Effect Of Baihuaxianglian Jiedu Granule On Serological Conversion Of HBeAg And Treg/Th17 Balance Axis In Patients With Chronic Hepatitis B

Objective: Effect of Baihuaxianglian jiedu granule on serological conversion of HBeAg and Treg/Th17 balance axis in patients with chronic hepatitis B.Methods: The clinical data of 80 patients with chronic hepatitis B who met the diagnostic criteria of HBeAg positive chronic hepatitis B from January2019 to December 2019 were collected.The patients were randomly divided into control group(n=40)and observation group(n=40).The control group was treated with entecavir dispersible tablets,and the observation group was treated with Baihuaxianglian jiedu granule on the basis of the control group.The course of treatment in both groups was 48 weeks.Serum HBeAg titer,HBV DNA,ALT,AST,TCM syndrome score,frequency of Treg and Th17 cells and Treg/Th17 ratio in peripheral blood before and after treatment were measured at 0 week,12 weeks,24 weeks and 48 weeks.Results: 1.Comparison of comprehensive curative effect: After treatment,the total effective rate of the control group was 77.50%.The total effective rate of the observation group was 92.50%.The total effective rate of observation group is higher than that of control group(P<0.05).2.Comparison of serum HBeAg titer: At 12 weeks,24 weeks and 48 weeks of treatment,the serum HBeAg titers of the two groups were lower than those of the same group before treatment,and the decreasing degree of serum HBeAg titers of the observation group was better than that of the control group at the same time(all P<0.05).3.Comparison of HBeAg negative conversion rate and HBeAg serological conversion rate: At 24 and 48 weeks of treatment,the HBeAg negative conversion rate and HBeAg serological conversion rate in the observation group were higher than those in the control group(all P<0.05).4.Comparison of the decreasing value of serum HBV DNA: From 12 weeks of treatment,serum HBV DNA showed a continuous downward trend in both groups.After 12,24 and 48 weeks of treatment,the decrease value of serum HBV DNA in 2 groups was higher than that before treatment(all P<0.05),and the observation group was higher than the control group at the same period(all P<0.05).5.Comparison of virological response rate,HBV DNA negative conversion rate and ALT normalization rate: At 12 weeks,24 weeks and 48 weeks of treatment,the virological response rate,HBVDNA negative rate and ALT normalization rate in the observation group were better than those in the control group(all P<0.05).6.Comparison of the frequency of Treg and Th17 cells and the ratio of Treg/Th17 in peripheral blood: After 48 weeks of treatment,the frequency of Treg and Th17 cells and the ratio of Treg/Th17 in peripheral blood of 2groups were lower than before treatment(all P<0.05),and the observation group was lower than the control group at the same period(all P<0.05).7.Comparison of Treg/Th17 ratio before treatment between HBeAg serological conversion group and non-conversion group: according to whether serological conversion of HBeAg occurred in the two groups at 48 weeks of treatment,the patients were divided into conversion group and non-conversion group.The ratio of Treg/Th17 before treatment was compared between the two groups.The results showed that the frequency of Treg and Th17 cells and the ratio of Treg/Th17 in peripheral blood in the conversion group were lower than those in the non-conversion group(all P<0.05).8.Liver function comparison: After 12,24 and 48 weeks of treatment,ALT and AST in 2 groups were improved compared with those before treatment(all P<0.05),and observation group was better than control group(all P<0.05).9.Comparison of TCM syndrome scores: After 12,24 and 48 weeks of treatment,TCM syndrome scores in 2 groups were decreased compared with before treatment(all P<0.05),and observation group was better than control group at the same period(all P<0.05).10.Safety comparison: there were no adverse reactions in both groups during the trial.Conclusion(s):Baihuaxianglian jiedu granule combined with entecavir can promote the serological conversion of HBeAg in patients with chronic hepatitis B,increase the negative rate of HBV DNA and the rate of virological response,and improve the clinical symptoms and liver function of patients.The therapeutic mechanism may be that Baihuaxianglian jiedu granule can restore the function of HBV-specific CTL immune response by regulating the Treg/Th17 balance axis,thus promoting the serological conversion of HBeAg.