加味四逆理中汤调控cGAS/STING信号通路干预脾虚肝郁型盆腔炎性疾病后遗症的免疫新机制
Novel Immune Mechanism of Modified Sini Lizhong Decoction in Regulating the cGAS/STING Signaling Pathway to Intervene in Sequelae of Pelvic Inflammatory Disease with Spleen Deficiency and Liver Stagnation Syndrome

目的：探讨加味四逆理中汤通过调控cGAS/STING信号通路干预脾虚肝郁型盆腔炎性疾病后遗症(SPID)的免疫新机制。方法：选取2023年4月至2023年12月就诊于成都中医药大学附属医院且符合纳入和排除标准的脾虚肝郁型SPID患者20例，采用加味四逆理中汤治疗8周，同时设置健康对照组20例，不予任何处理。采用qRT-PCR和ELISA法检测，观察前后外周血清cGAS mRNA、STING mRNA以及下游效应分子(IFN-α, IFN-β, IL-6, TNF-α, TBK1, IRF3)的表达水平，比较组内及组间差异。结果：观察前，治疗组外周血清STING mRNA、IFN-β、IL-6、TBK1、IRF3的表达高于对照组(P < 0.01或P < 0.05)，而cGAS mRNA无显著差异(P > 0.05)；观察后，治疗组STING mRNA、IFN-α、TNF-α、TBK1、IRF3的表达下降(P < 0.01或P < 0.05)，cGAS mRNA的表达升高(P < 0.05)；观察后，治疗组与对照组cGAS mRNA、STING mRNA、IFN-α、IFN-β、IL-6、TNF-α、TBK1、IRF3的表达均无统计学差异(P > 0.05)。结论：cGAS/STING信号通路相关因子的表达失调参与了SPID的发病进程。加味四逆理中汤可能通过调控cGAS/STING信号通路，下调炎症因子表达，恢复免疫稳态，从而有效干预SPID的发生发展。
Objective: To investigate the novel immune mechanism of modified Sini Lizhong Decoction (MSLD) in treating spleen deficiency and liver stagnation syndrome sequelae of pelvic inflammatory disease (SPID) through the regulation of the cGAS/STING signaling pathway. Methods: Twenty SPID patients diagnosed with spleen deficiency and liver stagnation syndrome were selected from the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine between April 2023 and December 2023 and treated with MSLD for 8 weeks. A healthy control group of 20 individuals received no treatment. The expression levels of cGAS mRNA, STING mRNA, and downstream effector molecules (IFN-α, IFN-β, IL-6, TNF-α, TBK1, IRF3) in peripheral serum were measured using qRT-PCR and ELISA before and after treatment, and differences within and between groups were compared. Results: Before treatment, the expression levels of STING mRNA, IFN-β, IL-6, TBK1, and IRF3 were significantly higher in the treatment group than in the control group (P < 0.01 or P < 0.05), while no significant difference was observed in cGAS mRNA (P > 0.05). After treatment, the expression levels of STING mRNA, IFN-α, TNF-α, TBK1, and IRF3 in the treatment group decreased significantly (P < 0.01 or P < 0.05), while the expression of cGAS mRNA increased (P < 0.05). After treatment, no significant differences were observed between the treatment and control groups in the expression levels of cGAS mRNA, STING mRNA, IFN-α, IFN-β, IL-6,