益肝化湿饮对乙肝肝纤维化患者T淋巴细胞亚群的影响

高志远; 何新颖; 许迪; 祁月英; 徐湘江

doi:10.3969/j.issn.1671-038X.2023.07.15

益肝化湿饮对乙肝肝纤维化患者T淋巴细胞亚群的影响

- 1.
  沧州中西医结合医院脾胃肝病科(河北沧州，061000)
- 2.
  沧州中西医结合医院放化疗一科

详细信息

通讯作者: 高志远，E-mail：gzycrystal@126.com

中图分类号: R512.62

收稿日期: 2023-02-02

刊出日期: 2023-07-15

Influence of Yigan Huashi Decoction on T lymphocyte subsets in patients with hepatitis B liver fibrosis

- 1.
  Department of Spleen, Stomach, and Liver Diseases, Cangzhou Hospital of Integrated Traditional and Western Medicine, Cangzhou, Hebei, 061000, China
- 2.
  Department of Radiochemotherapy, Cangzhou Hospital of Integrated Traditional and Western Medicine

More Information

Corresponding author: GAO Zhiyuan, E-mail: gzycrystal@126.com

Received Date: 02 February 2023

Publish Date: 15 July 2023

摘要

摘要: 目的探讨益肝化湿饮联合恩替卡韦对乙肝肝纤维化患者T淋巴细胞亚群的影响。方法将118例乙肝肝纤维化患者随机分为对照组(60例)和治疗组(58例)。对照组采用恩替卡韦等常规治疗，治疗组在常规治疗基础上加用益肝化湿饮治疗。24周为1个治疗周期，观察两组患者的T淋巴细胞亚群、中医证候、肝功能、肝纤维化指标的变化。结果经过24周治疗，治疗组的有效率为87.93%，对照组为71.67%，治疗组优于对照组，差异有统计学意义(P < 0.05)；两组患者的CD3⁺、CD4⁺、CD4⁺/CD8⁺均较治疗前升高，治疗组CD4⁺、CD4⁺/CD8⁺的升高优于对照组，差异有统计学意义(P < 0.05)；两组患者的肝纤维化指标均较治疗前降低(均P < 0.05)，治疗组显著低于对照组，差异有统计学意义(P < 0.05)。结论益肝化湿饮可延缓乙肝肝纤维化的进展，其作用机制可能与调控T淋巴细胞亚群有关。
- 慢性乙型病毒性肝炎 /
- T淋巴细胞亚群 /
- 肝纤维化 /
- 益肝化湿饮
Abstract: Objective To explore the effect of Yigan Huashi Decoction combined with entecavir on T lymphocyte subsets in patients with hepatitis B liver fibrosis.Methods One hundred and eighteen patients with hepatitis B liver fibrosis were randomly divided into control group(60 cases) and treatment group(58 cases). The control group was given routine treatment and the treatment group received Yigan Huashi Decoction on the basis of the control group. The course of treatment was 24 weeks. The T lymphocyte subsets, symptom scores, liver function and liver fibrosis indexes were compared for both groups, before and after treatment.Results After 24 weeks'treatment, the total effective rate was 87.93% in the treatment group, which was better than that 71.67% in the control group. The levels of CD3⁺, CD4⁺, CD4⁺/CD8⁺ were obviously increased compared with treatment before and the CD4⁺, CD4⁺/CD8⁺ of the treatment group was higher than the control group(P < 0.05). The liver fibrosis indexes were decreased compared with treatment before. The treatment group was significantly lower than that in the control group(P < 0.05).Conclusion Yigan Huashi Decoction can delay the progression of hepatic fibrosis. The mechanism may be related to regulating the level of T lymphocyte subsets.
- chronic hepatitis B /
- T lymphocyte subsets /
- liver fibrosis /
- Yigan Huashi Decoction

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表 1 两组患者的临床资料比较例，X±S

组别	例数	性别		年龄/岁	病程/年
组别	例数	男	女	年龄/岁	病程/年
治疗组	58	27	31	43.01±9.72	9.32±4.77
对照组	60	26	34	42.05±10.73	10.53±5.81

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表 2 两组患者治疗后临床疗效的比较例

组别	例数	显效	有效	无效	有效率/%
治疗组	58	23	28	7	87.93¹⁾
对照组	60	19	24	17	71.67
与对照组比较，¹⁾P < 0.05。

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表 3 两组患者中医证候积分治疗前后的比较分，X±S

组别	例数	治疗前	治疗后
治疗组	58	11.39±3.74	2.56±1.28¹⁾²⁾
对照组	60	10.86±3.18	4.01±2.23¹⁾
与本组治疗前比较，¹⁾P < 0.05；与对照组比较，²⁾P < 0.05。

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表 4 两组患者肝功能变化情况的比较 X±S

组别	例数	时间	ALT/(U/L)	AST/(U/L)	TBil/(μmol/L)	γ-GT/(U/L)
治疗组	58	治疗前	150.07±31.48	98.13±28.62	34.50±10.11	132.94±20.05
		治疗后	43.46±15.07¹⁾	34.82±14.77¹⁾	16.11±7.52¹⁾	55.08±13.29¹⁾
对照组	60	治疗前	147.26±34.22	101.42±30.15	32.61±9.53	127.66±18.08
		治疗后	45.01±16.10¹⁾	32.74±15.62¹⁾	15.83±6.95¹⁾	56.30±15.02¹⁾
与本组治疗前比较，¹⁾P < 0.05。

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表 5 两组患者肝纤维化指标变化的比较 ng/mL，X±S

组别	例数	时间	PⅢP	Ⅳ-C	LN	HA
治疗组	58	治疗前	199.02±32.05	96.28±21.63	145.02±35.17	280.54±45.37
		治疗后	83.07±26.35¹⁾²⁾	51.11±17.03¹⁾²⁾	59.26±23.11¹⁾²⁾	97.06±34.73¹⁾²⁾
对照组	60	治疗前	185.26±28.94	100.47±20.52	139.82±34.96	292.33±46.02
		治疗后	105.44±25.37¹⁾	69.18±18.53¹⁾	76.30±26.61¹⁾	139.98±37.08¹⁾
与本组治疗前比较，¹⁾P < 0.05；与对照组治疗后比较，²⁾P < 0.05。

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表 6 两组患者T淋巴细胞亚群变化的比较 X±S

组别	例数	时间	CD3⁺/%	CD4⁺/%	CD8⁺/%	CD4⁺/CD8⁺
治疗组	58	治疗前	56.41±5.82	30.55±4.82	31.16±4.05	1.06±0.29
		治疗后	60.18±6.03¹⁾	38.95±5.61¹⁾²⁾	25.92±4.11¹⁾²⁾	1.69±0.42¹⁾²⁾
对照组	60	治疗前	55.29±6.11	31.02±4.63	32.36±4.19	1.08±0.35
		治疗后	61.06±6.25¹⁾	36.18±5.26¹⁾	28.57±4.32¹⁾	1.27±0.49¹⁾
与本组治疗前比较，¹⁾P < 0.05；与对照组治疗后比较，²⁾P < 0.05。

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