The Clinical Research Of Treatment Of HBV Carriers Based On The Characteristics Of CD4~+CD25~+Tregs In HBV

Objective With the guidance of the theroy of TCM,on the ground of in tutor formerly clinical study and the guidance of the professor, to investigate the distribution differences of syndrome in HBV and the Changes and Value of the proportion of CD4+CD25+regulatory T cells (Tregs) in HBeAg(+) and HBeAg(-) chronic asymptomtic hepatitis B virus carriers(ASC),and to explore the immune state after the treatment of oxymatrine and Chinese Angelica Decoction for Tonifying the Blood.Methods200patients with HBV, collected from the second hospital of Nanjing, are deversed into HBeAg(+) group (100patients) and HBeAg(-) group (100patients). Investatigating the characteristics and distribution of syndrome types by syndrome differentiation of Traditional Chinese Medicine.Patients with HBeAg(+) HBV carriers (n=16),HBeAg(-)(n=27),treatment with oxymatrine(n=16),treatment with Chinese Angelica Decoction for Tonifying the Blood(n=10) and normol subjects(n=25) confirmed to the accepted standard are recruited in this study. First,Compared oxymatrine group and Chinese Angelica Decoction for Tonifying the Blood group to ASC,to observe the effect of Chinese medicine to the immune state of ASC. Detect the quantification of peripheral CD3+,CD4+,CD8+T lymphocyte subgroup,CD4+/CD8+,NK,NKT and CD4+CD25+Tregs.Results The main proportion of ASC was syndrome of liver depression with spleen insufficiency, the rest were showed syndrome of damp-heat obstruction,syndrome of live-kidney yin deficency,syndrome of stagnant-blood obstructing collaterals,and there is no patient classified into syndrome of spleen-kidney yang deficiency. People in HBeAg(+) group shows a certain degree syndrome of dampness and heat,secondly is syndrome of blood stasis,accompanied by syndrome of deficiency.People in HBeAg(+) group mainly shows syndrome of yin and blood deficiency, accompanied by syndrome of blood stasis. The proportion of CD3,CD4+, CD8+T lymphocyte subgroup has no significant difference among healthy controls, HBeAg(+) and HBeAg(-) ASC. The proportion of CD4+CD25+Trcgs as follows(%):4.82±3.49,2.15±2.36,2.02±0.82;Contrast to healthy controls, The proportion of CD4+CD25+Tregs in HBeAg(+) patients is elevated(p<0.05),but there is no significant difference between healthy controls and HBeAg(-) patients. Compared oxymatrine group and Chinese Angelica Decoction for Tonifying the Blood group to HBeAg(+), The proportion of CD3+,CD4+,CD8+,CD4+/CD8+T lymphocyte subgroup has no significant difference,The proportion of CD4+CD25+Tregs as follows(%):4.82±3.49,1.13±1.46,1.48±0.94; Contrast to HBeAg(+) ASC,the proportion of CD3+,CD4+,CD8+T lymphocyte subgroup of oxymatrine and Chinese Angelica Decoction for Tonifying the Blood has no significant difference, but the proportion of CD4+CD25+Tregs is descent(p<0.05).Contrast to HBeAg(-) ASC,The proportion of CD3+,CD4+,CD8+,CD4+/CD8+, CD4+CD25+T lymphocyte subgroup has no significant difference,and the proportion of CD4+CD25+Tregs as follows(%):2.15±2.36,1.13±1.46,1.48±0.94.Conclusion (1)The main proportion of ASC was syndrome of liver depression with spleen insufficiency.(2)Contrast to HBeAg(-) group,People in HBeAg(+) shows more percentage of syndrome of dampness and heat,but less percentage of syndrome of deficiency.(3)The proportion of CD4+CD25+Tregs in both HBeAg(+) and HBeAg(-)ASC is higher than health controls, showing that they are in different immune state.(4).oxymatrine and Chinese Angelica Decoction for Tonifying the Blood influence the immune response to HBV by downregulating the proportion of CD4+CD25+Tregs in ASC.