Objective: To measure the proportions of blood T cel subsets, Th1, Th2, Th17, Th22, and Treg cel s, and other parameters in patients with chronic immune thrombocytopenia(CITP) before and after treatment with Yiqi Tongyang Decoction(益气通阳方, YTD) to explore T cel status of patients with CITP, and to define the mechanism of action of YTD. Methods: The changes in peripheral blood T lymphocyte subsets, and those of Th1, Th2, Th17, Th22, and Treg cel s in 30 patients with CITP(22 females and 8 males) were analyzed using multiparametric flow cytometry before and after treatment with YTD for 6 months, and 26 healthy volunteers(14 males and 12 females) acted as a control. T-box expressed in T-cel s(T-bet) and GATA binding protein 3(GATA-3) m RNA levels in patients and controls were analyzed using real-time reverse transcription-polymerase chain reaction. Results: The proportions of Th1, Th17, Th22, Th1/Th2, and Th17/Treg cells increased in the peripheral blood of patients with CITP compared to those in controls before YTD therapy(P〈0.05). Th1 cel numbers and the Th1/Th2 ratio fel in the treated patients with CITP to approximate the values of the control group(P〉0.05). Th17 cel numbers and the Th17/Treg ratio also decreased in the treatment group(P〈0.05), but not to the levels of the controls. The number of Treg cel s in the peripheral blood of patients with CITP before treatment was lower than that in the control group(P〈0.05), but increased after YTD treatment(P〈0.05), but not to the level of controls. T-bet and GATA-3 m RNA levels in peripheral blood were initially higher in patients before treatment than controls(P〈0.05), but decreased after YTD therapy(P〈0.05). Conclusions: Imbalances in T lymphocyte levels, particularly those of Th1/Th2 and Th17/Treg cel s, play important roles in the pathogenesis of CITP. YTD efficiently regulated the dynamics of Th1/Th2 and Th17/Treg equilibria.
YANG Xiu-pengMA RouYANG Xiao-hongZHU Hui-lanXU Yong-gang