| Objective To observe the effect of Warming Yang therapy on the levels of CD3+,CD4+,CD8+T lymphocytes,Treg cells,Th17 cells and serum conversion of e antigen in peripheral blood of patients with HBe Ag-positive Chronic Hepatitis B.Compared with antiviral drugs of nucleoside(acid)analogues,the effect of Warming Yang method on cellular immunity of patients with Chronic Hepatitis B and its mechanism of action were discussed,so as to provide a evidence-based medical basis for the effectiveness of traditional Chinese medicine in the treatment of Hepatitis B virus.Methods70 patients with HBe Ag-positive Chronic Hepatitis B who met the inclusion criteria were randomly divided into the warming Yang group and the control group.The control group was treated with entecavir 0.5mg/ time,1time/day,and the warming Yang group was treated with warming Yang prescription on the basis of the control group.The treatment course of both groups was 24 weeks.Liver function(ALT,AST,TBIL,ALB),HBV-M,HBV DNA,t-lymphocyte subsets(CD3+,CD4+,CD8+,CD4+/CD8+),liver stiffness measurement(LSM)were detected before and after treatment,and Treg cells and Th17 cells were detected by flow cytometry,and HBV-M were detectedonce at the 12 th week of treatment.At the same time,vital signs,blood routine,urine routine,renal function and electrocardiogram of the two groups of patients were tested before and after treatment to evaluate the safety.SPSS 26.0 software was used for statistical analysis of the experimental data.Results1.Liver function: After treatment,the indexes of the warming Yang group and the control group were significantly improved except for TBIL(P <0.05).In comparison between the two groups,the increase of ALB was more obvious in the warm Yang group(P < 0.05),while the difference in ALT,AST and TBIL indicators was not statistically significant(P > 0.05).2.Liver stiffness measurement: After treatment,the liver stiffness measurement decreased in the warm Yang group and the control group,and the difference between the two groups was statistically significant(P <0.05).There was no significant difference in liver hardness between the two groups(P >0.05).3.HBe Ag: Compared with the control group at the 12 th week of treatment,HBe Ag level decreased significantly in the warm Yang group(P <0.05),but there was no statistically significant difference between the two groups(P > 0.05).After 24 weeks of treatment,compared with after 12 weeks of treatment,the level of HBe Ag decreased significantly in the two groups(P< 0.05),and the difference between the two groups was statistically significant(P < 0.05).After the treatment,the HBe Ag negative conversion rate between the two groups was compared,and the difference between the wenyang group(14.29%)and the control group(8.6%)was not significant(P >0.05),but the trend of rise was more obvious in the warm Yang group.4.Virology: After treatment,the HBV DNA level in both the warm Yanggroup and the control group decreased significantly(P < 0.05),but the difference between the two groups was not statistically significant(P >0.05).Comparing the negative conversion rate of HBV DNA between the two groups,there was no significant statistical significance between the warm Yang group(69.23%)and the control group(58.33%)(P >0.05),but there was a more significant upward trend in the warm Yang group.5.T lymphocyte subsets: After treatment,the levels of CD3+T cells and CD4+T cells in the warm Yang group increased significantly compared with the control group(P <0.05),while those in the control group did not(P >0.05).The levels of CD8+T cells in both groups were significantly lower than those before treatment(P <0.05),but the difference between the two groups was not statistically significant(P >0.05).The CD4+/CD8+ ratio in both groups increased significantly compared with that before treatment(P<0.05),and the increase was more significant in the warm Yang group(P<0.05).6.Treg/Th17 cells: After treatment,the number of Treg cells decreased significantly in the warm Yang group and the control group(P <0.05),but there was no significant difference between the two groups(P > 0.05).After treatment,compared with before treatment,Th17 cells in the two groups did not decrease significantly in the control group(P >0.05),while Th17 cells in the wenyang group decreased significantly(P <0.05).The ratio of Treg/Th17 between the two groups increased in the wenyang group and decreased in the control group,but the difference between the two groups was not significant(P > 0.05),and the difference between the two groups was not statistically significant(P >0.05).Conclusion1.The combination of warming Yang method and nucleoside(acid)drugs in the treatment of HBe Ag-positive patients with chronic hepatitis B,compared with the use of nucleoside(acid)drugs alone,can better reduce liver cell inflammation,improve liver cell function,reduce virus replication,and help e-antigen negative transformation.2.The warm Yang method may regulate the cellular immune status by regulating the balance of CD4+/CD8+ and Treg/Th17 in the peripheral blood of the body,affecting the cellular immune function of hbeag-positive patients with chronic hepatitis b,improving the immune suppression of the body,and thereby enhancing the body's ability to clear HBV virus. |
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