The clinical effects of Sijunzi decoction on gut barrier protection and immune regulation in patients with persistent inflammation -immunosuppression catabolism syndrome accompanied by spleen-qi deficiency
10.3969/j.issn.1008-9691.2014.05.005
- VernacularTitle:四君子汤对持续性炎症-免疫抑制分解代谢综合征脾虚证患者的肠道保护及免疫调节作用
- Author:
Suping NIU
;
Wei CHEN
;
Guojing LI
;
Xuefeng ZANG
;
Lei ZHAO
;
Xingzhong FENG
- Publication Type:Journal Article
- Keywords:
Sijunzi decoction;
Persistent inflammation-immunosuppression catabolism syndrome;
Spleen-qi deficiency type;
Gastrointestinal tract;
Immunity
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2014;(5):335-339
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo observe the role of Sijunzi decoction on the gut barrier protection and immunity regulation in spleen-qi deficiency type patients with persistent inflammation-immunosuppression catabolism syndrome (PICS).Methods A prospective study was conducted, and according to random number table, 46 patients with PICS accompanied by spleen-qi deficiency admitted to Department of Critical Care Medicine of Beijing Shijitan Hospital of Capital Medical University were randomly divided into two groups: control group and Sijunzi decoction group(each 23 cases). Conventional therapy was given to both groups, and the patients in Sijunzi decoction group were additionally treated with modified Sijunzi decoction 100 mL by nasal feeding, while those in the control group were treated with an equal amount of warm boiled water by nasal feeding. The course of treatment was 2 weeks in both groups. The improvement in traditional Chinese medicine(TCM) syndrome and gastrointestinal function was observed in two groups before and after treatment. At the same time, the changes of lymphocyte subsets including total T cells(CD3+ cells),helper/inducer T cells(CD3+/CD4+T cells), suppressor/cytotoxic T cells(CD3+/CD8+ T cells), CD4/CD8, total natural killer cells(NK cell,CD3-/CD16+CD56+ cells),natural killer like T cells(NK T cell,CD3+/CD16+CD56+ T cells),total B cells(CD19+ cells),regulatory T cells(Treg T cells, CD4+/CD25+ T cells),suppressor T cells(CD8+/CD28- T cells) and cytotoxic T cells(CD8+/CD28+ T cells)were analyzed.Results① There were no differences in the acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,acute gastrointestinal injury(AGI)grades and peripheral blood lymphocyte subsets between Sijunzi decoction group and control group before treatment( allP>0.05).② After 2 weeks of treatment, all the patients' clinical symptoms of spleen-qi deficiencywere improved, and there was no difference in effect between the Sijunzi decoction and control group(valid:11 cases vs. 6 cases, invalid:12 cases vs.17 cases, bothP>0.05) . In both groups, the patients' AGI condition was improved, but the improvement in treatment group was more significant than that in the control group(valid: 14 cases vs. 7 cases, P<0.05) .③ In the control group,the numbers of CD3+, CD3+/CD8+,CD8+/CD28- T cells after treatment were increased significantly〔CD3+:(62.37±7.83)% vs.(54.08±11.65)%, CD3+/CD8+:(31.52±10.55)% vs. (23.94±9.22)%, CD8+/CD28-:(24.97±10.25)% vs.(16.78±10.55)%〕 and CD19+ number was decreased obviously〔(5.78±5.33)% vs.(9.73±8.02)%〕 at the same time(allP<0.05). After treatment, in the Sijunzi decoction group, the numbers of CD3+,CD3+/CD4+, CD3+/CD8+, CD8+/CD28-, CD8+/CD28+ T cells were increased significantly compared with those before treatment〔CD3+:(74.53±7.64)% vs.(52.98±10.05)%, CD3+/CD4+:(36.27±12.08)% vs.(30.00±8.60)%, CD3+/CD8+:(37.33±12.56)% vs.(22.88±9.97)%, CD8+/CD28-:(26.89±10.80)% vs.(17.01±9.48)%, CD8+/CD28+:(12.08±5.50)% vs.(8.47±4.29)%〕, and total CD19+ number was decreased remarkably at the same time〔(4.60±4.28)% vs.(9.86±8.61)%,P<0.05〕. In the Sijunzi decoction group, after 2 weeks of treatment, the number of CD3+ T cells was increased more significantly than that in the control group〔(8.29±9.28)% vs.(5.80±5.33)%,P<0.05〕.ConclusionUsing Sijunzi decoction combined with conventional therapy can improve the clinical symptoms of patients with PICS accompanied by spleen-qi deficiency and gastrointestinal dysfunction, the mechanism is possibly via enhancing immunity by regulating the numbers of B and T lymphocytes, and maybe the cell-mediated immunity plays a more prominent role.
