[目的]观察易激灵2号方对大肠湿热型腹泻型肠易激综合征(diarrheatypeirritablebowelsyndrome,IB孓D)患者T细胞亚群的影响,并探讨其作用机制。[方法]将174例大肠湿热型IBS-D患者随机分为两组,中药组采用易激灵2号方,煎取200ml,早晚分服;西药组采用马来酸曲美布汀片(商品名:舒丽启能)0.1g/次,枯草杆菌二联活菌肠溶胶囊(商品名:美常安)0.5g/次,3次/d,口服;同时设立正常组24名,两组疗程均为4周。采用流式细胞仪测定外周血CD3^+。、CD4^+和CD8^+T淋巴细胞分布百分率。[结果]与正常组相比,大肠湿热型IBS-D患者CD4^+细胞水平显著降低(P〈O.01),CD8^+细胞水平显著升高(P〈O.05),CD4^+/CD8^+比值下降明显(P〈0.05)。中药组和西药组治疗后,CD4^+。细胞水平较治疗前均明显升高(P〈O.01,P〈0.05),但中药组升高更为明显,组间差异有统计学意义(P〈0.05);CD8^+细胞水平较治疗前均有明显下降(P〈O.05),CD4^+/CD8^+比值均有明显升高(P〈0.05)。与西药组相比,中药组治疗后CD8^+细胞水平和CD4’/CD8’比值有一定程度升高,但差异无统计学意义。[结论]以抑肝扶脾清热利湿立法的易激灵2号方很可能通过调节T细胞亚群的变化,达到消除或减轻IBS-D患者临床症状的效果。
[Objective]To observe the effect of soothing liver and invigorating spleen, clearing-away heat and eliminating dampness on the express of T cell subsets in patients with irritable bowel syndrome of large intestine clamp-heat. [Methods]One hundred and seventy-four patients were assigned to 2 groups: Chi- nese medicine group was treated with Yijiling-2,decocted 200 ml,twice daily by oral administration; west- ern medicine group was treated with Trimebutine maleate tablets 0. 1 g and Meiehang'an 0.5 g, 3 times dai- ly by oral administration. The therapeutic course was 4 weeks for all. The expression of CD3^+ , CD4^+ , CD8^+ of T lymphocyte was analyzed by flow cytometry. [Results]The percentage of CD4+ was significantly lower(P〈0. 01), the percentage of CD8^+ was significantly higher(P~0. 05)and the ratio of CD4^+/CD8^+ were significantly lower(P〈0. 05)in IBS-D patients than in the normal group. After treatment, the expres- sion of CD4^+ and the ratio of CD4^+/CD8^+ were significantly higher in IBS-D patients of Chinese medicine group and western medicine group(P〈0. 01, P〈0. 05), while the expression of CD8^+ were significantly lower(P〈0.05). But the expression of CD4^+ in Chinese medicine group was significantly higher than that in the western medicine group(P〈0. 05). [Conclusion]Soothing liver and invigorating spleen, clearing away heat and eliminating dampness might influence the T cell subsets thus eliminate or ameliorate symptoms of IBS patients.