清温并用法对慢加急性肝衰竭大鼠结肠组织调节性T淋巴细胞/辅助性T淋巴细胞17细胞因子的影响

目的 研究清温并用法对慢加急性肝衰竭（acute-on-chronic liver failure，ACLF）大鼠结肠组织Treg/Th17相关型细胞因子表达的影响，探讨其抗ACLF肠源性内毒素血症（intestinal endotoxemia，IETM）的可能调控机制。方法 140只SD大鼠随机分为正常组、模型组、清法组、温法组及清温并用法组。牛血清白蛋白致敏法建立免疫性肝纤维化大鼠模型，腹腔注射D-氨基半乳糖+脂多糖急性攻击建立ACLF大鼠模型，各组予以相应干预，观察24 h内各组大鼠外周血内毒素、外周血Treg/Th17细胞比值、结肠组织Treg/Th17型细胞因子变化。结果 与正常组比较，模型组大鼠在各时间点内毒素明显升高（P<0.01）、Treg/Th17型细胞因子明显升高（P<0.01）、Treg/Th17比值明显降低（P<0.01）；与模型组比较，清法、温法、清温并用法组在1、12、24 h各个时间点内毒素、Treg/Th17相关细胞因子表达均降低（P<0.05），以清温并用法组下降最显著（分别与清法组、温法组比较，P<0.05）；各组与模型组比较，仅清温并用法组Treg/Th17比值明显升高（P<0.05）。结论 清温并用法抗肝衰竭IETM的机制可能与调节结肠组织Treg/Th17型细胞因子失衡，促使Treg/Th17细胞恢复平衡有关。

Effects of Clearing and Warming Simultaneously on Colonic Regulatory T Lymphocytes/Assistant T Lymphocyte 17 Cytokines in Rats with Acute and Chronic Liver Failure

Objective To investigate the effects of clearing and warming simultaneously on the expression of Treg/Th17 associated cytokines in colon tissue of rats with acute and chronic liver failure (ACLF), and to explore its possible regulation mechanism of ACLF against intestinal endotoxemia (IETM).Methods A total of 140 SD rats were randomly divided into a normal group, a model group, a clearing group, a warming group, and a clearing and warming simultaneously group. The rats model of immune hepatic fibrosis were established by sensitization with bovine serum albumin, and then ACLF rats were induced by intraperitoneal injection of D-galactose and lipopolysaccharide (LPS). The changes of endotoxin in peripheral blood, ratio of Treg/Th17 cells in peripheral blood and Treg/Th17 cytokines in colonic tissue were observed within 24 hours.Results Compared with the normal group, the toxins in the model group were significantly increased at each time point (P<0.01), the Treg/Th17 cytokines were significantly increased (P<0.01), and the Treg/Th17 ratio was significantly lower (P<0.01). Compared with the model group, the expression of toxin and Treg/Th17-related cytokines were decreased in the clearing group, the warming group, the clearing and warming simultaneously group at 1 h, 12 h, and 24 h (P<0.05). The decrease in the clearing and warming simultaneously group was the most significant (compared with the clearing group, the warming group, P<0.05). Compared with the model group, the ratio of Treg/Th17 was significantly increased in the clearing and warming simultaneously group than in the model group (P<0.05) Conclusion The mechanism of treating acute-on-chronic liver failure IETM in using clearing and warming simultaneously is related to the regulation of Treg/Th17 cytokine in colonic tissue and promoting the balance of Treg/Th17 cells