补肾清热育阴方治疗干燥综合征肝肾阴虚证患者疗效及对Tfh、Tfr细胞比例的影响OA

Objective To observe the effects of the Bushen Qingre Yuyin Decoction(Kidney-Tonifying,Heat-Clearing,and Yin-Nourishing Formula)on the ratio of T follicular helper(Tfh)cells and T follicular regulatory(Tfr)cells in patients with Sjögren's syndrome(SS)presenting with the liver and kidney yin deficiency pattern,and to explore the potential mechanism of this formula in treating primary SS.Methods A total of 60 patients with primary SS and with the liver and kidney yin deficiency pattern were enrolled and randomly assigned to either the experimental group or the control group.The control group received hydroxychloroquine sulfate(0.2 g,twice daily),while the experimental group received the oral Bushen Qingre Yuyin Formula.Both treatments were administered continuously for 12 weeks.Serum levels of Interleukin-6(IL-6)and Interleukin-21(IL-21)were measured using ELISA.The proportions of peripheral blood Tfh and Tfr cells were detected by flow cytometry.The following parameters were recorded before and after treatment:the Visual Analogue Scale(VAS)scores for dry mouth and dry eyes,the EULAR Sjögren's Syndrome Patient Reported Index(ESSPRI),the EULAR Sjögren's Syndrome Disease Activity Index(ESSDAI),salivary flow rate,and TCM syndrome scores.Results After 12 weeks of treatment,the total clinical efficacy rate based on TCM criteria in the treatment group was 96.6%,which was significantly higher than that in the control group(P<0.01).Both groups showed significant reductions in VAS scores for dry mouth and eyes,ESSDAI,and ESSPRI scores compared to their respective baselines(P<0.05),with the treatment group demonstrating superior outcomes to the control group.The salivary flow rate in the treatment group increased significantly compared to pre-treatment levels(P<0.01).Furthermore,the treatment group exhibited significant decreases in serum levels of IL-6 and IL-21,as well as in the proportions of Tfh and Tfr cells(P<0.05).Conclusion Bushen Qingre Yuyin Formula can effectively improve lacrimal and salivary gland secretion,alleviate clinical symptoms,reduce the proportions of Tfr and Tfh cells,and modulate cytokine levels,thereby suppressing immune inflammation.