Meta-analysis Of The Effect Of TCM Treatment On Immune Indexes Of Patients With Chronic Hepatitis B

ObjectiveTo evaluate the effection of traditional Chinese medicine therapy on the immune indexes of patients with chronic hepatitis B.MethodAll literatures were searched from Wan Fang database,Chinese sci-tech periodicals database(VIP),China knowledge resources general repository(CNKI),PubMed,MEDLINE and Cochrane Library since the date of the establishment of the library to December 2017 by using the meathod of electronic retrieval and manual retrieval.Screened of obtained documents according to inclusion exclusion criteria and extracted the data of final inclusion documents.After analysised the data through Review Manager 5.3,we discussed the results and got a conclusion in the end.ResultsWe have obtained 721 articles by preliminary search,51 articles were screened out after being excluded.Among them,4 cases were treated with traditional Chinese medicine(TCM),8 cases were treated with TCM combined with conventional therapy,27 cases were treated with TCM combined with NAs,4 cases were treated with TCM combined with interferon,8 cases were treated with TCM combined NAs and conventional therapy.It can be seen that the use of traditional Chinese medicine alone is less,and most of them are combined.To analyze the therapeutic results of different intervention measures we can find that:Compared with untreatment,TCM therapy can promote the differentiation of CD4~+Th cells into Th1.Compared with conventional liver-conserving therapy,TCM therapy has better effect on correcting the imbalance of T cell subsets.Compared with NAS treatment,TCM therapy has a better effect on improving CD4~+T cell and IL-2 level.However,NAs is better in reducing CD8~+T cell level.Compared with interferon therapy,TCM can promote the differentiation of CD4Th cells into Treg,thus relieving the liver inflammation.Interferon can promote the differentiation of CD4 Th cells into Th1,which can help to remove the virus.Compared with conventional treatment,TCM combined with conventional therapy has an advantage in improving DC expression,correcting the imbalance of t-cell subgroup distribution and promoting Treg differentiation,but there is no difference in the differentiation of Th1 and Th17 between the two groups.Compared with NAs treatment,TCM combined with NAs therapy can improve the innate immunity,correct the imbalance of T cell subset distribution,promote Th1 differentiation,reduce Treg expression,reduce inflammatory factors,and promote virus clearance.Compared with interferon,TCM combined with interferon can improve the expression of DC cells and promote the transformation of Th1,but there is no difference in the effect of the two groups on the T cell subgroup.Compared with NAs combined conventional therapy,TCM combined with NAs and conventional therapy has a good effect in improving T cell subset imbalance,promoting Th1 differentiation,inhibiting Th2 and Treg differentiation,reducing immunoglobulin and improving complement level.There is no difference in the efficacy of NK cell between two groups.Conclusion1.Nucleotide analogue(NAs)is the main therapeutic method for chronic hepatitis B at present.2.Traditional Chinese medicine therapy plays an important role in alleviating the inflammatory response in the treatment of chronic hepatitis B.3.In terms of regulation of immune function in patients with chronic hepatitis B,TCM therapy has advantages over no treatment,conventional liver-preserving therapy and NAS therapy,but compared with interferon,there is little difference between the two treatments.4.In terms of immunomodulation,Chinese medicine can enhance innate immunity and cellular immunity in order to promote virus clearance on the one hand,on the other hand,it can also reduce inflammatory cytokines and alleviate liver inflammation.