苦参素对慢性乙型肝炎患者特异性、非特异性细胞免疫影响的研究

Influence of Kurarinol on specific and non-specific cell immunity in patients with chronic hepatitis B

目的探讨苦参素对慢性乙型肝炎（CHB）患者特异性、非特异性细胞免疫的影响。方法74例CHB患者随机分为两组，治疗组36例，用苦参素葡萄糖注射液600mg，静脉滴注，每日1次，1个月后改为苦参素胶囊200mg，口服，每日3次，2个月，水飞蓟宾葡甲胺片200mg，口服，每日3次，3个月。对照组38例，只用水飞蓟宾葡甲胺片，用法、用量同治疗组。比较两组患者的HBV特异性细胞毒性T细胞（CTL）、非特异性CTL、T细胞亚群、Th1、Th2水平的变化和HBVDNA、HBe觚阴转率。结果治疗组苦参素治疗3个月后，HBV特异性CTL高于治疗前（P〈0.01），也高于对照组治疗后（P〈0．05），非特异性CTL高于治疗前（P〈0．05），也高于对照组治疗后（P〈0．01），CD4^＋高于治疗前（P〈0．05），也高于对照组治疗后（P〈0．01），Th1高于治疗前（P〈0．05），也高于对照组治疗后（P〈0．01），HBVDNA阴转和HBeAg阴转高于对照组（P〈0．01）。结论苦参素能提高CHB患者的特异性、非特异性细胞免疫功能，是苦参素清除或抑制CHB患者HBV的机制之一。

Objective To explore influence of Kurarinol on specific and non-specific cell immunity in patients with chronic hepatitis B. Methods 74 cases of CHB were randomly divided into two groups, 36 cases in treatment group, treated with 600mg Kurarinol glucose injection, Ⅳ , once a day. After one month, Kurarinol capsule was used orally, three times a day for 2 months, 200 mg Silybin Meglumine Tablets orally, three times a day for 3 months. 38 cases in control group, only Silybin Meglumine Tablets was used, method and dosage were the same as treatment group. Compare HBV specific CTL, non-specific CTL, sub-group of T cells, changes of Thl and Th2, negative conversion rate of HBV DNA and HBeAg of the two groups. Results In treatment group, 3 months after treatment with Kurarinol, HBV specific CTL is higher than that before treatment （P 〈 0.01 ）, it is also higher than that of control after treatment, P 〈 0.05）. Non-specific CTL is higher than that before treatment （P 〈 0.05）, it is also higher than that of control after treatment （ P 〈 0.01 ）. CD4^＋ is higher than that before treatment （ P 〈 0.05）, it is also higher than that of control after treatment （ P 〈 0.01）, Thl is higher than that before treatment （ P 〈 0.05）, it is also higher than that of control after treatment （ P 〈 0.01 ）. Negative conversion of HBV DNA and HBeAg is higher than that of control （ P 〈 0.01 ）. Conclusion Kurarinol can improve specific and non-specific cell immunity in patients with CHB. It is one of the mechanisms that Kurarinol can clear or inhibit HBV of patients with CHB.