补肾方对慢性乙型肝炎自然杀伤细胞免疫效应分子的影响

作者	单位
高月求	上海中医药大学附属曙光医院上海中医药大学肝肾疾病病证教育部重点实验室
姚嫣	上海中医药大学附属曙光医院上海中医药大学肝肾疾病病证教育部重点实验室
李曼	上海中医药大学附属曙光医院上海中医药大学肝肾疾病病证教育部重点实验室

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中文摘要:

目的观察补肾方治疗肝肾阴虚兼湿热未尽型慢性乙型肝炎的免疫调控作用机制。方法收集HBV DNA阳性、ALT异常的肝肾阴虚兼湿热未尽型慢性乙型肝炎患者35例,其中治疗组22例给予补肾方治疗,对照组13例给予α-2b干扰素,疗程6个月,分别于用药前后检测患者谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)和HBV DNA水平,用流式细胞法检测外周血自然杀伤细胞(NK)的免疫效应分子穿孔素(PF)、颗粒酶B(GrB)、颗粒溶素(GNLY)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)的表达情况。结果两组治疗后ALT及AST均低于治疗前(P<0.05,P<0.01),治疗后组间比较差异无统计学意义。两组治疗后中医证候总积分都明显下降(P<0.01);治疗后治疗组总积分明显低于对照组(P<0.05)。治疗组治疗后的中医证候疗效总有效率明显高于对照组(P<0.05)。治疗组治疗后PF(%)34.86±31.60和GNLY(%)25.72±24.98均低于治疗前69.62±27.58,64.54±25.96(P<0.05),与对照组治疗后比较差异无统计学意义。结论补肾方治疗肝肾阴虚兼湿热未尽型慢性乙型肝炎的免疫调控作用机制在于降低NK细胞的相关免疫效应分子的表达,促进受损肝脏的痊愈。

英文摘要:

Objective To investigate the immunoregulation mechanism of Bushen Recipe(BSR)in patients with chronic hepatitis B(CHB)of Gan-Shen yin-deficiency and lingering damp-heat syndrome(GSS). Methods Thirty-five patients with positive HBV DNA and abnormal alanine transaminase(ALT)level were assigned to the treatment group(22 patients)and the control group(13 patients),they were treated with BSR andα-2b interferon for 6 months respectively.Blood levels of alanine aminotransferase(ALT),aspartate aminotransferase (AST),total bilirubin(TBIL)and HBV DNA were measured before and after treatment.And the expressions of immune effector molecules of nature killer(NK)cell,including perforin(PF),granzyme B(GrB), granulysin(GNLY),tumor necrosis factor-α(TNF-α)andγ-interferon(γ-IFN),were detected using flow cytometry. Results Levels of ALT and AST declined significantly in both groups after treatment(P<0.05 or P<0.01),showing insignificant difference between them.And the expressions(%)of PF and GNLY in the treatment group reduced significantly after treatment,from 69.62±27.58 to 34.86±31.60 for PF and from 64.54±25.96 to 25.72±24.98 for GNLY(both P<0.05).In the treatment group and the control group,as compared with before treatment,the total scores of Chinese medicine symptoms were significantly declined after treatment (P<0.01),and the toal scores of Chinese medicine symtoms in the treatment group was significantly lower than that of the control group(P<0.05).As compared with the total effective rate of Chinese medicine syndromes in the control group after treatment,that in the treatment group was significantly increased(P<0.05).Conclusion The mechanism of BSR in immuneregulating on patients with CHB of GSS is by way of declining the expressions of relative immune effector molecules to promote the recovery of the damaged liver.

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