中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 12
Dec.  2023
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2023  >  39(12): 2908-2913

Theory and practice of immunoregulatory therapy with traditional Chinese medicine for chronic hepatitis B

DOI: 10.3969/j.issn.1001-5256.2023.12.023
  • 1.

    Beijing University of Chinese Medicine，Beijing 100029，China

  • 2.

    Shenzhen Hospital Affiliated to Beijing University of Chinese Medicine，Shenzhen，Guangdong 518172，China

Research funding:

General Project of National Natural Science Foundation of China (81973733);

Shenzhen Science and Technology Plan Project (JCYJ20220530172812028);

Shenzhen Longgang Medical and Health Science and Technology Innovation Plan (LGKCYLWS2021000015);

Medical and Health Technology Research Project in Longgang District, Shenzhen (LGKCYLWS2022006)

More Information
  • Corresponding author: HU Shiping， 2078200488@qq.com （ORCID： 0000-0002-0534-0341）
  • Received Date: 2023-03-28
  • Accepted Date: 2023-04-17
  • Published Date: 2023-12-12
    Abstract
  • Chronic hepatitis B （CHB） is still a malignant infectious disease that seriously threatens human health， and currently nucleos（t）ide analogues and interferon are the main treatment methods for CHB， but they cannot achieve functional cure. The development and progression of CHB are closely associated with immune function dysregulation in the host， and therefore， regulating host immunity has become a key link in the treatment of CHB. Recent studies have shown that traditional Chinese medicine exerts a therapeutic effect on CHB by regulating host immune function. This article introduces the relationship between traditional Chinese medicine theory and immunity and summarizes the theoretical basis and related studies for traditional Chinese medicine in the immune regulation of CHB， in order to provide new ideas for integrated traditional Chinese and Western medicine therapy for CHB.

     

    • FullText(HTML)
  • loading
    • References(46)
  • [1]
    LIU J, LIANG WN, JING WZ, et al. Countdown to 2030: Eliminating hepatitis B disease, China[J]. Bull World Health Organ, 2019, 97( 3): 230- 238. DOI: 10.2471/BLT.18.219469.
    [2]
    CHANG KM, LIU MF. Chronic hepatitis B: Immune pathogenesis and emerging immunotherapeutics[J]. Curr Opin Pharmacol, 2016, 30: 93- 105. DOI: 10.1016/j.coph.2016.07.013.
    [3]
    ZHOU WW, HUANG J, PAN FM. Research progress in epidemiological characteristics and therapeutic drugs of chronic hepatitis B[J]. J Chang Univ Chin Med, 2022, 38( 12): 1420- 1424. DOI: 10.13463/j.cnki.cczyy.2022.12.028.

    周薇薇, 黄俊, 潘发明. 慢性乙型肝炎流行病学特点和治疗药物研究进展[J]. 长春中医药大学学报, 2022, 38( 12): 1420- 1424. DOI: 10.13463/j.cnki.cczyy.2022.12.028.
    [4]
    SHI JJ, ZHANG JY, WANG FS. Research progress in immunopathogenesis and antiviral therapy of hepatitis B virus infection[J]. Chin J Viral Dis, 2017, 7( 3): 161- 166. DOI: 10.16505/j.2095-0136.2017.03.001.

    史继静, 张纪元, 王福生. HBV感染的免疫发病机制及抗病毒治疗策略[J]. 中国病毒病杂志, 2017, 7( 3): 161- 166. DOI: 10.16505/j.2095-0136.2017.03.001.
    [5]
    WU L, ZHANG ZP, CAI WT, et al. Research progress on anti-hepatitis B virus activity and mechanisms of traditional Chinese medicine[J]. Chin Tradit Herb Drugs, 2020, 51( 24): 6367- 6376. DOI: 10.7501/j.issn.0253-2670.2020.24.028.

