补肾健脾方对慢性乙肝病毒携带者病毒复制及Th1/Th2型细胞因子的影响  

Effects of Bushen Yipi Fang on Hepatitis B Virus Replication and Th1/Th2 Cytokines in Chronic Hepatitis B Virus carriers

作　　者：郑颖俊[1] 贺劲松[1] 陈亮[1] 李淑惠[1] 周大桥[1] 童光东[1] 邢宇锋[1] 陈英杰[1] 高辉[1] 邱梅[1] 

机构地区：[1]广州中医药大学深圳附属医院,广东深圳518033

出　　处：《南京中医药大学学报》2012年第3期211-215,共5页Journal of Nanjing University of Traditional Chinese Medicine

基　　金：国家"十一五"科技重大专项(2008ZX10005-008);深圳市科技计划项目(200902125)

摘　　要：目的观察补肾健脾方对慢性乙肝病毒携带者乙肝病毒复制及对Th1/Th2型细胞因子的影响。方法选择符合慢性乙肝病毒携带者诊断标准,ALT(丙氨酸氨基转移酶)水平男性在30～40U/mL,女性在19～40U/mL者120例,采用语音交互式中央随机分配系统随机分为治疗组和对照组各60例。治疗组接受补肾健脾方治疗,对照组接受安慰剂治疗共48周。分别观察治疗前及治疗后24、48周时血清HBV DNA定量、血清乙肝标志物和Th1/Th2型细胞因子(IL-2、IL-4、IL-10、IFN-γ)水平的变化。结果治疗48周时,治疗组血清HBV DNA较基线下降值≥2log10U/mL及阴转比例分别为55.4%、7.1%,明显优于对照组的7.0%、0%(P<0.01);治疗组不同基线HBV DNA水平患者HBV DNA定量均较治疗前明显下降,显著高于对照组(P<0.01),且基线HBV DNA水平越低下降越多,基线HBV DNA 105～<107 U/mL水平患者下降最多达(2.70±1.04)log10U/mL。血清HBsAg水平较基线下降值比较上,治疗组24、48周时均明显优于对照组(P<0.01),而HBeAg阴转率和血清转换率2组间差异无统计学意义(P>0.05);治疗24、48周时治疗组Th1细胞因子IFN-γ、IL-2水平明显升高(P<0.01),Th2类细胞因子IL-4、IL-10水平明显下降(P<0.01),与对照组比较均有显著性差异(P<0.01)。结论补肾健脾方有一定的抑制慢性HBV携带者乙肝病毒复制的作用,可能通过恢复特异性T细胞免疫功能而实现。OBJECTIVE To investigate the effect of Bushen Yipi Fang on hepatitis B virus replication and Th1/Th2 cytokines in chronic hepatitis B virus carriers.METHODS 120 patients conforming to diagnostic standard of chronic hepatitis B carriers whose ALT levels were 30～40 IU/mL in men and 19～40 IU/mL in women were randomly divided into treatment group and control group,each with 60 cases.Patients in both treatment group and control group received Bushen Yipi Fang and placebo for 48 weeks respectively.The serum HBV DNA level,serum markers of HBV and Th1/Th2 cytokines level（including IL-2,IL-4,IL-10 and IFNγ） were detected before and after treatment for 24 weeks,48 weeks in all the patients.RESULTS After 48 weeks treatment,the proportion of patients with serum HBV DNA baseline values declined greater than or equal to 2log10;IU/mL and HBV DNA values below the detection limit rates were 55.4% and 7.1% respectively,obviously superior to the control group of 7.0% and 0%（P〈0.01）.In treatment group,HBV DNA values distinctly declined in all patients with different baseline serum HBV DNA,there was an obvious difference compared with control group（P〈0.01）.Furthermore,the lower baseline HBV DNA declined more,patients with baseline HBV DNA 105～107 IU/mL downed the most up to（2.70±1.04） log10IU/mL.After treatment for 24 weeks and 48 weeks,serum HBsAg levels in the treatment group dropped more obvious than those in control group（P〈0.01）.However,no difference existed between HBeAg negative conversion and serum conversion rates in the two groups（P〈0.05）.Treatment for 24 weeks and 48 weeks all resulted in significant increases of IFN-γ and IL-2 levels and reductions of IL-6 and IL-10 levels in treatment group（compared to control group）（P〈0.01）.CONCLUSION Bushen Yipi Fang is effective on inhibiting hepatitis B virus replication in chronic hepatitis B virus carriers.It achieved the action probably by restoring immune function of specific T cells.

关 键 词：慢性乙型肝炎病毒 携带者 补肾健脾方 TH1/TH2 细胞因子 

分 类 号：R256.4[医药卫生—中医内科学]