保元汤对慢性感染性乙型肝炎患者免疫功能和肝功能的影响

Effect of Bao Yuan Decoction on immune function and liver function in patients with chronic infectious hepatitis

目的探讨保元汤对慢性感染性乙型肝炎患者免疫功能和肝功能的影响。方法选取2014年2月-2016年2月医院肝病科收治的慢性乙型肝炎患者166例,分为对照组与研究组,各83例;对照组患者予以阿德福韦酯治疗,研究组患者在对照组基础上予以保元汤治疗,观察并记录两组间免疫功能、肝功能、肝纤维化相关指标水平,同时比较临床疗效及不良反应。结果研究组总有效73例多于对照组62例,但两组患者疗效差异无统计学意义;治疗后研究组患者外周血CD3+、CD4+T淋巴细胞及CD4+/CD8+分别为(66.25±8.67)%、(44.39±6.16)%、(1.71±0.24)高于对照组,CD8+T淋巴细胞水平为(26.34±3.53)%低于对照组(P<0.001);研究组血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBil)、白蛋白(ALB)、血清透明质酸(HA)、Ⅲ型前胶原(PC III)、Ⅳ型胶原(IV-C)和层粘连蛋白(LN)水平分别为(42.28±5.18)U/L、(56.47±7.65)U/L、(24.34±2.78)μmol/L、(40.04±4.37)g/L,(80.04±11.15)ng/ml、(19.17±2.41)ng/ml、(65.45±8.15)ng/ml和(98.75±12.15)ng/ml低于对照组(P<0.001)。两组间不良反应差异无统计学意义。结论保元汤治疗慢性乙型肝炎能提高患者细胞免疫功能,改善肝功能,防止肝纤维化,且安全性较高。

OBJECTIVE To investigate the effect of Bao Yuan Decoction on immune function and liver function in patients with chronic infectious hepatitis.METHODS A total of 166 patients with chronic hepatitis B from Feb.2014 to Feb.2016 from hepatology department in our hospital were selected,and were divided into control group and experiment group,with 83 cases in each group.Patients in control group were treated with adefovir dipivoxil,and in experiment group were treated with Bao Yuan Decoction on the basis of control group.The immune function,liver function,and hepatic fibrosis index levels of the two groups were recorded,and the clinical effect and incidence of adverse reaction were compared.RESULTS There were 73 cases of effectiveness in experiment group and 62 cases in control group,but there was no significant difference.The peripheral blood levels of CD3＋,CD4＋T lymphocytes and CD4＋/CD8＋in experiment group were（66.25±8.67）%,（44.39±6.16）% and（1.71±0.24）,which were higher than those in control group,levels of CD8＋T lymphocytes was（26.34±3.53）%,which was lower than that of contol group（P〈0.001）.Levels of serum alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,total bilirubin（TBil）,albumin（ALB）,hyaluronic acid（HA）,type III procollagen（PC III）,type IV collagen（IV-C）and laminin（LN）in experiment group were（42.28±5.18）U/L,（56.47±7.65）U/,（24.34±2.78）μmol/L,（40.04±4.37）g/L,（80.04±11.15）ng/ml,（19.17±2.41）ng/ml,（65.45±8.15）ng/ml and（98.75±12.15）ng/ml,which were lower than those in control group（P〈0.001）.there was no significant difference in adverse reactions between the two groups.CONCLUSIONBao Yuan Decoction can significantly improve the cellular immune function of patients,improve liver function,prevent liver fibrosis,and the safety is high.