    伍磊, 张志鹏, 蔡文涛, 等. 中药抗乙肝病毒活性及作用机制的研究进展[J]. 中草药, 2020, 51( 24): 6367- 6376. DOI: 10.7501/j.issn.0253-2670.2020.24.028.
    [6]
    YE ZR, MENG SH. Thoughts on immunological research of traditional Chinese medicine[J]. J Shaanxi Univ Chin Med, 2017, 40( 5): 10- 12, 18. DOI: 10.13424/j.cnki.jsctcm.2017.05.003.

    叶峥嵘, 孟淑华. 对中医药免疫研究的思考[J]. 陕西中医药大学学报, 2017, 40( 5): 10- 12, 18. DOI: 10.13424/j.cnki.jsctcm.2017.05.003.
    [7]
    ZHI YX, LI HM, XU AL. Re-understanding of immunity via combined view of traditional Chinese medicine and western medicine: A discussion based on syndrome differentiation and immune state[J]. J Tradit Chin Med, 2022, 63( 21): 2001- 2008. DOI: 10.13288/j.11-2166/r.2022.21.001.

    智宇星, 李红梅, 徐安龙. 中西医学视角下对免疫的再认识: 基于辨证论治和免疫态的讨论[J]. 中医杂志, 2022, 63( 21): 2001- 2008. DOI: 10.13288/j.11-2166/r.2022.21.001.
    [8]
    GUO J, WANG JY, LIU ZD. Analysis of traditional Chinese medicine and immunology[J]. Chin Arch Tradit Chin Med, 2013, 31( 9): 1982- 1984. DOI: 10.13193/j.issn.1673-7717.2013.09.144.

    郭净, 王菊勇, 刘忠达. 中医药与免疫的思考[J]. 中华中医药学刊, 2013, 31( 9): 1982- 1984. DOI: 10.13193/j.issn.1673-7717.2013.09.144.
    [9]
    HAN XW, MA XD, GUAN HQ. Discussing relationship between theory of qi blood and body fluid in TCM and modern immunology[J]. Chin Arch Tradit Chin Med, 2009, 27( 7): 1380- 1381. DOI: 10.13193/j.archtcm.2009.07.37.hanxw.021.

    韩晓伟, 马贤德, 关洪全. 中医“气血津液”学说与现代免疫学思想[J]. 中华中医药学刊, 2009, 27( 7): 1380- 1381. DOI: 10.13193/j.archtcm.2009.07.37.hanxw.021.
    [10]
    SHI JJ, CHANG WX, LI YY, et al. Current state and challenges of clinical treatment of chronic hepatitis B[J]. Sci Technol Rev, 2016, 34( 20): 34- 39. DOI: 10.3981/j.issn.1000-7857.2016.20.005.

    史继静, 常文仙, 李元元, 等. 慢性乙型肝炎临床治疗的现状与挑战[J]. 科技导报, 2016, 34( 20): 34- 39. DOI: 10.3981/j.issn.1000-7857.2016.20.005.
    [11]
    Hepatobiliary Specialized Committee of China Association of Chinese Medicine, Liver Diseases Specialized Committee of China Medical Associa-tion of Minorities. The clinical guidelines of diagnosis and treatment of chronic hepatitis B with traditional Chinese medicine(2018)[J]. J Clin Hepatol, 2018, 34( 12): 2520- 2525. DOI: 10.3969/j.issn.1001-5256.2018.12.007.

    中华中医药学会肝胆病专业委员会, 中国民族医药学会肝病专业委员会. 慢性乙型肝炎中医诊疗指南(2018年版)[J]. 临床肝胆病杂志, 2018, 34( 12): 2520- 2525. DOI: 10.3969/j.issn.1001-5256.2018.12.007.
    [12]
    ZHOU YN. Liu duzhou’s experience in treating viral hepatitis B[J]. World Chin Med, 2011, 6( 5): 418- 419. DOI: 10.3969/j.issn.1673-7202.2011.05.029.

