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目的观察五色六味方治疗慢性乙型肝炎的疗效及可能作用机制。方法 78例慢性乙型肝炎患者随机分为治疗组和对照组各39例。对照组口服拉米夫定片,每次100mg,每日1次;治疗组在对照组基础上加服五色六味方颗粒剂,每日1剂,两组疗程均为48周。于治疗前及治疗24周、48周时检测患者乙型肝炎病毒(HBV)DNA载量观察阴转率,以及外周血白细胞介素17(IL-17)、FOXP3水平和辅助性T细胞17/调节性T细胞(Th17/Treg)值。结果治疗组治疗24周、48周时HBV DNA阴转率分别为80.77%、92.30%,对照组分别为57.70%、69.23%,治疗组治疗后各时间点HBV DNA阴转率均明显高于对照组(P<0.05)。两组治疗48周时IL-17、FOXP3水平及Th17/Treg值较本组治疗前均有所下降(P<0.05);治疗组治疗24周、48周时IL-17、FOXP3水平及Th17/Treg值均低于同时间点对照组(P<0.05)。结论五色六味方联合拉米夫定片可明显减轻慢性乙型肝炎患者肝脏炎症、增强抗病毒效力,其机理可能与调节Th17/Treg平衡有关。
Objective To observe the curative effect and possible mechanism of Wuse Liuufang on chronic hepatitis B. Methods 78 patients with chronic hepatitis B were randomly divided into treatment group and control group, 39 cases each. The control group oral lamivudine tablets, each 100mg, 1 times a day; the treatment group in the control group based on the plus five-color Liuwei Fang granules, a daily dose of two courses were 48 weeks. Before treatment and at 24 weeks and 48 weeks, HBV DNA load was observed in patients with negative conversion rate and the levels of interleukin 17 (IL-17), FOXP3 and helper T cells 17 / Regulatory T cell (Th17 / Treg) values. Results After treatment for 24 weeks and 48 weeks, the HBV DNA negative conversion rates were 80.77% and 92.30% in the treatment group and 57.70% and 69.23% in the control group respectively. The HBV DNA negative conversion rates in the treatment group were significantly higher than those in the control group Group (P <0.05). The levels of IL-17, FOXP3 and Th17 / Treg in both groups decreased at the 48th week (P <0.05), and the levels of IL-17, FOXP3 and Th17 / Treg values were lower than the same time point control group (P <0.05). Conclusion The combination of five colors and six flavors in combination with lamivudine can obviously alleviate the liver inflammation and enhance the antiviral efficacy in patients with chronic hepatitis B, and its mechanism may be related to the regulation of Th17 / Treg balance.