Based On The Expression Levels Of Th17 And Treg Cells,the Clinical Efficacy Of Jiedu Huayu Prescription In Treating Patients With HBV-associated Chronic Acute Liver Failure Was Investigated

Objective: To observe the clinical efficacy of Jiedu Huayu prescription on patients with hepatitis b associated chronic acute liver failure(HBV-ACLF)and its effect on the expression levels of Th17 and Treg cells.Methods: Select patients with HBV-ACLF 50 cases,randomly divided into western medicine group 25 cases(western medicine treatment)and Chinese and western medicine group 25 cases(Jiedu Huayu prescription combined with western medicine treatment).The survival and improvement of the patients were observed before treatment,4 weeks after treatment and 8weeks after treatment.Compare the total curative effect,TCM syndrome integral,ALT,AST,TBil,propagated,PTA and MELD score.To evaluate the clinical effect of Jiedu Huayu prescription on HBV-ACLF patients.Compared with the proportion of Th17 and Treg in CD4+T cells in peripheral blood of healthy people,peripheral blood cell levels of the two groups were detected before treatment and 8 weeks after treatment,and the effects of detoxification and stasis removing prescription on the expression levels of Th17 and Treg cells in hbv-aclf patients were observed.Results:(1)The 8-week survival rate of Chinese and western medicine group(76%)was better than that of western medicine group(48%).The improvement rate of Chinese and western medicine group(60%)was better than that of western medicine group(32%),and the differences werestatistically significant(P<0.05).(2)The scores of TCM syndrome score,TBi L,Alb,ALT,AST,PTA and MELD in both groups were improved after treatment(P < 0.05).After 4weeks of treatment,the TCM syndrome score,TBi L,Alb,ALT,AST,PTA and MELD scores in the TCM group were better than those in the control group(P<0.05).After 8 weeks of treatment,the improvement of TCM syndrome score,TBi L and MELD score in the TCM group was better than that in the control group(P<0.05),and there was no significant difference in Alb,ALT,AST and PTA(P>0.05).(3)The levels of Th17 and Treg cells in hbv-aclf patients were significantly higher than those in the normal group(P<0.01).After 8 weeks of treatment,the levels of Th17 cells in both the western medicine group and the western medicine group decreased,and the decrease was more significant in the western medicine group(P<0.05).Treg cell levels decreased in the Chinese and western medicine group,while Treg cells in the western medicine group were significantly higher than those in the Chinese and western medicine group,and there was a significant difference between the two groups(P<0.01).Conclusion:Jiedu Huayu prescription combined with western medicine in the treatment of HBV-ACLF can improve the survival rate and recovery rate of patients.Improve TCM syndrome score,liver function,coagulation function.Reduce the level of Th17 and Treg cells,and correct the imbalance of immune system.The combined treatment of traditional Chinese and western medicine with Jiedu Huayu prescription as the main method can improve the clinical efficacy,and the therapeutic mechanism may be related to the reduction of Th17 and Treg cell levels.