补肾颗粒对慢性乙型肝炎患者CD4^+T淋巴细胞整体免疫调控网络的影响

Effects of “Kidney-nourishing Granule” on the Whole Immune Regulation Network of CD4 T Lymphocytes in Patients with Chronic Hepatitis B

目的:从整体免疫调控网络平衡的角度探讨补肾颗粒对慢性乙型肝炎患者整体免疫调控环节的作用及其优势环节。方法:将70例慢性乙型肝炎患者给予补肾颗粒治疗,疗程20周。观察治疗前后患者外周血各免疫细胞(Th17、Th1、Th2、Treg、Th1/Th2、Treg/Th17)、细胞因子(IL-17、IL-6、TGF-β1、IFN-α、IL-4)、效应分子(穿孔素、颗粒酶B)和核转录因子(RORγt、Foxp3)的变化。结果:1治疗后,CD3+、CD4+、CD4+/CD8+T淋巴细胞比例显著提高(P<0.05),CD8+细胞比例显著下调(P<0.05)。2治疗后Th1升高,Th2下调,Th1/Th2比例提高;Th17比例降低,Treg比例提高,Treg/Th17比例提高,但均无统计学差异(P>0.05)。3治疗后IL-17和IL-4表达显著降低(P<0.05),IL-6和INF-α表达显著提高(P<0.05);TGF-β1表达治疗前后无显著影响(P>0.05)。4治疗后RORγt表达显著下调(P<0.05),穿孔素和颗粒酶B表达无显著变化(P>0.05)。结论:补肾颗粒能通过多个环节对慢性乙型肝炎患者的免疫状态实现良性调控,其优势作用环节主要体现在对核转录水平和细胞因子水平的调控。

Objective： From the perspective of the balance of the whole immune regulation network,to clear the immune regulation mechanism and advantage of ＂Kidney-nourishing Granule＂in the treatment of chronic hepatitis B. Methods： 70 patients with mild chronic hepatitis B were treated with＂Kidney-nourishing Granule＂for 20 weeks. The changes of peripheral blood immune cells（ Th17,Th1,Th2,Treg,Th1 / Th2,Treg / Th17,flow cytometry）,related cytokines（ IL-17,IL-6,TGF- beta,IFN- alpha,IL-4,ELISA）,the main effector molecules（ perforin,Granzyme B,flow cytometry（ alone） and nuclear transcription factornuclear receptor ROR gamma T,Foxp3,PCR） were observed. Results： 1The therapy of＂Kidneynourishing Granule＂could obviously improve the proportion of CD3,CD4,CD4 / CD8 T lymphocytes（ P 0. 05）,and could significantly reduce the percentage of CD8 cells（ P 0. 05）. 2After the treatment,Th1 increased,Th2 decreased,and the proportion of Th1 / Th2 increased（ P 0. 05）; ＂Kidney-nourishing Granule＂could to some extent reduce the proportion of Th17,increased Treg ratio,so as to improve the Treg / Th17 ratio（ P 0. 05）. 3After the treatment,the expression of IL-17 and IL-4 decreased（ P 0. 05）,IL-6 and INF-α increased（ P 0. 05）,but the expression of TGF-β1in chronic hepatitis B patients had no significant effect（ P 0. 05）. 4 Expression of kidney tonifying method could significantly reduce the ROR gamma t（ P 0. 05）,and Tonifying kidney for perforin and granzyme B expression had no significant effect（ P 0. 05）.Conclusion： The therapy of＂Kidney-nourishing Granule＂through multi links of chronic hepatitis B immune state of imbalance to realize the benign regulation,in addition to the overall increase the number of immune cells,its advantages were mainly embodied in the regulation of the function of link nuclear transcription and cellfactor level.