柴芍六君汤治疗慢性乙型肝炎肝纤维化疗效及对患者血清Treg/Th17的影响

Therapeutic effect of Chaishao Liujun decoction on hepatic fibrosis in chronic hepatitis B and effect on serum Treg/Th17

目的:探讨柴芍六君汤治疗慢性乙型肝炎肝纤维化疗效及对患者血清Treg/Th17的影响。方法:90例慢性乙型肝炎肝纤维化肝郁脾虚证患者随机分为两组,对照组给予恩替卡韦治疗,治疗组在对照组基础上加用柴芍六君汤,疗程24周。比较两组疗效、中医证候积分、肝功能指标[丙氨酸氨基转移酶(ALT)、γ-谷氨酸酰基转移酶(GGT)及天门冬氨酸氨基转移酶(AST)]、肝纤维化指标[层黏蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)和透明质酸(HA)]、免疫功能(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))及Treg/Th17水平指标。结果:治疗组总有效率93.33%,对照组75.56%,组间比较差异有统计学意义(P<0.05)。治疗后,治疗组腹胀、胁肋疼痛、便溏、倦怠乏力及纳食减少证候评分低于对照组(均P<0.05)。治疗后治疗组血清ALT、GGT、AST、PCⅢ、Ⅳ-C、LN、HA、CD8^(+)、Th17细胞、Treg细胞及Treg/Th17低于对照组(均P<0.05)。治疗后治疗组血清CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组(均P<0.05)。结论:柴芍六君汤治疗慢性乙型肝炎肝纤维化疗效较好,可改善患者肝功能和免疫功能,抑制肝纤维化,调节Treg/Th17平衡。

Objective:To explore curative effect of Chaishao Liujun decoction in treatment of hepatic fibrosis in chronic hepatitis B and its influence on serum Treg/Th17.Methods:90 patients with hepatic fibrosis in chronic hepatitis B of Ganyu Pixu syndrome were randomly divided into two groups.The control group was treated with entecavir,and the treatment group treated with Chaishao Liujun decoction for 24 weeks.Therapeutic effects,TCM syndrome scores,liver function indexes[alanine aminotransferase(ALT),γ-glutamate acyl transfer Enzymes(GGT)and aspartate aminotransferase(AST),Index of liver fibrosis[laminin(LN),typeⅢprocollagen(PCⅢ),typeⅣcollagen(Ⅳ-C)and hyaluronic acid(HA)],immune function[CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)]and Th17/Treg level indicators.Results:The total effective rate was 93.33%in the treatment group and 75.56%in the control group,difference statistically significant(P<0.05).After treatment,symptom scores of Fuzhang,Xielei Tengtong,Biantang,Juandai Fali,Nashi Jianshao in the treatment group were lower than those in the control group(all P<0.05).Serum ALT,GGT,AST,PCⅢ,Ⅳ-C,LN,HA,CD8^(+),Th17 cells,Treg cells and Treg/Th17 were significantly lower than those in the control group(all P<0.05).After treatment,serum CD3^(+),CD4^(+),CD4^(+)/CD8^(+)levels in the treatment group were significantly higher than those in the control group(all P<0.05).Conclusion:Chaishao Liujun decoction is effective in treating hepatic fibrosis in chronic hepatitis B.It can significantly improve liver function and immune function,inhibit liver fibrosis,and regulate ratio of Treg/Th17.