Study On The Variation Of Th1/Th2 Shift In Deep Venous Thrombosis And The Interventional Mechanism Of Di-dang Decoction

Objective:To investigate the pathogenesis of deep venous thrombosis(DVT) from the view of Th1/Th2 shift and interventional mechanism of Di-dang decoction on DVT, in order to provide objective basis for clinical diagnosis and treatment.Methods:66 patients of DVT were divided into groups according to the course of diseases and the syndrome differentiation type of traditional Chinese medicine(TCM) respectively. According to course of diseases, it was divided into four groups:1 to 3 days group,4 to 7 days group,8 to 15 days group and 16 to 30 days group. Based on the type of TCM, it was divided into the syndrome of pathogenic dampness-heat, the syndrome of blood stasis and dampness,30 health volunteers were taken as control. All patients and healths were detected blood serum levels of TNF-α, IFN-γ, IL-4, IL-10 by radio-immunization and elisa. In the experiment,180 Wistar rats were divided into six groups which included Di-dang decotion large dose group and small dose group, Chuan Wang Xiao Yan tablets group, Fu Fang Dan Shen tablets group, model group, sham group. Inferior vena cava ligation rat was applied as models. Then to observe the pathological character, the serum levels of TNF-α, IFN-γ,IL-4, IL-10 and the expression of the inflammation cells, TNF-α, IL-10, IFN-γmRNA, IL-4mRNA in the vein walls.Results:Clinical studies have shown that the serum levels of TNF-α, IFN-γ, IL-4, IL-10 were increased in DVT patients(P<0.05, P<0.01), The ratio of IL-10/TNF-αis lower than the control group in 1 to 3 days group and 4 to 7 days group,but the ratio of IFN-γ/IL-4 is increased than the control group, there is the reverse result in 8 to 15 days group and 16 to 30 days group, which notes the early DVT may exist Th2 to Thl shift; thrombosis machine of reperfusion period may exist Th1 to Th2 shift. The ratio of IL-10/TNF-αis lower than the control group in the syndrome of pathogenic dampness-heat, but the ratio of IFN-γ/IL-4 is increased than the control group, there is the opposite result in the syndrome of blood stasis and dampness, which indicates that the syndrome of pathogenic dampness-heat may be Th2 to Thl shift and the syndrome of blood stasis and dampness may be Thl to Th2 shift. Experimental studies have shown that pathological changes of the inferior vena cava was severe in the model group comparing with sham group, the serum levels of TNF-α, IFN-γ, IL-4, IL-10 and the vein wall inflammatory cells, TNF-α, IL-10 and IFN-ymRNA, IL-4mRNA expression increased (P<0.05, P<0.01). The ratio of IL-10/TNF-α, IFN-γ/IL-4 dynamic change with the course of the disease which confirm the existence of Th1/Th2 shift in DVT rats. Di-dang detection affect the direction and extent of Th1/Th2 shift through reducing serum levels of TNF-α, IFN-γand increasing IL-4, IL-10 levels, The Di-dang detection group can effectively improved the pathological changes, reduced the expressions of these inflammatory cells and IFN-ymRNA and increased IL-4mRNA expression, better than Chuan Wang Xiao Yan tablets group, Fu Fang Dan Shen tablets group.Conclusions:Th1/Th2 shift occurred in DVT, Th1/Th2 drift can be used as clinical diagnosis of the disease and the objective index of the syndrome type of TCM, while the Di-dang decoction can interfere with the Th1/Th2 drift to achieve the purpose of treatment of DVT.