大柴胡汤加味对梗阻性黄疸患者血T细胞亚群和肿瘤坏死因子的影响

Effect of Jiawei Dachaihu Decoction on Blood T Lymphocyte Subsets and Tumor Necrosis Factor in Patients with Obstructive Jaundice

目的：观察围手术期应用大柴胡汤加味对改善梗阻性黄疸患者细胞免疫功能的作用。方法：将４０例患者随机分为单纯手术组（Ａ组）和手术加服大柴胡汤加味治疗组（Ｂ组），手术前后测定Ｔ细胞亚群（ＣＤ３、ＣＤ４及ＣＤ８）、肿瘤坏死因子（ＴＮＦ）进行比较。结果：患者ＣＤ３、ＣＤ４及ＣＤ４／ＣＤ８下降，ＴＮＦ升高。术后第２天ＣＤ３、ＣＤ４及ＣＤ４／ＣＤ８进一步下降，低于术前水平。Ａ组术后第２０天ＣＤ３、ＣＤ４及ＣＤ４／ＣＤ８比术前明显增高，ＴＮＦ明显降低（均Ｐ＜０．０５）。Ｂ组术后第１０天ＣＤ２、ＣＤ４比Ａ组明显增高，ＴＮＦ明显降低（均Ｐ＜０．０５）。结论：手术有利于Ｔ细胞免疫功能的恢复和ＴＮＦ水平的下降，围手术期中药治疗是重要辅助措施。

To observe the effect of the preoperative Jiawei Dachaihu decoction in improving cellular immune functions in patients with obstructive jaundice. Mathods: Forty patients were randomly divided into two groups with (group B) and without (group A) the herbal therapy. And their preoperative T lymphocyte subsets, TNF and the postoperative dynamic changes were measured. Results: CD3, CD4 and CD4/CD8 decreased and TNF increased in the patients. CD3, CD4 and CD4/CD8 decreased much less and were lower than preoperative levels 2 days after the operation. CD3, CD4 and CD4/CD8 were higher and TNF lower than preoperative levels in group A after 20 days of the operation (all of them P<0.05). Conclusions: The operation could be helpful to recover immune functions of T lymphocyte and decrease TNF levels. The perioperative herbal therapy is an imPOrtant adjuvant measure.