Clinical Study On The Relationship Between Dampness-Heat Syndrome In Chronic Hepatic Disease And Chronic Inflammation

Objective: To explore the relationship between dampness-heat syndromeof liver-gallbladder and chronic inflammation was explored, by detecting thechanges of immunological state (CD4+, CD8+, CD4+/CD8+), cytokinesexpression (IL-4, IFN-r, IL-10, TNF-a1) in peripheral blood mononuclear cell(PBMC) and the levels of plasma cytokines (IL-1, IL-6, IL-8, TNF-a1, IL-10,TGF-?1) in different TCM-types. The changes of the parameters above were assessed, in patients ofdampness-heat syndrome of liver and gallbladder after treatment withQing-Re-Hua-Shi decoction. Methods: All the subjects with chronic hepatic disease were divided into4 groups according to TCM types, dampness-heat syndrome of liver andgallbladder, qi-deficiency syndrome of spleen and stomach, yin-deficiencysyndrome of liver and kidney, blood-stasis syndrome of liver and gallbladder,compared with 30 healthy volunteers from physicals examiners. The expression of CD4+, CD8+ on peripheral blood T-lymphocyte (PBTC)and the expression of IL-4 IFN-r IL-10, TNF-a1 in peripheral bloodmononuclear cell (PBMC), were determined by flow cytometry. The levels of plasma IL-1, IL-6, IL-8, TNF-a1 were detected by RIA, andthe levels of plasma IL-10, TGF-?1 were explored by ELISA. After treatment on dampness-heat syndrome cases, which were takenorally Qing-Re-Hua-Shi decoction, with a dose of 150 ml twice a day for twoweeks, the changes of the parameters above were assessed again and theclinical effective rate were evaluated. Results: Compared with the control group(CD4+39.93±2.19; CD8+1.42±0.09), decrease of CD4+(34.31±3.37, 35.06±4.17, 33.94±3.49, 34.74± 6英 文 摘 要3.06), CD4+/CD8+(1.26±0.30, 1.30±0.17, 1.24±0.16, 1.25±0.12) (P<0.01)in the 4 groups of dampness-heat, qi-deficiency, blood-stasis, yin-deficiencywere significantly shown, but no statistical difference of CD4+, CD4+/CD8+(p>0.05) was observed among the 4 groups. There was no statistical difference of CD8+(p>0.05) among thedampness-heat (28.41±2.59), qi-deficiency (27.54±3.17), yin-deficiency(27.53±3.07), and the control group (28.28±1.98). Compared with group ofdampness-heat as well as the control group, decrease of CD8+ (p<0.05) in thegroup of blood-stasis (27.08±1.77) was obviously shown. Compared with the control group (14.21±1.77), significant increase ofIFN-r expression (P<0.01) in PBMC was shown in 4 groups of patients; Theexpression of IFN-r in the groups of blood-stasis (16.44 ± 2.03) andyin-deficiency (18.25 ± 2.79) was significantly higher than that indampness-heat (15.83±1.77) (P<0.01) and qi-deficiency group (16.44±2.03)(P<0.05), but there was no statistical difference (P>.05) betweendampness-heat and qi-deficiency group as well as between blood-stasis andyin-deficiency group. Compared with the control group (17.47±2.37), significant increase ofIL-4 expression (P<0.01) in PBMC was shown in dampness-heat group (19.77±2.49), no statistical change (P>0.05) in qi-deficiency group (17.28±2.54)was observed, but significant decrease (P<0.01) was found in blood-stasis(14.32±1.64) and yin-deficiency (13.30±1.98) group. Compared with thedampness-heat group, decrease of IL-4 expression (P<0.01) in PBMC wassignificantly shown in the groups of qi-deficiency, blood-stasis syndrome, andyin-deficiency. The expression of IL-4 in PBMC, in groups of blood-stasis andyin-deficiency, was distinctly lower than that of in qi-deficiency group(P<0.01), but there was no statistical difference between groups ofblood-stasis and yin-deficiency (P>0.05). Compared with the control group (14.85±1.61) and the qi-deficiencygroup (14.06±1.81), significant increase of TNF-a1 expression (P<0.01) inPBMC was shown in groups of dampness-heat (20.19±1.45), yin-deficiency 7英 文 摘 要(18.51±2.67), and blood-stasis (16.43±1.72). The expression of TNF-a1 indampness-heat group...