To Observe the Clinical Efficacy of Modified Guizhi Decoction Combined with Yupingfeng Powder in the Treatment of Chronic Spontaneous Urticaria Based on Th17/Treg Balance Axis
Objective To evaluate the clinical effect of modified Guizhi Decoction combined with Yupingfeng Powder on chronic spontaneous urticaria(CSU)(wind-cold invading exterior,ying-wei disharmony syndrome)and its influence on Th17/Treg balance axis. Methods A total of 116 patients with CSU were randomly divided into control group (58 cases) and test group (58 cases). The control group was treated with oral antihistamines (ebastine tablets,loratadine tablets). The test group was additionally treated with Guizhi Decoction and modified Yupingfeng Powder on the basis of the control group. The course of treatment was 12 weeks and followed up for eight weeks. Indices detection include:the weekly score of urticaria severity (UAS7),chronic urticaria quality of life questionnaire (CUQ2oL),the standard-reaching rate of urticaria control test (UCT),TCM syndrome score,and related biological parameters[levels of D-dimer(D-D),total immunoglobulin E(TIgE),complement C3 and C4,Th17,proportion of Th17 and Treg cells,ratio of Th17/Treg,levels of interleukin (IL)-17,IL-23,IL-35,and transforming growth factor-β(TGF-β)]. UAS7 symptom score reduce index(SSRI)was used as a criterion for efficacy evaluation. Results After treatment,the UAS7 scores of the two groups at different time points were lower than those before treatment(P<0.05),and those were significantly lower in the test group than in the control group (P<0.05). At 4 weeks,8 weeks and 12 weeks after treatment,and at 4 weeks and 8 weeks of follow-up,the standard-reaching rate of UCT in the test group was higher than that in the control group (P<0.05). After treatment,the factor scores and total scores of CUQ2oL scale of the two groups were significantly lower than those before treatment (P<0.05),the levels of D-D and TIgE of peripheral blood were also significantly lower than those before treatment(P<0.05). But the levels of C3 and C4 were significantly higher than those before treatment (P<0.05). The levels of Th17 cells and the ratio of Th17/Treg were significantly lower than those before treatment(P<0.05). Treg cell level was obviously increased after treatment(P<0.05). In addition,the levels of IL-17,IL-23 and TGF-β were obviously decreased after treatment (P<0.05). IL-35 level was obviously increased after treatment(P<0.05). TCM syndrome score of two groups reduced obviously (P<0.05). The difference was statistically significant (P<0.05) by comparison between the control group after treatment and the test group. Furthermore,the test group showed a significant effect. The cure-markedly effective rate of test group was 60.34％ (35/58),which was significantly higher than that of control group[39.66％(23/58)]. The difference between groups was statistically significant (P<0.05). Conclusion A combination of modified Guizhi Decoction and Yupingfeng Powder therapies on the basis of antihistamines can control the disease activity of CSU patients,improve the disease control effect,improve the quality of life,and increase effectiveness. Its mechanism of action may be related to the regulation of the levels of Th17,Treg cells and the expression of related inflammasons,and the maintenance of Th17/Treg immune balance.
万方数据
维普