    周亚男. 刘渡舟治疗病毒性乙型肝炎的经验方[J]. 世界中医药, 2011, 6( 5): 418- 419. DOI: 10.3969/j.issn.1673-7202.2011.05.029.
    [13]
    ZHOU FF, CHEN YY, SHANG BY, et al. Mechanism of chronic hepatitis B virus from theory of warm disease due to latent qi[J]. Liaoning J Tradit Chin Med, 2020, 47( 2): 88- 89. DOI: 10.13192/j.issn.1000-1719.2020.02.028.

    周峰峰, 陈逸云, 商斌仪, 等. 从伏气温病理论探讨乙型病毒性肝炎慢性化机制[J]. 辽宁中医杂志, 2020, 47( 2): 88- 89. DOI: 10.13192/j.issn.1000-1719.2020.02.028.
    [14]
    TONG GD, WANG YX, XING YF, et al. Treatment of chronic hepatitis B and related liver cirrhosis and liver cancer from the perspective of“deficiency, toxin, stasis and accumulation”[J]. J Tradit Chin Med, 2021, 62( 16): 1404- 1407. DOI: 10.13288/j.11-2166/r.2021.16.006.

    童光东, 王宇新, 邢宇锋, 等. 从“虚、毒、瘀、积”论慢性乙型肝炎及相关肝硬化、肝癌的治疗[J]. 中医杂志, 2021, 62( 16): 1404- 1407. DOI: 10.13288/j.11-2166/r.2021.16.006.
    [15]
    TIAN GJ, CHI XL, TAN B, et al. Quantitative relationship between TCM syndrome distribution and immunological parameters and HBV-DNA in chronic hepatitis B[J]. J Clin Med Pract, 2012, 16( 21): 31- 33, 44. DOI: 10.13192/j.ljtcm.2009.07.6.wangzhch.040.

    田广俊, 池晓玲, 谈博, 等. 慢性乙型肝炎中医证型分布与免疫学指标、HBV-DNA定量关系的研究[J]. 实用临床医药杂志, 2012, 16( 21): 31- 33, 44. DOI: 10.13192/j.ljtcm.2009.07.6.wangzhch.040.
    [16]
    WANG ZC, MAO DW, HUANG B, et al. Study on the correlation between immune status of chronic hepatitis B and TCM syndrome types[J]. Liaoning J Tradit Chin Med, 2009, 36( 7): 1058- 1059. DOI: 10.13192/j.ljtcm.2009.07.6.wangzhch.040.

    王振常, 毛德文, 黄彬, 等. 慢性乙型肝炎免疫状态与中医证型的相关性研究[J]. 辽宁中医杂志, 2009, 36( 7): 1058- 1059. DOI: 10.13192/j.ljtcm.2009.07.6.wangzhch.040.
    [17]
    YE YA, LI XK, ZHOU DQ, et al. Chinese herbal medicine combined with entecavir for HBeAg positive chronic hepatitis B: Study protocol for a multi-center, double-blind randomized-controlled trial[J]. Chin J Integr Med, 2018, 24( 9): 653- 660. DOI: 10.1007/s11655-018-3011-5.
    [18]
    COLLIN M, BIGLEY V. Human dendritic cell subsets: An update[J]. Immunology, 2018, 154( 1): 3- 20. DOI: 10.1111/imm.12888.
    [19]
    YONEJIMA A, MIZUKOSHI E, TAMAI T, et al. Characteristics of impaired dendritic cell function in patients with hepatitis B virus infection[J]. Hepatology, 2019, 70( 1): 25- 39. DOI: 10.1002/hep.30637.
    [20]
    van der MOLEN RG, SPRENGERS D, BINDA RS, et al. Functional impairment of myeloid and plasmacytoid dendritic cells of patients with chronic hepatitis B[J]. Hepatology, 2004, 40( 3): 738- 746. DOI: 10.1002/hep.20366.
    [21]
    OU S, SUN KW, PENG JP, et al. Effects of Bushen Jiedu recipe and Jianpi Jiedu recipe containing plasma on dendritic cells of chronic hepatitis B virus infection patients under different immune states[J]. Chin J Integr Tradit West Med, 2013, 33( 2): 208- 213.

