化湿中药对慢性乙型肝炎湿证患者激活和功能T淋巴细胞亚群水平的影响

目的 探讨化湿中药对慢性乙型肝炎（chronic hepatitis B，CHB）湿证患者临床疗效与激活和功能T淋巴细胞亚群水平变化的关系。方法 将CHB湿证患者75例非随机分为两组，治疗组（45例）采用化湿中药治疗，对照组（30例）采用核苷类似物治疗，观察治疗1年后两组临床疗效及激活和功能T淋巴细胞亚群水平变化。结果 CHB患者外周血CD8^＋CD28^＋、CD4^＋CD28^＋T细胞水平与健康人比较均明显下降（P〈0．01）；CD8^＋CD38^＋T细胞水平与健康人比较均明显升高（P〈0．05）；经治疗后，治疗组CD4^＋CD28^＋、CD8^＋CD28^＋T细胞水平较治疗前明显升高（P〈0．05），CD8^＋CD38^＋T细胞水平较治疗前明显下降（P〈0．05），对照组CD8^＋CD38^＋T细胞水平较治疗前明显下降（P〈0．05）。两组总有效率及显效率相比较，差异无显著性（P〉0．05）。CHB显效患者治疗后CD8^＋CD28^＋、CD4^＋CD28^＋T细胞水平明显升高（P〈0．05），CD8^＋CD38^＋T细胞水平较治疗前明显下降（P〈0．05）；非显效患者治疗前后CD8^＋CD28^＋、CD4^＋CD28^＋、CD8^＋CD38^＋、CD4^＋CD25^＋T细胞水平无明显变化（P〉0．05）。结论 化湿中药对CHB湿证患者激活和功能T淋巴细胞亚群水平有一定的调节作用，这可能是抑制病毒复制、清除病毒的重要途径。

Effect of Chinese Medicine for Resolving Dampness on Activated and Functional T Lymphocyte Subsets in Chronic Hepatitis B Patients with Dampness Syndrome

ObjectiveTo explore the relation between the effect of Huashi Decoction(HD)and levels of activated and functional T lymphocyte subsets in chronic hepatitis B(CHB)patients of dampness syndrome(DS).Methods Seventy CHB patients were nonrandomly assigned to two groups,the treated group(n=45)treated by HD and the control group(n=30)by nucleotide analogies.The clinical efficay was observed and levels of activated and functional T lymphocyte subsets were detected before and after treatment.Results The peripheral blood levels of CD 8CD 28 and CD 4CD 28T cells were significantly lower in CHB patients than those in the healthy subjects(P<0.01),which were higher in the treated group after treatment compared with those before treatment(P<0.05),while the CD 8CD 38 T cell level was significantly higher in CHB patients than in the healthy subjects(P<0.05),which was lower in the treated and the control groups after treatment than those before treatment respectively(P<0.05).No significant difference was found in the markedly effective rate and total effective rate between the two groups(P>0.05).The levels of CD 8CD 28 and CD 4CD 28 T cells increased and the CD 8CD 38 and CD 4CD 25 T cell level decreased obviously after treatment in those who acquired marked effectiveness(P<0.05),while they changed insignificantly in those who did not acquire marked effectiveness(P>0.05).Conclusion HD is effective in regulating activated and functional T lymphocyte subsets in CHB patients with DS,which might be its mechanism of inhibiting virus replication and eliminating virus.