益气解毒化瘀方联合抗病毒治疗对难治性慢性丙型肝炎患者外周血淋巴细胞亚群和炎性细胞因子的影响

目的 探讨益气解毒化瘀方联合抗病毒治疗对难治性慢性丙型肝炎（DT-CHC）患者外周血淋巴细胞亚群及炎性因子的影响。方法 选择2013年3 月～2015年2 月收治的84例难治性慢性丙型肝炎患者为研究对象，采用随机数字表法随机分为观察组和对照组（各42 例）。给予对照组聚乙二醇干扰素（Peg-INF-α）联合利巴韦林治疗，观察组采用益气解毒化瘀方联合Peg-INF-α和RBV治疗。随访6 个月，比较两组临床疗效、淋巴细胞亚群、炎性因子变化。结果 治疗6个月时，观察组总有效率和HCV RNA转阴率分别为81.0%和14.3%，均显著高于对照组（57.1%和2.4%，P<0.05）； 观察组外周血CD3+、CD4+、CD4/CD8和CD8+细胞分别为（69.3±6.1）%、（36.4±4.2）%、（1.4±0.4）和（25.4±2.5）%，显著高于对照组【分别 为（62.5±5.5）%、（30.2±3.6）%、（1.1±0.4）和（26.9±3.5）%，P<0.05】；观察组L-选择素、可溶性细胞间粘附分子、白细胞介素-6、肿瘤坏死因子-α含量分别为（886.2±154.5） ng/ml、（258.7±65.4） ng/ml、（88.7±11.6） pg/ml和（1.3±0.5） ng/m，均显著低于对照组【分别为（1268.9±235.8） ng/ml、（379.6±80.3） ng/ml、（121.6±14.2） pg/ml和（1.6±0.5） ng/ml，P<0.05】；观察组治疗后白细胞和血小板计数均明显高于对照组（P<0.05）。结论 益气解毒化瘀方联合Peg-INF-α和利巴韦林治疗能有助于缓解难治性丙型肝炎患者病毒学应答率，改善免疫功能，减少对骨髓抑制的影响，提高治疗效果。

Impact of Yiqi Jiedu Huayu compound combined with antiviral therapy on peripheral blood lymphocyte subsets and inflammatory cytokines in patients with refractory chronic hepatitis C

Objective To explore the effect of Yiqi Jiedu Huayu compound combined with antiviral therapy on peripheral blood lymphocyte subsets and inflammatory cytokines in patients with refractory chronic hepatitis C （CHC）. Methods 84 patients with refractory CHC between March 2013 and February 2015 were recruited in this study and they were randomly divided into observation group and control group with 42 cases in each. Patients in control group were given polyethylene glycol interferon combined with ribavirin as antiviral therapy，while patients in observation group received Yiqi Jiedu Huayu compound at the base of antiviral therapy. All patients were followed up for 6 months，and clinical efficacy，peripheral blood lymphocyte subsets，inflammatory cytokines were observed and compared between the two groups. Results At the end of 6-month treatment，the total effective rates and negative conversion rates of HCV RNA in observation group were 81.0% and 14.3%，significantly higher than those in control group（57.1% and 2.4%，respectively，P<0.05 for both）；Patients in observation group had higher percentage of CD3+cells，CD4+cells and the ratio of CD4/CD8，but lower percentage of CD8+ cells than patients in control group [（69.3±6.1）% vs.（62.5±5.5）%，（36.4±4.2）% vs. （30.2±3.6）%，（1.4±0.4） vs. （1.1±0.4） and （25.4±2.5）% vs. （26.9±3.5）%，respectively，P<0.05 for all]；Serum levels of L-selectin，soluble intercellular adhesion molecule，interlukin-6 and TNF-α in observation group were lower than those in control group [（886.2±154.5） ng/ml vs. （1268.9±235.8） ng/ml，（258.7±65.4） ng/ml vs. （379.6±80.3） ng/ml，（88.7±11.6） pg/ml vs. （121.6±14.2） pg/ml，（1.3±0.5） ng/ml vs. （1.6±0.5） ng/ml，respectively，P<0.05 for all]；The patients in observation group had higher white blood cell and platelet counts than in control group（P<0.05）. Conclusion Yiqi Jiedu Huayu compound combined with antiviral therapy is able to attenuate the inflammatory reactions，modulate lymphocyte subset disorders，reduce bone marrow suppression，and improve the clinical efficacy in patients with refractory CHC.