目的 芍药汤治疗大肠湿热证溃疡性结肠炎（Ulcerative Colitis，UC）的机制研究。方法 将研究对象随机分为实验组65例，对照组62例。实验组予以芍药汤联合美沙拉嗪肠溶片口服，对照组口服美沙拉嗪肠溶片，疗程均为连续治疗4周。治疗前后进行Mayo评分，单项症状评分，生活质量评定，比较缓解率、有效率、内镜应答率、黏膜愈合率等临床指标。流式细胞术检测治疗前后两组外周血中Th17细胞比例，Treg细胞比例，Th17/Treg细胞，实时荧光定量多聚合酶链反应（RT-qPCR）检测ROR-γt和Foxp3在各组外周血单个核细胞（PBMCs）中转录水平表达，Elisa检测两组血清中IL-10和IL-17蛋白水平。结果 实验组和对照组患者在治疗后的各项临床指标均较治疗前好转（P < 0.05），实验组治疗后在缓解率、内镜应答率、黏膜愈合率和腹痛、腹泻、里急后重粘液脓血便等单项症状评分，以及生活质量评定的肠道症状、社会能力、全身症状、情感能力等方面较对照组治疗后显著好转（P < 0.05）。实验组和对照组治疗后均出现Th17细胞比例降低，ROR-γt mRNA水平和IL-17表达减少，Treg细胞比例升高，Foxp3 mRNA水平和IL-10的表达提高（P < 0.05）。实验组治疗后Th17细胞比例，Treg细胞比例，Th17/Treg细胞，ROR-γt和Foxp3 mRNA，IL-10和IL-17水平均较对照组治疗后变化明显（P < 0.05）。结论 芍药汤可通过调控Th17/Treg细胞平衡，大幅缓解大肠湿热证溃疡性结肠炎患者肠道症状，促进肠道黏膜恢复，提高患者生活质量。

Objective To study the mechanism of Shaoyao Decoction in the treatment of Ulcerative Colitis (UC) with damp-heat syndrome in the large intestine.Methods The study subjects were randomly divided into 65 cases in the experimental group and 62 cases in the control group. The experimental group was given Shaoyao Decoction combined with mesalazine enteric tablets orally, and the control group was given mesalazine enteric tablets orally, and the course of treatment was 4 weeks continuously in both groups. Mayo score, single symptom score, quality of life assessment, remission rate, efficiency rate, endoscopic response rate, mucosal healing rate and other clinical indexes were compared before and after treatment. Flow cytometry was performed to detect the ratio of Th17 cells, Treg cells, Th17/Treg cells in peripheral blood of both groups before and after treatment, real-time fluorescence quantitative multiplex polymerase chain reaction (RT-qPCR) was performed to detect the expression of ROR-γt and Foxp3 in the transcript level of peripheral blood single nucleated cells (PBMCs) of each group, and Elisa was performed to detect the serum levels of IL-10 and IL-17 protein levels in both groups.Results The clinical indexes of the experimental group and the control group were improved after treatment (P < 0.05). The remission rate, endoscopic response rate, single symptom diarrhea, intestinal symptoms, social ability and emotional ability of the experimental group were significantly improved after treatment compared with those of the control group (P < 0.05). After treatment, the proportion of Th17 cells decreased, the expression of ror -γt mRNA and IL-17 decreased, the proportion of Treg cells increased, the expression of Foxp3 mRNA and IL-10 increased in both groups (P < 0.05). After treatment, the proportion of Th17 cells, Treg cells, Th17/Treg cells, ror -γt and Foxp3 mRNA, IL-10 and IL-17 levels in the experimental group were significantly higher than those in the control group (P < 0.05).Conclusion Shaoyao Decoction can significantly relieve the intestinal symptoms of patients with ulcerative colitis of damp heat syndrome of large intestine, promote the recovery of intestinal mucosa and improve the quality of life of patients by regulating the balance of Th17/Treg cells.

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