慢性乙型肝炎中医证型与免疫功能的相关性研究

Correlative Study on TCM Syndrome of Chronic Virus Hepatitis B and Immunological Function

目的观察乙型肝炎患者机体免疫功能与中医证型的关系,为临床辨证论治提供依据。方法收集初次治疗的慢性乙型肝炎患者515例,分为湿热中阻型、肝郁脾虚型、肝肾阴虚型、脾肾阳虚型和瘀血阻络型,并检测各患者血CD3+、CD4+、CD8+和血IgM、IgG、IgA。结果CD4+水平在湿热中阻证中最高,与肝肾阴虚、脾肾阳虚证相比有显著性差异(P<0.05);CD8+水平在脾肾阳虚证中最高,与湿热中阻、瘀血阻络证相比差异显著(P<0.05);血IgM、IgG水平在湿热中阻证中最高,与脾肾阳虚证相比有显著性差异(P<0.05)。结论慢性乙型肝炎患者的中医辨证分型与机体免疫功能之间存在相关性,相关免疫指标对辨证分型有参考价值。

Objective To observe the correlativity between TCM syndrome of chronic virus hepatitis B and immunological function and provide evidences for TCM clinical syndrome differentiation and treatment. Methods Five hundreds and fifty patients with chronic hepatitis B were enrolled in this study. They all received the primary treatment and were categorized into five TCM syndromes, including syndrome of damp-heat obstruction, syndrome of liver depression with spleen insufficiency, syndrome of liver-kidney yin deficiency, syndrome of spleen-kidney yang deficiency, and syndrome of stagnant-blood obstructing collaterals. The relative immunological indexes in these patients were detected after treatment. Results The serum CD4^＋ level was higher in syndrome of damp-heat obstruction than in syndrome of liverkidney yin deficiency and spleen-kidney yang deficiency,P〈 0.05. Compared with syndrome of damp-heat obstruction and stagnant-blood obstructing collaterals, the serum CD8^＋ level in syndrome of spleen-kidney yang deficiency were significantly higher, P〈 0.05. In addition, both serum IgM and IgG were at the highest level in syndrome of damp-heat obstruction. Conclusion This study showed that there was an obvious correlativity between TCM syndrome of chronic virus hepatitis B and immunological function. It is suggested that the relative immunological indexes may help syndrome differentiation and treatment of chronic hepatitis B.