辨证施治联合核苷（酸）类似物治疗慢性乙型肝炎疗效的初步评价

目的：观察辨证施治联合核苷（酸）类似物治疗慢性乙型肝炎的疗效。方法：收集100例符合抗病毒治疗指征的慢性乙型肝炎患者,分为观察组与对照组,观察组患者采用中医中药联合核苷（酸）类似物治疗,对照组患者仅用核苷（酸）类似物治疗,定期观察其临床症状及肝功能、HBV DNA、肝纤维化等指标,疗程均为52周。结果：观察组与对照组相比,在改善临床症状、缩短肝功能复常时间、改善血清肝纤维化指标等方面差异均有显著性意义（P〈0.05）;在HBV DNA转阴率、HBeAg血清转换率、病毒反跳率等方面,两组比较差异无显著性意义（P〉0.05）。结论：联合用药能提高治疗慢性乙型肝炎的疗效。     

降酶中药疗效影响因素的研究进展

目前很多保肝（降酶）药是中药材有效成分的提取物的制剂,具有良好的保肝降酶效果（如五脂片、叶下珠片等）。但往往将这些含有降酶作用有效成分的原药材经辨证施治,加入中药组方中制成中药汤剂,降低血清转氨酶效果往往没有成药的效果好,甚至于效果并不明显。     

慢性乙型肝炎免疫学机制和中医药治疗研究进展

慢性乙型肝炎（chronic hepatitis B,CHB）的发生、发展及预后与机体的免疫功能关系密切,包括特异性和非特异性免疫的研究。传统中医药治疗慢性乙型肝炎的免疫机制日益被人们所关注。     

加味酸枣仁汤对睡眠剥夺所致大鼠细胞免疫功能紊乱的调节作用

目的 观察加味酸枣仁汤对睡眠剥夺所致大鼠细胞免疫功能紊乱的调节作用。方法 选择SPF级SD大鼠（体重200±20g）40只，随机分为正常组、模型组、西药组、中药组。正常组大鼠给予无干扰常规喂养7天；余3组均采用BW-NSD404睡眠剥夺仪进行平台随机移动法造模7天，同时模型组每天予生理盐水灌胃、西药组予劳拉西泮片0.105mg·kg-1·d-1每天灌胃、中药组予加味酸枣仁汤6.3g·kg-1·d-1每天灌胃。测量各组大鼠体重，通过旷场实验进行行为学评定，处死大鼠、测定静脉血中CD4+、CD8+、CD4+/CD8+，以及血清中IL-2、IL-6、IL2/IL6水平。结果 和正常组比较：模型组大鼠体重显著下降（P<0.01），旷场实验的水平与垂直得分显著升高(P<0．01)， CD4+/CD8+、IL2/IL6明显下降（P<0.05）。与模型组比较：中药组体重明显升高（P<0.05）但和西药组无明显差异（P>0.05），旷场实验水平和垂直得分明显下降（P<0.05），但明显高于西药组（P<0.05）；CD4+/CD8+、IL2/IL6比值明显升高（P<0.01）,并明显高于西药组（P<0.01）。结论 睡眠剥夺能导致大鼠体重下降、行为学改变和细胞免疫功能紊乱。加味酸枣仁汤能改善睡眠剥夺导致的体重下降和行为学改变，并能纠正模型大鼠细胞免疫功能紊乱。     

Relationship of anxiety state with lymphocyte subsets and the effect of chinese medical treatment on anxiety in patients with chronic hepatitis B

Objective:To analyze the relationship of anxiety state with CD4~+ level and CD4~+/CD8~+ ratio and to observe the effect of Chinese medicine(CM) treatment on anxiety in chronic hepatitis B(CHB) patients. Methods:The anxiety state of 120 CHB patients was evaluated based on Hamilton Anxiety Scale(HAMA) scoring.According to the scores,63 patients with scores≥14 were classified to anxiety and 57 patients with scores<14 to non-anxiety.The differences in CD4~+ cells and CD4~+/CD8~+ ratio between patients with anxiety and non-anxiety were analyzed.Moreover,63 patients with anxiety were randomized into two groups:31 in the control group were treated with lamivudine(100 mg per day) alone and 32 in the observation group were given equal dosage lamivudine combined with CM treatment depending on syndrome differentiation,all for 12 weeks. The effects of treatment on anxiety state and T-lymphocyte subsets as well as its impact on some CHB-related indices were observed and compared.Results:The anxiety state of CHB patients was negatively correlated with CD4~+ and CD4~+/CD8~+;the level of CD4~+ in patients with anxiety was significantly lower than that in non-anxiety patients(P<0.01 or P<0.05).After treatment,anxiety state in the observation group was significantly improved, with their HAMA scores significantly lowered(P<0.01),and the levels of CD4~+ and CD4~+/CD8~+ were significantly higher than those in the control group(P<0.05 or P<0.01).Moreover,the alanine transaminase recovery rate and the HBV-DNA-negative conversion rate in the observation group were significantly higher than those in the control group,respectively(P<0.05).Conclusions:The anxiety state of CHB patients was related to CD4~+ and CD4~+/CD8~+ levels.CM treatment could improve the anxiety state and showed certain regulatory effect on the patients’ immune system.     

辨证施治联合核苷（酸）类似物治疗慢性乙型肝炎的疗效及其与外周血调节性T细胞的相关性

目的：观察辨证施治联合核苷（酸）类似物治疗慢性乙肝的疗效及其与外周血调节性T细胞的相关性。方法：收集100例符合抗病毒治疗指征的慢性乙肝患者,分为观察组与对照组,观察组采用中医中药联合核苷（酸）类似物治疗,对照组仅用核苷（酸）类似物治疗,定期观察临床症状、肝功能、HBV-DNA、调节性T细胞等指标,疗程均为1年。结果：观察组与对照组相比,在改善临床症状、缩短肝功能、病毒载量恢复时间等方面经统计学处理有明显差异（P〈0.05）;观察组治疗后外周血Treg比例明显低于对照组,经统计学处理有明显差异（P〈0.05）;两组组内比较,治疗后外周血Tregs比例明显降低,经统计学处理有明显差异（P〈0.05）。结论：辨证施治联合核苷（酸）类似物能够提高治疗慢性乙肝的疗效,其机理与调节性T细胞有关。