| Objective:The present study aimed to explore the relationships between the traditional Chinese medicine(TCM)syndromes of chronic hepatitis B(CHB)and the levels of IL-21 and IL-35,and to provide objective basis for TCM syndrome differentiation.Methods:One hundred and fifty patients with CHB who met the criteria for inclusion and 30 healthy individuals who underwent physical examination in our hospital were selected as the research subjects.Collect the four diagnostic information of the patients respectively,and the syndrome classification of traditional Chinese medicine are carried out.Meanwhile,the clinical data of CHB patients including gender,age,liver function indexs,virology indexs were collected,and use ELISA to detect serum IL-21,IL-35 levels in CHB patients and healthy physical examinees.The database was established and the data were analyzed by using SPSS 20.0 statistical software,and analyze the relationship between TCM syndrome types and laboratory index results in CHB patients.Results:1.A total of 150 CHB patients were included in the study.Of which 42.67% were dampness-heat internal junction syndrome,33.33% were liver depression and spleen deficiency syndrome,9.33% were liver-kidney yin deficiency syndrome,both spleen-kidney yang deficiency syndrome and stasis of blood blocking collaterals syndrome take up 7.33%.Among them,dampness-heat internal junction syndrome,liver depression and spleen deficiency syndrome were accounted for the highest proportion.There was a statistical significanceof the in the levels of ALT,AST,TBIL,and DBIL in different TCM syndrome types(P<0.05).The levels of ALT,AST,TBIL,and DBIL are highest in CHB with dampness-heat internal junction type.2.There was no statistical significanceof the difference in the quantitative distribution of serum HBsAg levels between the different TCM syndromes(P =0.148).There was a statistical significanceof the difference in the levels of HBV DNA in different TCM syndrome types(P=0.020).HBV DNA level was the lowest in spleen-kidney yang deficiency syndrome.3.There was a statistical significanceof the difference in the levels of serum IL-21 in different TCM syndrome types(P<0.001).The level of serum IL-21 was the highest in the dampness-heat internal junction syndrome,and the level of serum IL-21 in the spleen-kidney yang deficiency syndrome was the lowest.There was a statistical significanceof the difference in the levels of serum IL-35 in different TCM syndrome types(P=0.009).The level of serum IL-35 was the lowest in the dampness-heat internal junction syndrome,and the level of serum IL-35 in the spleen-kidney yang deficiency syndrome was the highest.4.The peripheral serum IL-21 levels in CHB patients were higher than those in the healthy control group,while the levels of serum IL-35 in CHB patients were lower than thoseinthe healthy control group,and the difference between the two was statistically significant(P<0.001).The distribution of serum IL-21,IL-35 levels were different in patients with different clinical grading of CHB(P<0.05).The levels of serum IL-21 in patients with severe CHB were higher than that in mild to moderate CHB,and the levels of serum IL-35 in patients with severe CHB were lower than that in mild to moderate CHB.5.The levels of serum IL-21 in CHB patients were positively correlated with ALT,AST,TBIL,DBIL,AFP,and PT(r were 0.537,0.564,0.519,0.514,0.443,0.336,P<0.001).The levels of IL-35 were negatively correlated with ALT,AST,TBIL,DBIL,AFP,and PT(r were-0.446,-0.459,-0.291,-0.295,-0.192,-0.189,P <0.05).There was no correlation between the levels of serum IL-21 and IL-35 and serum HBsAg,HBV DNA levels,and the difference was not statistically significant(P >0.05).6.The difference of the serum IL-21 and IL-35 levels between HBeAg-positive CHB patients and HBeAg-negative CHB patients were not statistically significant(P>0.05).Conclusion:There are significant differences in serum IL-21 and IL-35 levels in different TCM syndrome types of CHB patients.It reveals that immune function is different among the syndrome types.Serum IL-21 and IL-35 levels may become an objctive index of TCM syndrome types.Serum IL-21,IL-35 levels and ALT,AST,TBIL,DBIL,serum AFP,PT were correlated.It reveals that the levels of IL-21 and IL-35 may be a new reference index for evaluating the severity of CHB patients. |
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