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[目的]探讨和解汤对慢性乙型肝炎(CHB)功能性T淋巴细胞亚群的影响。[方法]将72例CHB患者随机分为2组,治疗组(42例)采用和解汤治疗,对照组(30例)采用核苷类似物治疗,观察2组治疗后外周血功能性T淋巴细胞亚群(CD8+CD28+、CD4+CD28+)、白细胞介素2(IL-2)水平及乙肝病毒(HBV)标志物及肝功能的变化。[结果]治疗组治疗后CD8+CD28+、CD4+CD28+T细胞和IL-2水平较治疗前明显升高(P<0.05),6例患者HBeAg阴转、HBV DNA量下降至1×105copy/ml以下;对照组治疗前后CD8+CD28+T细胞、CD4+CD28+T细胞及IL-2水平无明显变化(P>0.05),1例患者HBeAg阴转,22例HBV DNA量下降至1×105copy/ml以下。CHB显效者治疗后CD8+CD28+、CD4+CD28+T细胞水平和IL-2水平明显升高(P<0.01);非显效组治疗前后CD8+CD28+T细胞、CD4+CD28+T细胞水平无明显变化(P>0.05)。[结论]和解汤清除HBV的疗效,可能与CD8+CD28+T细胞的有效激活有关,细胞免疫在HBV感染发病机制和病毒清除过程中起重要作用。
[Objective] To explore the effect of Hejie Tang on the subtypes of chronic hepatitis B (CHB) functional T lymphocytes. [Methods] 72 cases of CHB patients were randomly divided into 2 groups. The treatment group (42 cases) was treated with Hejie Decoction. The control group (30 cases) were treated with nucleoside analogues. The functional T lymphocytes of the peripheral blood of the 2 groups after treatment were observed. Changes in subgroups (CD8+CD28+, CD4+CD28+), interleukin-2 (IL-2) levels, hepatitis B virus (HBV) markers, and liver function. [Results] The levels of CD8+CD28+, CD4+CD28+ T cells and IL-2 in treatment group were significantly higher than those before treatment (P<0.05). The HBeAg negative rate and HBV DNA level in 6 patients decreased to 1×105 copy/ Less than ml; the levels of CD8+CD28+ T cells, CD4+CD28+ T cells, and IL-2 had no significant changes before and after treatment in the control group (P>0.05), HBeAg in 1 patient, and HBV DNA in 22 patients decreased to 1× 105copy/ml or less. The levels of CD8+CD28+, CD4+CD28+ T cells and IL-2 were significantly increased after treatment with CHB (P<0.01); the levels of CD8+CD28+ T cells and CD4+CD28+ T cells were not increased before and after treatment in non-observed group Significant changes (P>0.05). [Conclusion] The efficacy of He Jie Tang to clear HBV may be related to the effective activation of CD8+CD28+ T cells. Cellular immunity plays an important role in the pathogenesis of HBV infection and virus clearance.