慢性乙型肝炎中医辨证与细胞因子病毒指标的关系

目的:观察慢性乙型肝炎(慢乙肝)患者细胞因子及病毒指标与中医证型的关系。方法:对400例慢乙肝患者进行辨证分型,检测血清T淋巴细胞亚群(CD4、CD8、CD4/CD8)、白细胞介素-2、10、12(IL-2、IL-10、IL-12)、HBV-DNA、HBV标志物。结果:肝郁脾虚、肝肾阴虚和脾肾阳虚证CD4渐降而CD8、CD4/CD8渐升(P<0.01);湿热中阻证与脾肾阳虚、肝肾阴虚证相比CD8明显降低而CD4/CD8渐高(P<0.01);慢乙肝各中医证型的IL-2、IL-10、IL-12明显高于正常对照组(P<0.01或P<0.05);肝郁脾虚、脾肾阳虚组HBV-DNA定量>1.0×105cop ies/mL、HBVeAg及抗K-HbcIgM(+)均高于湿热中阻、瘀血阻络组(P<0.01或P<0.05)。结论:细胞因子、病毒指标检测可为慢乙肝中医辨证的客观化提供依据。

Correlative Study on TCM Syndrome of Chronic Hepatitis B between Indices of Serum Cytokine and Replication of Virus

Objective：To explore the correlation between different syndrome types of TCM and serum cytokines and replication of Virus index in chronic hepatitis B（CHB）. Methods ：400 patients of CHB were classified as well as diagnosed with serum CD4, CD8 ,CD4/CD8 ,IL-2 ,IL-10, IL-12, HBV-DNA and HBV markers. Results：①CD4 were activity decreased and meanwhile CD8, CD4/CD8 markedly elevated in liver depression and spleen defficiency, spleen-kidney yang deficiency and liver-kidney yin deficiency（P 〈0. 01）;②Comparied with spleen-kidney yang deficiency and liver-kidney yin deficiency CD8 were activity decreased and meanwhile CD4/CD8 markedly elevated in damp-heat obstracting the center（P 〈0. 01 ） ;③Comparied with health control group revealed that IL-2, IL-10 ,IL-12 were markedly elevated in different syndrome types （P 〈 0. 01orP 〈 0. 05 ） ;④Comparied with dampheat obstracting the center and static blood obstructing the network vessels HBV-DNA（ 〉 1.0 × 10^5copies/mL） ,HBVeAg（ ＋ ） ,anti - HbelgM（ ＋ ） were markedly elevated in liver depression and spleen deffieien, spleen - kidney yang deficiency （ P 〈 0.01orP 〈 0. 05）. Conclusion ： Serum cytokines and replication of virus could serve as objective index for syndrome typing of CHB.