益肾健脾清化方结合恩替卡韦对慢性HBeAg阳性乙型肝炎患者细胞免疫功能的影响研究  

Research on the impacts of Yishen Jianpi Qinghua Prescription combined with entecavir on cellular immune function in patients with chronic HBeAg positive hepatitis B

作　　者：章燕燕[1] 姜宏伟[1] 吴莹雯[1] ZHANG Yanyan;JIANG Hongwei;WU Yingwen(Department of Infectious Disease,Yuyao People′s Hospital in Zhejiang Province,Yuyao 315400,China)

机构地区：[1]浙江省余姚市人民医院感染科,浙江余姚315400

出　　处：《中国现代医生》2021年第28期4-8,共5页China Modern Doctor

基　　金：浙江省宁波市第二批科技项目经费计划项目(2016C51005)。

摘　　要：目的探讨慢性乙型肝炎病毒e抗原(HBeAg)阳性乙型肝炎患者服用益肾健脾清化方结合恩替卡韦后对血清细胞免疫功能辅助性Th1/Th2细胞因子及其肝功能的影响。方法选取2018年1月至2019年12月余姚市人民医院感染科收治的慢性HBeAg阳性乙型肝炎患者120例,分为对照组(采用恩替卡韦治疗)与治疗组(采用益肾健脾清化方+恩替卡韦治疗),每组各60例。两组分别治疗12周,观察治疗前后肝功能中的谷丙转氨酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、白蛋白(ALB);血清Th1/Th2细胞因子γ干扰素(IFN-γ)、白介素IL-12、IL-4、IL-13;HBeAg阴转率、HBeAg血清学转换率及HBV DNA阴转率的变化。结果治疗12周后,治疗组肝功能ALT、AST、TBIL、ALB指标均明显优于对照组(P<0.05),同时治疗组对血清Th1中的IFN-γ、IL-12指标上升值优于对照组(P<0.05),而血清Th2中IL-4、IL-13指标下降值亦优于对照组(P<0.05),说明治疗组更利于血清Th1/Th2细胞因子平衡,从而提高患者免疫水平。在HBeAg阴转率、HBeAg血清学转换率及HBV DNA阴转率上,治疗组效果与对照组比较无明显提高,差异无统计学意义(P>0.05)。结论益肾健脾清化方可有效调节血清中Th1/Th2细胞因子功能的平衡,同时能改善慢性HBeAg阳性乙型肝炎患者肝功能,可一定程度提高HBeAg阴转率及HBeAg血清学转换率。Objective To explore patients with chronic hepatitis B virus E antigen(HBeAg)positive hepatitis B after taking Yishen Jianpi Qinghua Prescription combined with entecavir on serum cellular immune function helper Th1/Th2 cytokines and hepatic function.Methods A total of 120 patients with chronic HBeAg positive hepatitis B admitted to the department of infectious disease of Yuyao People′s Hospital from January 2018 to December 2019 were selected and divided into the control group(n=50,using the entecavir treatment)and the treatment group(n=50,using the Yishen Jianpi Qinghua Prescription combined with entecavir treatment).The patients in the two groups were treated for 12 weeks,and the alanine aminotransferase(ALT),aspartic acid amino transferase(AST),total bilirubin(TBIL),albumin(ALB),serum Th1/Th2 cytokine IFN-γ(gamma interferon),IL(interleukin)-12,IL-4,IL-13,the negative conversion rate of HBeAg,the serological conversion rate of HBeAg and the negative conversion rate of HBV DNA in hepatic functions were observed before and after treatment.Results After 12 weeks of treatment,improvement of the hepatic functions in the treatment group was significantly superior to the control group in ALT,AST,TBIL and ALB indexes(P<0.05).At the same time,the treatment group was superior to the control group in increasing indexes of IFN-γand IL-12 in serum Th1(P<0.05).The decreasing indexes of IL-4 and IL-13 in serum Th2 were also superior to the control group(P<0.05),which indicated that the treatment group was more conducive to the balance of serum Th1/Th2 cytokines,thus improving the immune level of patients.The negative conversion rate of HBeAg,serological conversion rate of HBeAg and negative conversion rate of HBV DNA in the treatment group were not significantly improved as compared with those in the control group,with no statistically significant differences(P>0.05).Conclusion Yishen Jianpi Qinghua Prescription can effectively regulate the balance of serum Th1/Th2 cytokine functions in serum.At the same time,it can impro

关 键 词：益肾健脾清化方 恩替卡韦 慢性HBeAg阳性乙型肝炎 血清Th1/Th2免疫水平 

分 类 号：R259.1[医药卫生—中西医结合]