补肾健脾方对恩替卡韦经治HBeAg阳性慢性乙型肝炎患者NKT细胞功能的影响  

Effects of Bushen Jianpi Recipe on NKT cell function in positive HBe Ag chronic hepatitis B patients after entecavir treatment

作　　者：乐凡 张鑫[1] 朱晓骏[1] 张景豪 李曼[1] 周振华[1] 高亚婷[1] 孙学华[1] 高月求[1] LE Fan;ZHANG Xin;ZHU Xiaojun;ZHANG Jinghao;LI Man;ZHOU Zhenhua;GAO Yating;SUN Xuehua;GAO Yueqiu(Department of Hepatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicin;Shanghai Key I,aboratory of Clinical Chinese Medicine, Shanghai 201203, China)

机构地区：[1]上海中医药大学附属曙光医院肝病科,上海市中医临床重点实验室,上海201203

出　　处：《上海中医药大学学报》2018年第3期22-27,共6页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(81673938,81473629,81503545,81473477,81673935,81774256);国家“艾滋病和病毒性肝炎等重大传染病防治”科技重大专项项目(2012ZX10005004-002);上海市科委科技支撑项目(16401970600);上海市科委生物引导项目(16401931300);上海申康市级医院新兴前沿技术联合攻关项目(SHDC12016121);上海市卫计委中医优势病种培育项目(zybz-2017004);上海市中医药新兴交叉学科资助计划项目

摘　　要：目的:观察补肾健脾方对HBeAg阳性慢性乙型肝炎(CHB)患者外周血自然杀伤T细胞(NKT细胞)数量、表型及功能特征的影响,探讨补肾健脾方抗乙型肝炎病毒(HBV)的作用机制。方法:将100例经恩替卡韦抗病毒治疗且肝功能正常、HBV-DNA阴性、HBeAg阳性的CHB患者随机分为治疗组和对照组,每组各50例。治疗组予恩替卡韦联合补肾健脾方治疗,对照组予恩替卡韦联合安慰剂治疗,疗程均为12个月。比较两组患者治疗前后的血清HBeAg水平,外周血NKT细胞数量、表型及功能变化。结果:治疗12个月后,两组患者的HBeAg水平与治疗前比较均明显下降(P<0.001),且治疗组的HBeAg水平低于对照组(P<0.05),治疗组的HBeAg下降幅度明显优于对照组(P<0.01)。治疗6个月后,治疗组的NKT细胞比例较治疗前明显升高(P<0.01);治疗12个月后,两组的NKT细胞比例较治疗前均明显升高(P<0.05,P<0.001),且治疗组的NKT细胞比例高于对照组(P<0.05)。治疗12个月后,治疗组的NKG2A+NKT、PD-1^+NKT细胞比例较治疗前均降低(P<0.05,P<0.01),且治疗组的PD-1^+NKT细胞比例低于对照组(P<0.05);治疗组的IFN-γ^+NKT细胞比例较治疗前明显升高(P<0.01),且治疗组的IFN-γ^+NKT细胞比例高于对照组(P<0.05)。结论:补肾健脾方可能通过调节CHB患者外周血NKT细胞数量、功能及表型发挥免疫调节及抗HBV作用。Objective： To observe the effects of Bushen Jianpi Recipe on the number,phenotype and function of peripheral blood natural killer T（ NKT） cells in positive HBeAg chronic hepatitis B（ CHB） patients,and explore the therapeutic mechanism of Bushen Jianpi Recipe on hepatitis B virus（ HBV）. Methods： 100 positive HBeAg CHB patients with normal liver function and negative HBV-DNA who had treated with entecavir were randomly divided into the treatment and control group,50 cases in each group. The treatment group was treated with entecavir and Bushen Jianpi Recipe,and the control group was treated with entecavir and placebo,with a course of 12 months. The serum HBeAg level,the number,phenotype and function of NKT cells in peripheral blood were compared between the two groups before and after treatment. Results： After treatment for 12 months,the HBeAg level was significantly decreased in the two groups（ P〈0.001）,and the HBeAg level in the treatment group was lower than that in the control group（ P〈0.05）,and the reduction of HBeAg in the treatment group was greater than that in the control group（ P〈0.01）. After treatment for 6 months,the proportion of NKT cells in the treatment group was significantly increased compared with treatment before（ P〈0.01）. After treatment for 12 months,the proportion of NKT cells in the two groups was significantly increased compared with treatment before（ P〈0.05,P〈0.001）,and the proportion of NKT cells in the treatment group was higher than that in the control group（ P〈0.05）. After treatment for 12 months,the proportions of NKG2 A＋NKT and PD-1-＋NKT cells in the treatment group were decreased compared with treatment before（ P 0. 05,P 0. 01）,and the proportion of PD-1-＋NKT cells in the treatment group was lower than that in the control group（ P〈0.05）; the proportion of IFN-γ-＋NKT cells in the treatment group was significantly increased compared with treatment before（ P〈0.01）,and the proportion of IFN-γ-＋NKT cells

关 键 词：慢性乙型肝炎 自然杀伤T细胞 补肾健脾方 抗病毒 

分 类 号：R512.62[医药卫生—内科学]