血功能、预后改善情况、病死率等方面优于对照组(P<0.05);治疗组外周血中Th17细胞在CD_4~+T细胞中的比例较对照组显著下降,差异具有统计学意义(P<0.05)。结论中西医结合方案的临床疗效要优于单纯西医治疗方案;其作用机制可能是通过降低ACLF患者外周血CD_4~+细胞中IL-17~+细胞的细胞数量,从而降低Th17细胞的频率,干预Th17细胞介导的免疫应答,达到改善ACLF患者预后的目的。
Objective To observe the intervention effect and clinical effect of Jiedu Huayu granules on Th17 cell-mediated immune response in ACLF treatment. Methods Randomized, parallel and controlled randomized clinical trial were divided into treatment group (detoxification and blood stasis granules + western medicine comprehensive basis) and control group (western medicine comprehensive treatment). The serum ALT, TBIL, PTA and other related biochemical indicators, the number of IL-17 ~ + cells in patients analyzed by flow cytometry, compared with the collected CD_4 ~ + cells in peripheral blood to get the change of Th17 cell frequency, to evaluate the effect of Jiedu Huayu granules on Therapeutic Effect of ACLF on Th17 Cell Mediated Immune Response. Results The liver function, coagulation function, prognosis and mortality in the treatment group were better than those in the control group (P <0.05). The percentage of Th17 cells in the peripheral blood of CD4 + T cells in the treatment group was significantly lower than that in the control group , The difference was statistically significant (P <0.05). Conclusion The clinical efficacy of integrated traditional Chinese and western medicine is better than that of Western medicine alone. The possible mechanism is that the number of IL-17 ~ + cells in peripheral blood CD_4 ~ + cells in ACLF patients may be decreased and the frequency of Th17 cells decreased. Intervention Th17 cell-mediated immune response, to achieve the purpose of improving the prognosis of patients with ACLF.