疏肝理脾汤治疗慢性乙型肝炎的疗效及对血清Treg/Th17变化的影响  

Effect of Shugan Lipi decoction on chronic hepatitis B and its impact on serum Treg/Th17 changes

作　　者：吴春明[1] 欧阳钦[1] 刘三海 赵安静 WU Chunming;OUYANG Qin;LIU Sanhai;ZHAO Anjing(Department of Infectious Diseases,Wenzhou Hospital of Traditional Chinese Medicine,Wenzhou 325000,Zhejiang,China)

机构地区：[1]温州市中医院感染科,浙江温州325000

出　　处：《中国现代医生》2023年第24期106-109,113,共5页China Modern Doctor

摘　　要：目的探讨疏肝理脾汤治疗慢性乙型肝炎病毒(hepatitis B virus,HBV)感染者的疗效及对血清调节性T细胞(regulatory cells,Treg)/辅助性T细胞17(T helper cell 17,Th17)变化的影响。方法选取2021年3月至2022年3月温州市中医院收治的96例HBV感染者,采用随机数字表法分为对照组(n=48)和观察组(n=48),对照组给予恩替卡韦片治疗,观察组在对照组的基础上给予疏肝理脾汤治疗,比较两组患者的疗效、透明质酸(hyaluronic acid,HA)Ⅳ型胶原(type Ⅳ collagen,ⅣC)、层粘连蛋白(laminin,LN)、Ⅲ型前胶原肽(procollagen Ⅲ peptide,PⅢP)、血清白细胞介素(interleukin,IL)-22、IL-6、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、血清Treg/Th17相关因子水平的变化(Treg、Th17、Treg/Th17)及不良反应。结果观察组患者治疗后的总有效率高于对照组(P<0.05);HA、ⅣC、LN、PⅢP、IL-22、IL-6、TNF-α、Treg、Th17、Treg/Th17明显降低(P<0.05);不良反应总发生率低于对照组(P<0.05)。结论疏肝理脾汤可提高HBV感染者的临床疗效,改善肝纤维化指标,降低炎症因子水平,下调血清Treg/Th17,安全性较好。Objective To investigate the therapeutic effect of Shugan Lipi decoction on chronic hepatitis B virus(HBV)infection and its influence on the changes of serum regulatory T cells(Treg)/T helper cell 17(Th17).Methods Totally 96 patients with HBV infection admitted to Wenzhou Hospital of Traditional Chinese Medicine from March 2021 to March 2022,were selected and randomly divided into control group and control group(n=48)and observation group(n=48),control group was given entecavir tablet,observation group was given Shugan Lipi decoction on the basis of the control group,hyaluronic acid(HA),typeⅣcollagen(ⅣC),laminin(LN),procollagenⅢpeptide(PⅢP),interleukin(IL)-22,IL-6,tumor necrosis factor-α(TNF-α),Treg/Th 17 and their adverse reactions.Results The total effective rate of observation group was higher than that of control group(P<0.05).The levels of HA,ⅣC,LN,PⅢP,IL-22,IL-6,TNF-α,Treg,Th17 and Treg/Th17 were significantly decreased in the observation group(P<0.05).The total adverse reaction rate of control group was significantly lower than that of control group(P<0.05).Conclusion Shugan Lipi decoction can improve the clinical curative effect of patients with HBV infection,improve the indicators of liver fibrosis,reduce the level of inflammatory factors,and down-regulate the serum Treg/Th17,which is safe.

关 键 词：疏肝理脾汤 慢性乙型肝炎 调节性T细胞 辅助性T细胞17 

分 类 号：R285.6[医药卫生—中药学]