化肝解毒汤对慢性乙型肝炎患者临床疗效及外周血T淋巴细胞、IL-6、GP73的作用研究  

Study on Clinical Efficacy of Huagan Jiedu Decoction on Patients with Chronic Hepatitis B and Effects of Peripheral Blood T Lymphocytes,IL-6 and GP73

作　　者：袁芳 石俊 高倩 周轶群 薛芳 汤海林 管玉洁 高月求[2] YUAN Fang;SHI Jun;GAO Qian;ZHOU Yiqun;XUE Fang;TANG Hailin;GUAN Yujie;GAO Yueqiu(Suzhou Hospital of Integrated Traditional Chinese and Western Medicine,Jiangsu Suzhou 215100,China;Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]苏州市中西医结合医院,江苏苏州215100 [2]上海中医药大学附属曙光医院,上海201203

出　　处：《中国中医基础医学杂志》2022年第7期1126-1129,1178,共5页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：苏州市科技局基金资助项目(SYS2019014)-基于HBx-HDAC1途径抑制肝细胞自噬探讨化肝解毒汤治疗慢性乙肝的机制研究;苏州市科技局基金资助项目(SYS2018003)-麦冬皂苷B通过调控miR-126介导的VEGF信号通路抑制肝癌血管生成及侵袭的作用机制研究;苏州市科技局科教兴卫科研基金(KJXW2020079)-“化肝解毒汤”通过PI3K/Akt/mTOR信号通路诱导肝癌细胞自噬与凋亡的机制;苏州市中西医结合医院科技项目(YJ2020007)-化肝解毒汤通过调节DC模式识别受体的表达诱导CD4^(+)T细胞亚群分化平衡治疗慢乙肝机制的研究;苏州市中西医结合医院科技项目(YJ2019013)-化肝解毒汤联合恩替卡韦治疗慢性乙型病毒性肝炎瘀血阻络证的临床研究;国家自然科学基金面上项目(8187150378)-补肾健脾方通过干预HBX-HMGB1(乙酰化)-Beclin1途径抑制肝细胞自噬治疗慢性乙型肝炎的机制研究。

摘　　要：目的:探讨化肝解毒汤治疗慢性乙型肝炎(chronic hepatitis B,CHB)热毒血瘀证患者的临床疗效及对外周血T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、白细胞介素6(interleukin 6,IL-6)、高尔基体蛋白73(golgi protein 73,GP73)的影响。方法:本研究共纳入60例乙肝e抗原(hepatitis B e antigen,HBeAg)阳性慢性乙型肝炎患者随机分为2组,对照组30例给予恩替卡韦口服,治疗组在对照组基础上给予化肝解毒汤口服,治疗6个月后观察2组治疗前后临床疗效,外周血T淋巴细胞亚群、IL-6、GP73水平的变化,HBeAg及乙肝病毒DNA(hepatitis B virus DNA,HBV-DNA)转阴率、肝功能[门冬氨酸氨基转移酶(aminotransferase,AST)、丙氨酸转氨酶(alanine aminotransferase,ALT)、总胆红素(total bilirubin,TBil)、直接胆红素(direct bilirubin,DBil)]复常率。结果:治疗组总有效率高于对照组(P<0.05),2组患者治疗后临床疗效指标均较前明显改善(P<0.05),与对照组比较,治疗组各项指标改善更明显(P<0.05)。结论:化肝解毒汤可有效改善HBeAg阳性慢性乙型肝炎热毒血瘀证患者的临床症状及实验室指标,不仅能保肝降酶、抗病毒,还能调节机体免疫功能,减轻肝脏炎症,且未发现明显不良反应。Objective:To investigate the clinical efficacy of Huagan Jiedu decoction in the treatment of chronic hepatitis B(CHB)patients with toxic heat and blood stasis syndrome(THBSS)and its effects on peripheral blood T-lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),IL-6,and GP73.Method:In this study,60 CHB patients with positive test results of HBeAg were randomly divided into two groups.The control group(n=30)was treated with entecavir,and the treatment group(n=30)was treated with Huagan Jiedu decoction in addition to the treatment for the control group.After 6 months of treatment,the clinical efficacy indexes of both groups before and after the treatment were observed,including changes in peripheral blood T-lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),IL-6,and GP73,negative rate of HBeAg and HBV-DNA,liver function recovery indexes(AST,ALT,TBil,DBil).Results:The overall effective rate was higher in the treatment group than in the control group(P<0.05).The clinical efficacy indexes of the two groups were improved after treatment(P<0.05).However,compared with the control group,the improvement of all the indexes in the treatment group was more obvious(P<0.05).Conclusion:Huagan Jiedu decoction can effectively improve the clinical symptoms and laboratory indexes of HBeAg-positive CHB patients with THBSS.It can not only protect the liver,lower the enzyme and resist the virus,but also regulate the immune function of the body and reduce the inflammation of the liver.Besides,no obvious adverse reactions were found during the treatment.

关 键 词：化肝解毒汤 慢性乙型肝炎 热毒血瘀证 CD3^(+) CD4^(+) CD8^(+) IL-6 GP73 

分 类 号：R512.62[医药卫生—内科学]