Study Of Effects And Immunology Mechanism Of TCM Strengtheningthe Spleen And Complement The Kidney On Systemic Lupus Erythematosus Patients

1.Objective To study the changes of on cytokines, regulatory T cells, quality oflife, anxious and depressed mood of Systemic lupus erythematosus (Systemic lupuserythematosus,SLE)from clinical.To observe the effection of strengthening the spleenand complement the kidney decoction on SLE and explore its mechanism.2.Method2.1Clinical research2.1.1To observe on50cases of Systemic lupus erythematosus patients’age, sex, durationof illness, quality of life, anxious and depressed mood, and symptom integral value ofthe TCM.2.1.2The change of cytokines, regulatory T cells expressing the frequency of SLE andstudy of the correlation: control group(30cases) come from health examinationcenter,the first hospital of Anhui University of Traditional Chinese Medicine. Age,gender are match to SLE group, without obvious organic disease. Using the UnitedStates R&D ELISA kit for the detection of healthy controls and patients with Sjogrensyndrome IL-17, IL-10,TGF-β changes, using the Beckman-coulter XL-ESPIC MCLflow cytometry in healthy controls and patients with serum CD4+CD25+Treg,CD4+CD25+CD127-regulatory T cells express frequency level, and at the same timedetermination of SLE patients in general laboratory indicators: peripheral blood redblood cell (RBC),white blood cell (WBC), hemoglobin (HGB), platelet(PLT),erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), C3, C4,immunoglobulin A (IgA), immunoglobulin G (IgG), immunoglobulin M (IgM). UsingSPSS17.0software for statistical analysis of life quality, cytokines, regulatory T cellsexpressing the frequency and the relationship between on other indicators.2.1.3Clinical study:50patients were randomly divided into the experimental group(25cases, strengthening the spleen and complement the kidney decoction) and controlgroup (25cases, Hydroxychloroquine Sulfate), using the quality of life scale Short Form-36(SF-36)concise, self-rating anxious scale (SAS),self-rating depression scale(SDS), TCM symptom score and treatment in the two groups were observed quality oflife before and after, anxious and depressed mood,symptom integral values, on theSLEDAI score, Interleukin17,Interleukin10, transforming growth factor-β, regulatoryT cells and related laboratory targets to improve the situation.3. Results3.1Theoretical results3.1.1Immune disorders play an important role in the pathogenesis of Systemic lupuserythematosus;3.1.2The quality of life has an important index in Systemic lupus erythematosus;3.1.3Immune disorders is an important manifestation of TCM Spleen and Kidneydeficiency;3.1.4Spleen and Kidney deficiency is a major mechanism of of Systemic lupuserythematosus in Traditional Chinese Medicine;3.1.5Strengthening the spleen and complement the kidney is the major treatment forSystemic lupus erythematosus in Traditional Chinese Medicine.3.2Changes of IL-17,IL-10,TGF-β in patients with SLEThe level of IL-17,IL-10of serum was higher than that NC group and the level ofTGF-β was lower in SLE group(P<0.05or P<0.01).3.3The change quality of life of Patients with SLEQuality of life of patients with SLE each dimension integral below normal group,anxious and depression scale score was significantly higher than that of normal group.3.4The level of IL-17in SLE patients correlated with other indexes：⑴Analysis of correlation revealed that the level of IL-17was correlated positivelywith IgG、hs-CRP、ESR、SLEDAI (P<0.05or P<0.01).⑵Analysis of correlation revealed that the level of IL-17was correlated negativelywith expressing frequencies Of IgM, C3,C4, CD4+CD25+Treg, CD4+CD25+CD127-Treg (P<0.05). ⑶Analysis of correlation revealed that the level of IL-17was was not correlated withIgA(P>0.05).⑷Analysis of correlation revealed that the level of IL-17was correlated positivelywith SAS,SDS(P<0.01).⑸Analysis of correlation revealed that the level of IL-17was correlated negativelywith expressing frequencies of SF-36each dimension integral(P<0.01).3.5The level of IL-10in SLE patients correlated with other indexes：⑴Analysis of correlation revealed that the level of IL-10was correlated positivelywith IgG、IgA、hs-CRP、ESR、SLEDAI (P<0.05or P<0.01).