慢性乙肝外周血调节性T细胞的临床意义及辨证施治对其的影响

Significance of Peripheral Blood Regulatory T Cell with Chronic Hepatitis B and the Effect of Determining the Treatment Based on Symptom Differentiation

探讨慢性乙肝外周血调节性T细胞的临床意义及辨证施治对其的影响。方法:收集100例符合抗病毒治疗指征的慢性乙肝患者,首先根据ALT、HBV-DNA水平分为高、中、低3组,观察Treg与其的关系;然后分为观察组与对照组,观察组采用中医中药联合核苷(酸)类似物治疗,对照组仅用核苷(酸)类似物治疗,观察肝功能、HBV-DNA、Treg等指标,疗程为52周。结果:随着ALT水平的升高,Treg频率逐渐降低,其中ALT低水平组与高水平组Treg频率比较差异有统计学意义(P<0.05),随着HBV-DNA载量的升高,Treg频率逐渐升高,HBV-DNA低载量组与中载量组、高载量组Treg频率比较差异均有统计学意义(P<0.05)。观察组与对照组在肝功能复常率、HBV-DNA转阴率差异无统计学意义(P>0.05)。治疗前后两组组内比较Treg频率差异均有统计学意义(P<0.05),治疗后两组组间比较差异有统计学意义(P<0.05)。结论:外周血调节性T细胞在慢性乙肝中具有重要的临床意义,辨证施治对其有调节作用。

Objective：To discuss the significance of peripheral blood CD_4~＋ CD_（25）~＋ regulatory T cell with chronic hepatitis B and the effect of determining the treatment based on symptom differentiation.Methods：First,100 patients were divided into three groups according to the levels of ALT and HBV-DNA.The frequency of Treg was observed.Then all patients were divided into two groups at random：observation group and control group,each group had fifty patients.Patients in the control group were only given nucleoside/nucleotide.Patients in the observation group were given nucleoside/nucleotide and traditional Chinese drugs.Liver function,HBV-DNA and Treg were observed at regular intervals.Results： Treg of the lower level group of ALT was higher than that of the highest level group（P0.05）.Treg of the lower level group of HBV-DNA was significantly different from that of the middle and highest groups（P0.05）.The negatively inversing rates of ALT and HBV-DNA of observation group were not significandy different from those of control group（P0.05）.Treg of observation group was significantly different from that of control group（P0.05）.Conclusion：The peripheral blood regulatory T cell with chronic hepatitis B has important significance and the treatment based on symptom differentiation can regulate it.