慢性乙型肝炎虚实证患者血清TNF含量及小柴胡汤加减对其影响的研究

The Effect of Modified Xiao Chai Hu Tang on Serum TNF Level in Chronicepatitis B with Deficiency and Excess Syndrome

我们利用双抗体夹心法对６５例慢性乙型肝炎（简称慢乙肝）虚实证患者（其中虚证３１例、实证３４例）及２０例正常对照者的血清ＴＮＦ含量进行了检测．并观察用小柴胡汤按虚、实证辨证加减治疗对ＴＮＦ及肝功能的影响。结果表明：１．慢乙肝患者血清ＴＮＦ含量较正常人显著升高（Ｐ＜０．００１）；２．慢乙肝虚、实证患者血清ＴＮＦ含量均较正常人显著升高（Ｐ＜０．００１），但虚证患者血清ＴＮＦ含量较实证低（Ｐ＜０．００２），提示慢乙肝虚、实证患者存在免疫状态的差别；３．慢乙肝患者血清ＴＮＦ含量与肝损害程度呈正相关（ｒ＝０．２６７，Ｐ＜０．０５），提示ＴＮＦ可作为衡量病情轻重的一个客观指标；４．用小柴胡汤按虚、实证辨证加减治疗慢乙肝虚、实证患者后，血清ＴＮＦ含量及肝功能均较治疗前改善（Ｐ＜０．００１或Ｐ＜０．０１），提示小柴胡汤是治疗慢乙肝的有效方剂。

Sixty一five cases of chronic hepatitis B(31 cases with deficiency syndrome and 34 cases withexcess syndrome)were treated by modified Xiao Chai Hu Tang(XCHT).Serum TNF level wasdetected before and after treatment,and 20 normal persons served as control. The results showedthat(1)Serum TNF level of chronic hepatitis B were obviously higher than that of control group(P<0. 001);(2 ) TNF level of patients with deticiency syndrome was lower than that of thosewith excess syndrome(P<0. 002),suggesting that the immune function is various between deficiency and excess syndrome;(3)There existed a positive correlation between TNF and ALTleve1(r=0. 267,P< 0.05 ),indicating that TNF may serve as a objective criterion for evaluatingthe severity of the disease;(4)Being treated by XCHT modified according to deficiency and excesssyndrome differetiation, TNF level, liver function and symptoms were all recovered in variousdegrees(P< 0. 001 or P < 0. 01). It is revealed that XCHT is an effective decoction for chronichepatitis B.