柴芍六君汤对慢性乙型肝炎肝郁脾虚证患者肝纤维化相关指标改善作用以及血清Treg/Th17比率变化的影响  

Improvement of Caihu Liujun Decoction on Correlated Indexes in Treating Liver Fibrosis of Chronic Hepatitis B with Syndromes of Liver Depression and Spleen Deficiency and The Effect on Serum Levels of The Ratio of Treg/Th17

作　　者：柏文婕[1] 石清兰[2] 毛德文[2] 吕超 BAI Wen-jie;SHI Qing-lan;MAO De-wen;LV Chao(Guangxi Traditional Chinese Medical University f Nanning 530200, China;The first affiliated hospital,Guangxi Traditional Chinese Medical University, Nanning 530023 , China)

机构地区：[1]广西中医药大学,南宁530200 [2]广西中医药大学第一附属医院肝病科,南宁530023

出　　处：《中国中医基础医学杂志》2019年第8期1111-1114,1122,共5页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：国家自然科学基金地区基金项目(81760849)-APE1/Ref-1对ACLF大鼠CD4~+CD25+调节性T细胞免疫功能的影响及解毒化瘀Ⅱ方干预研究

摘　　要：目的:探讨柴芍六君汤治疗慢性乙型肝炎肝郁脾虚证患者肝纤维化疗效以及对外周血辅助性T细胞17(Th17)和调节性T细胞(Treg)比率的调节作用。方法:将106例慢性乙型肝炎肝纤维化患者按随机数字表法分为观察组和对照组,2组给予恩替卡韦分散片治疗,对照组给予中药安慰剂,观察组采取柴芍六君汤内服,2组疗程均24周,比较2组肝郁脾虚证症状评分、肝功能、肝纤维化、疗效、乙型肝炎病毒(HBV)转阴率以及外周血Treg和Th17细胞水平。结果:治疗24周后,观察组肝郁脾虚证症状评分、肝功能以及肝纤维化明显低于对照组,观察组总有效率(90.57%)明显高于对照组,观察组的乙肝表面抗原(HBsAg)、乙肝病毒e抗原(HBeAg)、HBV-DNA转阴率明显高于对照组,观察组患者外周血Treg/Th17比率明显少于对照组。结论:在常规治疗基础上,柴芍六君汤治疗慢性乙型肝炎肝郁脾虚证疗效显著,调节Treg/Th17比率可能是其作用途径之一。Objective: To investigate the efficacy of Caihu Liujun decoction in treatment of liver fibrosis of chronic hepatitis B with syndromes of liver depression and spleen deficiency and the regulation role on the ratio of regulatory T cells(Treg)/T helper cell 17(Th17) in peripheral blood.Methods: One hundred-three chronic hepatitis B cases were randomly divided into the control group and the observation group referring to the random number table.Both groups were given with entecavir tablets.The control groups was given with the placebo.The observation group was treated with Caihu Liujun decoction.The course was for 24 weeks for two groups.Scores of symptoms of syndromes of liver depression and spleen deficiency,liver function, liver fibrosis,the efficacy, hepatitis b virus(HBV) conversion rate,and peripheral blood levels of Treg and Th17 were compared for both groups.Results: After 24 weeks’ treatment,scores of symptoms of syndromes of liver depression and spleen deficiency,liver function,liver fibrosis indexes in the observation group were lower than those in the control group,the total efficacy rate of the observation group(90.57%) was obviously higher than the control group,the negative conversion rate of hepatitis B surface antigen(HBsAg,hepatitis B virus e antigen(HBeAg) and HBV-DNA in the observation group were significantly higher than those in the control group, peripheral blood level of Treg/Th17 ratio of the observation group was obviously lower than that of the control group.Conclusion: On the basis of the routine therapy,Caihu Liujun decoction in treatment of liver fibrosis of chronic hepatitis B with syndromes of liver depression and spleen deficiency has a significant efficacy,and the regulation of the ratio of Treg/Th17 may be one of the effective ways.

关 键 词：柴芍六君汤 慢性乙型肝炎 肝郁脾虚证 肝纤维化 

分 类 号：R285.5[医药卫生—中药学]