⑵Analysis of correlation revealed that the level of IL-10was correlated negativelywith expressing frequencies of IgM, C3, C4, CD4+CD25+Treg, CD4+CD25+CD127-Treg (P<0.05).⑶A nalysis of correlation revealed that the level of IL-10was not correlated with C4(P>0.05).⑷Analysis of correlation revealed that the level of IL-10was correlated positivelywith SAS,SDS(P<0.01).⑸Analysis of correlation revealed that the level of IL-10was correlated negativelywith expressing frequencies of SF-36each dimension integral(P<0.01).3.6The level of TGF-β in SLE patients correlated with other indexes：⑴A nalysis of correlation revealed that the level ofTGF-β was correlated negativelywith IgG、hs-CRP、ESR、SLEDAI (P<0.05or P<0.01).⑵A nalysis of correlation revealed that the level ofTGF-β was correlated positivelywith expressing frequencies of IgM, C3,C4,CD4+CD25+Treg,CD4+CD25+CD127-Treg(P<0.05).⑶Analysis of correlation revealed that the level of TGF-β was not correlated withIgA(P>0.05).⑷A nalysis of correlation revealed that the level ofTGF-β was correlated negativelywith SAS,SDS(P<0.01). ⑸Analysis of correlation revealed that the level of TGF-β was correlated positivelywith expressing frequencies of SF-36each dimension integral(P<0.01).3.7The effects of strengthening the Spleen and complement theKidney decoction on various indicatorsStrengthening the Spleen and complement the Kidney decoction can significantlyimprove the quality of life of patients with SLE integral, TCM symptom score,Anxious and Depression Scale score, but also reduce IgG,IgA,ESR,CRP index;increase WBC, RBC, HGB, IgM, C3, C4index;at the same time can significantlydecrease the SLE in sera of patients with IL-17, IL-10, increased the content of TGF-β;increased the content of CD4+CD25+Treg, CD4+CD25+CD127-Treg expressionupregulation of strengthening the Spleen and complement the Kidney decoction whilefrequency; in the improvement of laboratory indexes and Hydroxychloroquine Sulfateeffects were similar, but the improvement in quality of life score, TCM symptom score,regulation of complement regulatory proteins, inhibition of inflammatory responsesand other aspects are better than the control group; and of strengthening the Spleen andcomplement the Kidney decoction in treating group without adverse drug reaction,significantly better than the control group. Tips of strengthening the Spleen andcomplement the Kidney decoction comprehensive effect is better than the controlgroup.4.Conclusion4.1Cytokines and the pathogenesis of Systemic lupus erythematosus is closely related.4.2Quality of life in all dimensions integral decline accompanied by anxious anddepressive mood of the patients with Systemic lupus erythematosus, Systemic lupuserythematosus on the quality of life of patients have obvious effect.4.3The level of IL-17, IL-10, TGF-β and quality of life, CD4+CD25+Treg,CD4+CD25+CD127-Treg, anxious and depressive mood, laboratory indexes,systemielupus erythematosus disease aetivity index were closely related.It suggests that theimmune inflammatory reaction in Systemic lupus erythematosus pathogenic processes, in patients with exacerbation of symptoms and signs, make the life quality of patientswith SLE each dimension integral decline, anxious and depression integral elevation.4.4Research group in the treatment of SLE clinical efficacy was better than the controlgroup, patients in improving the quality of life, improve clinical symptoms, reduceCRP, ESR and other inflammatory markers, decrease the SLE in sera of patients withIL-17, IL-10,increased the content of TGF-β;increased the content of WBC, RBC,HGB, PLT, IgM, C3, C4; reduce anxious and depression, upregulation ofCD4+CD25+Treg, CD4+CD25+CD127-Treg expression frequencies and weresignificantly better than the control group (P <0.05or P <0.01).4.5Patients with SLE in the pathogenic process and proinflammatory cytokine levelsare elevated and suppression of inflammatory factor level is reduced, at the same timewith the regulation of T cell expression of lower frequency, Strengthening the spleenand complement the kidney decoction is effective in treating SLE is the mechanism ofimmune anti-inflammatory effects, modulation of cytokine content and regulation ofcomplement regulatory protein content, improve anemia,improve metabolism, relievethe clinical symptoms, signs, improve the quality of life, reduce anxious anddepressive mood.