慢性乙型肝炎湿热蕴脾证和脾胃气虚证与TNF-α及IL-6相关性研究

Correlative Study on Pi Damp-Heat Stagnancy Syndrome and Pi-Wei Qi-deficiency Syndrome with Tumor Necrosis Factor-α and Interleukin-6 in Patients with Chronic Hepatitis B

目的 :探讨慢性乙型肝炎湿热蕴脾证和脾胃气虚证与肿瘤坏死因子 α(TNF α)及白细胞介素 6(IL 6 )之间的关系。方法 :选择慢性乙型肝炎 12 4例 ,辨证为湿热蕴脾证 6 4例 ,脾胃气虚证 6 0例 ,两证型均随机分为常规治疗组和加服中药组 ,另设健康对照组 30名 ,分别在治疗前后空腹抽取肘静脉血 ,采用双抗体夹心酶联免疫吸附 (ELISA)法检测血清TNF α、IL 6水平。结果 :慢性乙型肝炎湿热蕴脾证和脾胃气虚证TNF α、IL 6均升高 ,与健康对照组比较差异有显著性 (P <0 0 1) ;两证型治疗后TNF α、IL 6均下降 ,与治疗前比较差异有显著性 (P <0 0 1) ;湿热蕴脾证加服中药组TNF α水平显著低于常规治疗组 (P <0 0 5 ) ,脾胃气虚证加服中药组TNF α、IL 6水平低于常规治疗组 (P <0 0 5 ,P <0 0 1)。结论 :慢性乙型肝炎湿热蕴脾证较脾胃气虚证病情严重 ;慢性乙型肝炎结合中医辨证治疗可明显改善TNF α、IL 6水平的变化。

Objective: To study the relationship of Pi Damp Heat stagnancy Syndrome (PDHS) and Pi Wei Qi deficiency Syndrome with tumor necrosis factor α (TNF α) and interleukin 6 (IL 6) in patients with chronic hepatitis B (CHB). Methods: One hundred and twenty four patients with CHB were enrolled, among them 64 were typed as PDHS and the other 60 typed as Pi Wei Qi deficiency Syndrome (PWQDS). They were randomly divided into the control group (treated with conventional treatment) and the treated group (treated with conventional treatment plus Chinese herbal medicine), besides, a normal control group consisting of 30 subjects was also set up. Their fasting venous blood was drawn before and after treatment to determine TNF α and IL 6 by ELISA. Results: Levels of TNF α and IL 6 in all the patients were higher than those in the normal control group significantly (P<0 01). After treatment, levels of the two parameters were all obviously decreased, as compared with those before treatment, the difference was significant (P<0 01). As compared with the control group, in the treated group, TNF α level in patients with PDHS, and TNF α and IL 6 levels in patients with PWQDS were lower significantly (P<0 05 or P<0 01). Conclusion: In patients with CHB, the severity of patient with PDHS was more serious than those with PWQDS. Integrated conventional treatment with Chinese herbal medicine depending on Syndrome Differentiation could significantly improve the changes in TNF α and IL 6 levels in patients with CHB.