Th9细胞在乙肝病毒感染炎症过程中的变化及健脾补肾法对其的影响

Level of Th9 in Inflammatory Process of Patients with Hepatitis B Virus Infection and Effect of Chinese Medicine Therapy for Strengthening Spleen and Nourishing Kidney

目的:观察Th9细胞在乙肝病毒感染炎症过程中的变化及健脾补肾法对其的影响。方法:选择慢性HBV携带者、慢性乙肝患者ALT轻度异常、中度异常、重度异常各50例,测定Th9水平,观察Th9在慢性乙肝不同炎症程度过程中的变化;从以上病例中选择符合抗病毒治疗病例60例,分为观察组及对照组,每组各30例,观察组采用健脾补肾中药联合核苷(酸)类似物治疗,对照组仅用核苷(酸)类似物治疗,治疗前后观察Th9、肝功能、HBV-DNA等指标,疗程为24周。结果:随着ALT水平的升高,Th9细胞比例逐渐升高,四组比较差异均有统计学意义(P<0.05);Th9与ALT呈正相关(r=0.804,P<0.05),与HBV-DNA无相关性。观察组Th9治疗前后差异有统计学意义(P<0.05),对照组Th9治疗前后差异有统计学意义(P<0.05),观察组与对照组Th9治疗后比较差异有统计学意义(P<0.05)。观察组肝功能复常率、HBV-DNA的转阴率与对照组比较差异无统计学意义(P>0.05);两组肝功能复常时间、HBV-DNA转阴时间差异有统计学意义(P<0.05)。结论:Th9细胞与乙肝病毒感染炎症程度密切相关,健脾补肾中药可以通过调节Th9细胞,提高核苷(酸)类似物治疗慢性乙肝的疗效。

Objective：To discuss the level of Th9 in inflammatory process of patients with hepatitis B virus infection and effect of Chinese medicine therapy for strengthening spleen and nourishing kidney. Methods ：200 patients were divided into four groups according to the level of ALT：chronic HBV carriers, chronic hepatitis B with mild abnormal, moderate abnormal and severe abnormal levels of ALT. The frequency of Th9 was observed. And then 60 patients were divided into two groups：observation group and control group, each group having thirty patients. Patients in the control group were only given Nucleoside/nucleotide. Patients in the observation group were given Nucleoside/nucleotide and traditional Chinese drug. Liver function, HBV - DNA and Th9 were observed at regular intervals. Results ： With level of ALT elevating, per- centage of TH9 was increased gradually. There was significant difference within four groups（P 〈 0.05 ）. Th9 was positively correlated with ALT（r = 0. 804,P 〈 0.05 ）, but not correlated with HBV- DNA. Before and after treatment of two groups and after treatment of two groups, there was statistical significance of Th9 （ P 〈 0.05 ）. The negatively inversing rate of ALT and HBV - DNA of observation group were not significantly different than those of control group （ P 〉 0.05 ）. But the time of those had statistical significance （ P 〈 0.05 ）. Conclusion ： Th9 was intimately correlated with inflammatory. Chinese medicine therapy for strengthening spleen and nourishing kidney can improve the curative effect of chronical hepatitis B treated by Nucleoside/nucleotide.