| Objective: This topic through the clinical curative effect observation of Jianpi Qinghua Decoction intervention of TCM belongs to damp heat type chronic severe hepatitis B(CSHB)patients and to explore its effect on CSHB patients serum TH1/ TH2 balance.Methods: Select 2015 March 2016 January in Henan College of traditional Chinese Medicine First Affiliated Hospital of liver and spleen of inpatient treatment met inclusion criteria and exclusion criteria of chronic severe hepatitis B and syndrome differentiation of traditional Chinese medicine is damp heat syndrome patients,20 patients as the research object,randomly divided into experimental group and control group.Each 10 cases.The control group in the treatment of liver treated with entecavir(Cave Run Zhong)tablets(0.5mg,po,gd)treatment.In the experimental group,the control group on the basis of oral jpqhr(1 dose / day,morning and evening of the 1,after meals),the treatment lasted for 2 months.Basic information of the patients were collected,changes of TCM syndrome before and after treatment,clinical and laboratory examination of related data,including blood,liver and kidney function,blood coagulation function,hepatitis B virus load quantity,T lymphocyte subsets and the newly diagnosed and treated for 2 months after the selected patients blood collection the,the morning fasting 8 hours above elbow vein non anticoagulant about 5ml,isolated specimens of serum,using enzyme-linked immunosorbent method(ELISA)to detect both in serum of patients with TNF alpha,ifn-y and IL-10 and IL-18 levels observed the change.Using SPSS 21 statistical software,using the general statistical description,Fisher exact probability method,paired sample t test,independent sample t test,chi square test and other methods for data analysis.Results: 1.In the course of this study,the experimental group did not fall off and death cases,1 cases of death in the control group,so the actual number of 19 cases,the experimental group 10 cases,9 cases of the control group.Among them,14 were male,5 were female,and the proportion was 74% and 26%.The age of onset was most common in 40~50 years old,with an average age of 45 years.2.Two groups of patients with liver function(ALT,AST and TBIL)after treatment were significantly decreased,and experimental group compared with the control group decreased more significantly,after treatment between the two groups with ALT,AST and TBIL showed significant difference(P<0.05).3.The coagulation function(PT,INR)in the two groups were significantly decreased after treatment than before treatment,and the experimental group decreased more significantly,after treatment,the blood levels of PT and INR in the two groups were statistically significant(P<0.05).4.Experimental group and control group after treatment in patients with serum levels of PCRHBV-DNA treatment before were decreased significantly,and the former than the latter decreased significantly.After treatment,the patients in the two groups of serum levels of PCRHBV-DNA comparison have significant difference(P<0.05).5.After treatment,the patients in the two groups of serum cytokines(TNF alpha,IFN gamma and IL-18 level compared with before were significantly decreased and test group decreased more significantly,after treatment,the patients in the two groups of serum TNF,IFN-and IL-18 levels compared with difference(P<0.05).6.Experimental group and control group after treatment,serum IL-10 levels were significantly higher than before treatment,and the experimental group increased significantly,the two groups of patients after treatment of serum IL-10 levels were significantly different(P<0.05).7.Experimental group and control group after treatment in patients with TCM syndrome score compared with before were decreased significantly,and experimental group compared with the control group decreased more significantly,after treatment,the patients in the two groups of TCM syndrome score compared with statistical significance(P<0.05).8.After treatment,the patients in the two groups of T lymphocyte subsets CD3 +,CD4 +,CD8 + T cell treatment before were increased,and after treatment between the two groups is different,experimental group compared with the control group increased significantly(P<0.05),the ratio of CD4 + / CD8 + count in the two groups within groups and between groups,treatment and showed no significant difference(P>0.05).9.The two groups of patients after treatment of symptoms of TCM treatment,the experimental group compared with the control group,the treatment effect is good,the experimental group is higher than the effective rate,the difference is statistically significant(P<0.05).Conclusions: 1.Jianpi Qinghua Decoction could improve the damp heat type chronic severe hepatitis B patients with liver function(ALT,AST and TBIL),blood coagulation index(PT,INR),and decreased significantly in patients with hepatitis B virus load(HBV-DNA),indicating that Jianpi Qinghua Decoction can relieve the liver inflammation reaction,improve the function of blood coagulation.2.Jianpi Qinghua Decoction can decrease in chronic hepatitis B patients with severe hepatitis serum cytokines TNF-?,IFN-? and IL-18 levels,improve the level of cytokine IL-10 and prompt Jianpi Qinghua Decoction may by adjusting the TH1 / TH2 balance,improve the disorder of cytokines network state,to reduce the necrosis of liver cells and anti liver injury3.Jianpi Qinghua Decoction can improve chronic severe hepatitis patients with TCM syndrome integral,less adverse reaction,indicating that it can improve the clinical symptoms of the patients,with certain clinical curative effect. |
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