慢性乙型肝炎不同中医证候机体免疫功能的动态变化

目的：观察慢性乙型肝炎不同中医证侯机体免疫功能的动态变化，探讨慢性乙型肝炎中医证型与临床免疫指标的关联性。方法：选择初次治疗的慢性乙型肝炎肝胆湿热证和肝郁脾虚证患者各30例，动态观察两组患者血清CD3＋、CD4＋、CD8＋水平及IgA、IgM、IgG含量的变化。结果：肝胆湿热型患者CD3＋水平在初次、随访8周和16周时均明显升高，与肝郁脾虚型患者相应数值相比差异均有统计学意义（P〈0．05）。两组患者初次、随访8周和16周时CD4＋水平差异均有统计学意义（P〈0．05），肝胆湿热组高于肝郁脾虚组。两组患者初次IgM含量差异有统计学意义，肝胆湿热组低于肝郁脾虚组（P〈0．05），随访8周和16周时两组IgM含量差异均无统计学意义（P〉0．05）。两组患者CD8＋、IgA、IgG水平比较差异均无统计学意义（P〉0．05）；肝胆湿热组患者不同时间点血清CD3＋、CD4＋、CD8＋水平及IgA、IgM、IgG含量差异无统计学意义（P〉0．05），肝郁脾虚组患者不同时间点血清CD3＋、CD4＋、CD8＋水平及IgA、IgM、IgG含量差异亦无统计学意义（P〉0．05）。结论：①慢性乙型肝炎中医证型与机体免疫功能有一定的关联性，相关免疫指标可作为中医辨证分型的参考依据；②不同中医证型慢性乙型肝炎患者免疫功能具有一定稳定性。

Dynamic Changes of Immune Function in Chronic Hepatitis B with Different TCM Syndromes

Objective：To observe the dynamic changes of immune function in chronic hepatitis B with different TCM syndromes, and to explore the relevance between chronic hepatitis B （CHB） TCM types and clinical immune markers. Methods：The initial treatment patients who were corresponding to diagnosis on chronic hepatitis B standards were select- ed, with 30 cases in each of syndrome of dampness - heat of liver and gallbladder and syndrome of stagnation of liver qi and spleen deficiency. And the dynamic changes of two group serum CD3＋ , CD4＋ , CDs levels and IgA,IgM and IgG con- tents were observed. Results：At the first time,8 and 16 weeks of follow -up, CD3＋ levels were significantly increased in patients with syndrome of dampness - heat of liver and gallbladder, which were significantly different from that of patients with syndrome of stagnation of liver qi and spleen deficiency （P 〈 0.05 ）. At the first time, 8 and 16 weeks of follow - up, CD4＋ levels were statistically significant between two groups. The syndrome of dampness - heat of liver and gallbladder group was higher than that of syndrome of stagnation of liver qi and spleen deficiency group （ P 〈 0.05 ）. At the first time, IgM content was statistically significant between two groups. The syndrome of dampness - heat of liver and gallblad- der group was lower than that of syndrome of stagnation of liver qi and spleen deficiency group （P 〈 0. 05）. At 8 and 16 weeks of follow - up, there was no significant difference between two groups （ P 〉 0.05 ）. There were no significant differ- ences between the patients of two groups in serum CDs level and IgA and IgG contents （P 〉 0.05）. There were no sig- nificant differences between the different time points of patients with syndrome of dampness - heat of liver and gallbladder in serum CD3＋ , CD4＋ , CDs levels and IgA, IgM, IgG contents （P 〉 0.05）. There were no significant differences between the different time points of patients with syndrome of dampness - heat of liver and gallbladder in serum CD3＋ , CD4＋ , CDs levels and IgA, IgM an IgG contents too （P 〉 0. 05）. Conclusion ： ①There was certain relevance between chronic hepatitisB TCM syndromes and immune function. The associated immune indicators should be as reference of TCM syndrome types. ②The immune function in patients of different TCM syndromes of chronic hepatitis B has certain stability.