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目的:观察养阴清肺活血方对放射性肺纤维化大鼠外周血Th17/Treg平衡的影响,探讨其对放射性肺纤维化防治作用的机制.方法:将50只雌雄各半的SD大鼠随机分为正常组、模型组、激素组、中药组、联合用药组,直线加速器对正常组外的4组大鼠全胸单次照射,剂量为16 Gy.照射后d1起各组灌胃(ig)给予相应的药物.照射后8周,每组处死大鼠10只,取全肺称重计算肺系数,取全血标本进行流式细胞术检测.观察各组大鼠在放射后8周肺系数改变及Th17和Treg细胞表达和Th17/Treg的变化.结果:放射后8周,各组肺系数差异明显,正常组(2.57±0.19)与联合用药组(3.10±0.25)肺系数最为接近;模型组(1.51±0.30)与正常组(0.48±0.06)相比,Th17细胞比例增高,有统计学差异(P＜0.05),与模型组比较,联合用药组(0.54±0.31)Th17细胞比例明显下降并有统计学差异(P＜0.05);与正常组(11.91±0.91)相比,模型组Treg细胞(8.08±0.93)比例降低(P＜0.05),激素组、中药组、联合用药组分别与模型组比较,Treg细胞比例均升高,其中又以联合用药组(10.33±0.25)升高最为显著,有统计学差异(P＜0.05),激素组(8.26±0.71)与模型组、中药组(9.91±0.19)与联合用药组(10.33±0.25)两两比较,Treg比例无统计学差异(P＞0.05);模型组(0.14±0.05)与正常组(0.03±0.03)相比,Th17/Treg比值增大,有统计学差异(P＜0.05),激素组、中药组、联合用药组任何两组比较,Th17/Treg比值均无统计学差异(P＞0.05),但联合用药组与模型组相比差异明显(P＜0.05).结论:放射性肺纤维化大鼠外周血存在Th17/Treg失衡,养阴清肺活血方联合醋酸泼尼松龙可有效减轻放射性肺纤维化大鼠局部肺组织纤维化程度,其机制可能与调节Th17/Treg平衡有关.“,”Objective:To observe the effect of Yangyinqingfeihuoxue prescription on Th17/Treg balance in peripheral blood of rats with radioactive pulmonary fibrosis,and discuss the mechanism of effect on prevention and control of radioactive pulmonary fibrosis.Methods:Fifty rats,male and female in half,were randomly divided into the normal control group,model group,hormone group,traditional Chinese medicine group,and combination group.The rats in the four groups except to the normal control group received single dose linear accelerator irradiation on all chest at a dose of 16 Gy.One day after irradiation the rats were given corresponding drugs by lavage.Ten rats in each group were sacrificed after 8 weeks of irradiation,and the whole lung was taken for weighing to calculate lung coefficient.Whole blood was taken to undergo flow cytometry.The differences in pulmonary coefficient,expressions of Treg and Th17 cells,and Th17/Treg among different groups were observed.Results:Eight weeks after radiation,there were obvious difference in lung coefficient,which was the most close between the normal group (2.57 ± 0.19) and combination group (3.10 ± 0.25).The model group had higher proportion of Th17 cells (1.51 _± 0.30) compared with the normal group (0.48 ± 0.06) (P ＜ 0.05).Compared with the model group,the Th17 cell percentage of the combination group (0.54 ±0.31)decreased obviously (P ＜0.05).Compared with the normal group,the Treg cells of the model group (8.08 ± 0.93) vs (11.91 ± 0.91) reduced significantly (P ＜0.05).The Treg cell percentages of the hormone group,traditional Chinese medicine group,and combination group were higher than the model group,and the combination group increased in the most significant magnitude (10.33 ± 0.25) (P ＜ 0.05).There was no statistical difference in proportion of Treg cells between the hormone group (8.26 _± 0.71)and model group,or traditional Chinese medicine group (9.91 ± 0.19) and combination group (10.33 ± O.25) (P ＞ 0.05).The ratio of Th17/Treg of the model group (0.14 ± 0.05) increase statistically significant compared with the normal group (0.03 ±0.03)(P ＜0.05).The Th17/Treg ratios had no statistical difference between any two of the hormone group,traditional Chinese medicine group,combination group (P ＞0.05),but the combination group had significant difference compared with the model group (P ＜ 0.05).Conclusion:There exists peripheral blood Th17/Treg imbalance in rats of radioactive pulmonary fibrosis.Yangyinqingfeihuoxue prescription can effectively reduce the degree of local pulmonary fibrosis when combined with prednisone acetate dragon,the mechanism of which may be related to adjusting the balance between Th17 and Treg.