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目的观察健脾清化方对自身免疫性肝炎(AIH)患者外周血CD_4~+CD_(28)~-及CD_4~+CD_(25)~+T细胞亚群的影响。方法67例AIH患者随机分为2组,对照组33例给予基础保肝及对症支持治疗,治疗组34例在基础保肝及对症支持治疗基础上,给予健脾清化方(由泽泻、生黄芪、草决明、赤芍、荷叶组成),疗程均为6周,观察两组患者治疗前后肝功能、外周血CD_4~+CD_(28)~-及CD_4~+CD_(25)~+T细胞群的比例,ELISA法检测白细胞介素10(IL-10)、肿瘤坏死因子α(TNF-α)水平。结果健脾清化方可以明显降低对AIH患者外周血CD_4~+CD_(28)~-T细胞群的比例及TNF-α水平,并可提升CD_4~+CD_(25)~+T细胞群及IL-10水平,与对照组有显著差异(均P<0.05)。结论健脾清化方可能通过调整AIH患者外周血CD_4~+CD_(28)~-及CD_4~+CD_(25)~+T细胞群比例改善患者整体免疫失衡状态。
Objective To observe the effects of “Jianpi Qinghua Decoction” on peripheral blood CD_4 ~ + CD28 ~ + and CD_4 ~ + CD25 ~ + T cells in patients with autoimmune hepatitis (AIH). Methods Sixty-seven AIH patients were randomly divided into two groups. The control group received 33 cases of basic liver protection and symptomatic supportive treatment. The treatment group received 34 cases of Jianpi Qinghua Recipe (treated by Alisma orientale, The contents of CD_4 ~ + CD_ (28) ~ + and CD_4 ~ + CD_ (25) ~ + in peripheral blood of two groups were observed before and after treatment. + T cell population, and the levels of interleukin 10 (IL-10) and tumor necrosis factor alpha (TNF-alpha) were detected by ELISA. Results Jianpi Qinghua Decoction can significantly reduce the proportion of CD_4 ~ + CD28 (28) ~ -T cells in peripheral blood of patients with AIH and the level of TNF-α, as well as increase the percentage of CD_4 ~ + CD_ (25) ~ + T cells IL-10 levels were significantly different from the control group (all P <0.05). Conclusion Jianpi Qinghua Decoction can improve the overall immunological imbalance in patients with AIH by adjusting the ratio of CD_4 ~ + CD_ (28) ~ - and CD_4 ~ + CD_ (25) ~ + T cells in peripheral blood of AIH patients.