CAJ | 학술논문

[目的]观察中药芪灵合剂对拉米夫定片治疗慢性乙型肝炎（chronic hepatitis B, CHB）患者辅助性T细胞17（T helper cel s 17, Th17）、调节性T细胞（regulatory T cel s, Treg）及Treg/Th17平衡的影响。[方法]选取56例HBeAg阳性的CHB患者，随机分成治疗组和对照组，治疗组予以中药芪灵合剂联合拉米夫定片，对照组予以拉米夫定片，疗程均为48周。在基线期、24周、48周检测所有入组患者外周血的IL-17、FOXP3的频数，HBV-DNA的变化。[结果]两组HBV-DNA阴转率比较，治疗24周、48周后治疗组均高于对照组（P<0.05）；治疗组和对照组治疗48周后外周血HBV-DNA阴转率相对于治疗24周后均有所提高（P<0.05）。两组外周血IL-17、FOXP3频数及Treg/Th17比率比较，治疗24周、48周后治疗组均低于对照组（P<0.05）；治疗组和对照组治疗48周后均有所下降，与基线期比较差异均有统计学意义（P<0.05）。[结论]中药芪灵合剂可明显减轻肝脏炎症，增强抗病毒效力，改善免疫功能，其机理可能与其对Th17细胞及Tregs细胞的分布频率和功能调节有关。
[목적]관찰중약기령합제대랍미부정편치료만성을형간염（chronic hepatitis B, CHB）환자보조성T세포17（T helper cel s 17, Th17）、조절성T세포（regulatory T cel s, Treg）급Treg/Th17평형적영향。[방법]선취56례HBeAg양성적CHB환자，수궤분성치료조화대조조，치료조여이중약기령합제연합랍미부정편，대조조여이랍미부정편，료정균위48주。재기선기、24주、48주검측소유입조환자외주혈적IL-17、FOXP3적빈수，HBV-DNA적변화。[결과]량조HBV-DNA음전솔비교，치료24주、48주후치료조균고우대조조（P<0.05）；치료조화대조조치료48주후외주혈HBV-DNA음전솔상대우치료24주후균유소제고（P<0.05）。량조외주혈IL-17、FOXP3빈수급Treg/Th17비솔비교，치료24주、48주후치료조균저우대조조（P<0.05）；치료조화대조조치료48주후균유소하강，여기선기비교차이균유통계학의의（P<0.05）。[결론]중약기령합제가명현감경간장염증，증강항병독효력，개선면역공능，기궤리가능여기대Th17세포급Tregs세포적분포빈솔화공능조절유관。
Objective]To observe the effect of traditional Chinese medicine Qi Ling Mixture and lamivudine for patients with CHB Th17 cel s, Treg cel s, and Treg/Th17 balance. [Methods]Fifty-six patients with HBeAg-positive chronic hepatitis B were randomly divided into treatment group and control group, the treatment group received traditional Chinese medicine Qi Ling mixture combined with lamivudine, the control group received lamivudine, a course of 48 weeks. At baseline, 24 weeks, 48 weeks with the detection of al IL-17 and FOXP3 frequency, variation of the HBV-DNA.[Result] On HBV-DNA negative rate comparison,after 24 weeks and 48 weeks of treatment, the treatment group were higher than the control group;the peripheral blood of HBV-DNA negative rates of the treatment group and the control group after 48 weeks both more improved than after 24 weeks of treatment. On the peripheral blood of IL-17, FOXP3 frequency and Treg/Th17 after 24 weeks and 48 weeks of treatment, the treatment group were more declined than the control group, the treatment group and the control group after 48 weeks of treatment were declined, compared with baseline, the differences were statistical y significant. [Conclusion]Traditional Chinese medicine Qi Ling mixture can significantly reduce liver inflammation, enhance antiviral potency, improve immune function, and its mechanism may be related to Th17 cel s and Tregs cel s on the distribution frequencies and function of regulation.