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和剂汤对慢性乙型肝炎患者T细胞免疫状态的影响

Effect of Hejie decoction on T cell immune state of chronic hepatitis B patients.

作者信息

Zhang Shi-Jun, Chen Ze-Xiong, Lao Shao-Xian, Huang Bi-Jun

机构信息

Department of Traditional Chinese Medicine, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China.

出版信息

World J Gastroenterol. 2004 May 15;10(10):1436-9. doi: 10.3748/wjg.v10.i10.1436.

Abstract

AIM

To explore the effect of Hejie decoction (HJD) (mediation decoction) on T cellular immune state of chronic hepatitis B patients.

METHODS

Sixty-five patients with chronic hepatitis B were randomly divided into 2 groups. Forty patients in the treatment group were treated by HJD, and 25 patients in the control group were treated by routine Western medicine. The TCRVbeta7 gene expression, T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) levels were observed before and after treatment.

RESULTS

The level of CD4+ cells was lower whereas the level of CD8+ cells was higher in patients than in the normal group. There was no significant difference between the levels of CD3+ cells in patients and normal persons. After 6 months of treatment, ALT, AST, TB levels of the 2 groups were obviously decreased, and the level of CD4+ cells was increased whereas the level of CD8+ cells was decreased in the treatment group. However, the level of CD4+ cells and CD8+ cells had no significant difference in the control group. TCRVbeta7 expressions were detected in 6 patients of the treatment group, whose HBV-DNA and HBeAg turned negative and ALT became normal. HBeAg in another 3 patients turned negative while HBV-DNA did not, and TCRVbeta7 expressions were not detectable. TCRVbeta7 expression could not be detected in the control group, HBV-DNA of the control group did not turn negative. HBeAg in 1 patient turned negative while HBV-DNA did not, and TCRVbeta7 expressions were not detectable. The total effective rate was not significantly different between the 2 groups and the markedly effective rate was significantly different (P<0.01).

CONCLUSION

HJD is effective for treating chronic hepatitis B, and its effect seems to relate with the improvement of the TCRVbeta7 expression of chronic hepatitis B patients, thus activating T cells and eliminating HBV. T cellular immune function plays an important role in HBV infection and virus elimination.

摘要

目的

探讨和介汤(HJD)(调和汤)对慢性乙型肝炎患者T细胞免疫状态的影响。

方法

将65例慢性乙型肝炎患者随机分为2组。治疗组40例采用和介汤治疗,对照组25例采用常规西药治疗。观察治疗前后TCRVbeta7基因表达、T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)水平。

结果

患者CD4+细胞水平低于正常组,CD8+细胞水平高于正常组。患者与正常人CD3+细胞水平无显著差异。治疗6个月后,两组ALT、AST、TB水平均明显下降,治疗组CD4+细胞水平升高,CD8+细胞水平下降。然而,对照组CD4+细胞和CD8+细胞水平无显著差异。治疗组6例患者检测到TCRVbeta7表达,其HBV-DNA和HBeAg转阴,ALT恢复正常。另外3例患者HBeAg转阴,但HBV-DNA未转阴,未检测到TCRVbeta7表达。对照组未检测到TCRVbeta7表达,对照组HBV-DNA未转阴。1例患者HBeAg转阴,但HBV-DNA未转阴,未检测到TCRVbeta7表达。两组总有效率无显著差异,显效率有显著差异(P<0.01)。

结论

和介汤治疗慢性乙型肝炎有效,其疗效可能与改善慢性乙型肝炎患者TCRVbeta7表达有关,从而激活T细胞并清除HBV。T细胞免疫功能在HBV感染和病毒清除中起重要作用。

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