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目的:观察慢性乙型肝炎(慢乙肝)患者细胞因子及病毒指标与中医证型的关系。方法:对400例慢乙肝患者进行辨证分型,检测血清T淋巴细胞亚群(CD4、CD8、CD4/CD8)、白细胞介素-2、10、12(IL-2、IL-10、IL-12)、HBV-DNA、HBV标志物。结果:肝郁脾虚、肝肾阴虚和脾肾阳虚证CD4渐降而CD8、CD4/CD8渐升(P<0.01);湿热中阻证与脾肾阳虚、肝肾阴虚证相比CD8明显降低而CD4/CD8渐高(P<0.01);慢乙肝各中医证型的IL-2、IL-10、IL-12明显高于正常对照组(P<0.01或P<0.05);肝郁脾虚、脾肾阳虚组HBV-DNA定量>1.0×105cop ies/mL、HBVeAg及抗K-HbcIgM(+)均高于湿热中阻、瘀血阻络组(P<0.01或P<0.05)。结论:细胞因子、病毒指标检测可为慢乙肝中医辨证的客观化提供依据。
Objective: To observe the relationship between cytokines and viral markers and TCM syndromes in patients with chronic hepatitis B (chronic hepatitis B). Methods: Four hundred patients with chronic hepatitis B were divided into four groups according to syndrome differentiation. Serum levels of T lymphocyte subsets (CD4, CD8, CD4 / CD8), IL-2, IL-10, IL- 12), HBV-DNA, HBV markers. Results: CD4 of liver-qi and spleen deficiency, liver-kidney-yin deficiency and spleen-kidney yang deficiency decreased gradually and CD8 and CD4 / CD8 increased (P <0.01) (P <0.01 or P <0.01). The levels of IL-2, IL-10 and IL-12 in all TCM syndromes of chronic hepatitis B were significantly higher than those in normal controls (P <0.01 or P <0.05) HBV-DNA> 1.0 × 105copies / mL, HBVeAg and anti-K-HbcIgM (+) were significantly higher than those of middle-damp-spleen and spleen- . Conclusion: The detection of cytokines and virus indexes can provide evidence for objectification of syndrome differentiation of traditional Chinese medicine of chronic hepatitis B.