Study On The Relationship Between TCM Syndromes And The Levels Of Th17/Treg-related Cytokines In Chronic Hepatitis B Patients

ObjectiveThe purpose of this study was to explore the relationship between TCM syndromes and the levels of Th17/Treg-related cytokines IL-17 and TGF-?1 in chronic hepatitis B patients,and to further provide a reference for TCM syndrome differentiation and treatment of chronic hepatitis B.Methods100 CHB patients and 30 healthy controls were recruited as the research subjects.Patients with CHB were classified according to TCM syndrome differentiation,and their general data and laboratory indicators were also collected.The serum levels of IL-17 and TGF-?1 were detected by ELISA kit.Analyze the distribution of IL-17 and TGF-?1 levels in CHB patients with different TCM syndromes,and discuss their relationship with TCM syndromes.Results1.Among 100 CHB patients,the frequency of TCM syndrome type from high to low was liver depression and spleen deficiency > dampness-heat > liver-kidney yin deficiency >blood-stasis obstruction > spleen-kidney yang deficiency.The syndrome of liver stagnation and spleen deficiency(40.0%)and the syndrome of damp-heat internal knot(32.0%)were two main TCM syndrome types in this study.2.The distribution of Serum ALT,AST,HBsAg levels,HBV DNA load,liver tissue inflammation grade and fibrosis stage all had statistical significance in CHB patients with different TCM syndromes.3.Serum levels of IL-17 and TGF-?1 in the CHB group were higher than those in the control group,and the difference was statistically significant(P<0.001).4.There was statistical significance of the serum levels of IL-17 and TGF-?1 in CHB patients with different TCM syndromes: the highest serum IL-17 levels was found in dampness-heat,then followed by blood-stasis obstruction,liver-kidney yin deficiency,liver depression and spleen deficiency and spleen-kidney yang deficiency;the level of serum TGF-?1 from high to low were liver depression and spleen deficiency,liver-kidney yin deficiency,spleen-kidney yang deficiency,blood-stasis obstruction and dampness-heat.5.There was statistical significance of serum IL-17 levels between patients in dampness-heat and patients in liver stagnation and spleen deficiency,liver-kidney yin deficiency,and spleen-kidney yang deficiency,respectively(P<0.05);the level of serum TGF-?1 with liver depression and spleen deficiency was significantly different from that of dampness-heat and blood-stasis obstruction(P<0.05).6.There was a negative correlation between serum IL-17 level and serum TGF-?1 level in CHB patients(r=-0.608,P<0.001).7.Serum IL-17 level in CHB patients was positively correlated with ALT and AST levels,and the correlation coefficient r was 0.904 and 0.874,respectively,all P<0.001;there was no correlation between serum IL-17 level and HBV DNA load(P>0.05).Serum TGF-?1level was negatively correlated with ALT and AST levels,and the correlation coefficient r was-0.576 and-0.562,respectively,all P<0.001;serum TGF-?1 level was positively correlatedwith HBV DNA load(r=0.375,P<0.001).Conclusion1.These data showed a correlation between serum IL-17 and TGF-?1 levels and different TCM in CHB patients,which suggested that IL-17 and TGF-?1 levels may be the reference indexes for TCM syndrome differentiation of CHB.2.Serum levels of IL-17 and TGF-?1 were correlated with the level of liver function in CHB patients,which suggested that levels of IL-17 and TGF-?1 might be a reference index for reflecting the severity of CHB.