目的 比较补肾解毒方和健脾解毒方对慢性乙肝病毒(HBV)感染不同免疫状态患者外周血T淋巴细胞(Ts)功能的影响.方法 选择36例湖南中医药大学第一附属医院2010年6月～2011年5月门诊慢性HBV感染患者,根据患者免疫状态分为免疫耐受组(18例)、免疫清除组(18例),另选择10名健康人作健康组.分别采集抗凝外周静脉血,分离外周血单个核细胞(PBMCs),进一步分离提取培养T细胞,采用大鼠补肾解毒和健脾解毒药物血浆进行干预.检测T细胞亚群CD3+、CD4+、CD8+以及CD28+分子的表达,观察T细胞培养上清液IFN-γ的水平.结果 健脾解毒药物血浆与补肾解毒药物血浆干预后CD3+、CD4+、CD8+以及CD28+分子表达率升高,且补肾解毒组的CD28+表达率的提高优于健脾解毒组(P＜0.05).两组含药血浆干预后T细胞分泌的IFN-γ水平较干预前升高,差异有统计学意义(P＜0.05).结论 补肾解毒法和健脾解毒法都能促进慢性HBV感染患者T细胞功能的恢复,且两种含药血浆对慢性HBV感染免疫耐受期患者T细胞功能的影响更为显著.%Objective To investigate the effects of TCM decoction (Bushen Jiedu prescription and Jianpi Jiedu prescription) on the function of peripheral blood T cells (Ts) from hepatitis B virus (HBV) infection patients in different immunity. Methods 36 out-patients with chronic HBV infection of the First Affiliated Hospital of Hunan TCM University from June 2010 to May 2011 were divided into immune tolerance group(18 cases) and immune clearance group (18 cases) according to the immunity, and other 10 healthy persons were selected as control group. Ts were differentiated from peripheral blood mononuclear cells (PBMCs) and incubated, then the Ts were interfered by plasma containing with Bushen Jiedu decoction and Jianpi Jiedu decoction respectively. The expressions of CD3+,CD4+,CD8+ and CD28+ were detected by FACS, and the levels of IFN-γ in supernatants were detected by ELISA. Results After the drugs intervention, the expression levels of CD3+,CD4+,CD8+ and CD28+ were increased and the improvement of CD28+ expression level in Bushen Jiedu group was higher than that of Jianpi Jiedu group(P<0.05). After the drugs intervention, the IFN -γ expression levels in the two groups were enhanced, and the differences were statistically significant (P<0.05). Conclusion The Bushen Jiedu prescription and Jianpi Jiedu prescription can promote Ts functions in patients with chronic HBV infection. The influence of the two prescriptions on Ts from immune tolerance stage was much more prominent.
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