    欧松, 孙克伟, 彭建平, 等. 补肾解毒方与健脾解毒方含药血浆对慢性乙肝病毒感染不同免疫状态患者外周血树突状细胞功能的影响[J]. 中国中西医结合杂志, 2013, 33( 2): 208- 213.
    [22]
    LI SF, WANG X, GUI XE, et al. Effects of angelica polysaccharide on the functional status of dendritic cells in HBC trans-genie mice[J]. J Pract Diagn Ther, 2005, 19( 5): 313- 314, 317. DOI: 10.3969/j.issn.1674-3474.2005.05.001.

    李声方, 王兮, 桂希恩, 等. 当归多糖对乙肝病毒转基因小鼠树突状细胞功能状态的影响[J]. 实用诊断与治疗杂志, 2005, 19( 5): 313- 314, 317. DOI: 10.3969/j.issn.1674-3474.2005.05.001.
    [23]
    LU YP, ZHOU DQ, XIONG YQ, et al. Effect of dendritic cells and HBV-DNA to chronic hepatitis B patients with Liangxue zishen Yiqi method[J]. Chin J Exp Tradit Med Formulae, 2015, 21( 13): 160- 164. DOI: 10.13422/j.cnki.syfjx.2015130160.

    鲁艳平, 周大桥, 熊益群, 等. 凉血滋肾益气法对慢性乙肝患者树突状细胞和HBV-DNA的影响[J]. 中国实验方剂学杂志, 2015, 21( 13): 160- 164. DOI: 10.13422/j.cnki.syfjx.2015130160.
    [24]
    LI HJ, ZHAI NC, WANG ZF, et al. Regulatory NK cells mediated between immunosuppressive monocytes and dysfunctional T cells in chronic HBV infection[J]. Gut, 2018, 67( 11): 2035- 2044. DOI: 10.1136/gutjnl-2017-314098.
    [25]
    ZHANG Z, ZHANG SY, ZOU ZS, et al. Hypercytolytic activity of hepatic natural killer cells correlates with liver injury in chronic hepatitis B patients[J]. Hepatology, 2011, 53( 1): 73- 85. DOI: 10.1002/hep.23977.
    [26]
    SUN C, SUN HY, ZHANG C, et al. NK cell receptor imbalance and NK cell dysfunction in HBV infection and hepatocellular carcinoma[J]. Cell Mol Immunol, 2015, 12( 3): 292- 302. DOI: 10.1038/cmi.2014.91.
    [27]
    JIANG Y, GAO YQ, LI M, et al. Therapeutic effect of“lingmao decoction” combined with telbivudine in treating patients with chronic hepatitis B and the influence on the function of NK cells[J]. Acta Univ Tradit Med Sin Pharmacol Shanghai, 2017, 31( 2): 16- 21. DOI: 10.16306/j.1008-861x.2017.02.005.

    江云, 高月求, 李曼, 等. 灵猫方联合替比夫定治疗慢性乙型肝炎患者的疗效及对NK细胞功能的影响[J]. 上海中医药大学学报, 2017, 31( 2): 16- 21. DOI: 10.16306/j.1008-861x.2017.02.005.
    [28]
    GAO YQ, YAO Y, LI M. Effect of Bushen recipe on the immune effector molecules of natural killer cells in patients with chronic hepatitis B[J]. Chin J Integr Tradit West Med, 2010, 30( 7): 710- 713. DOI: 10.3969/j.issn.1005-0264.2009.05.004.

    高月求, 姚嫣, 李曼. 补肾方对慢性乙型肝炎自然杀伤细胞免疫效应分子的影响[J]. 中国中西医结合杂志, 2010, 30( 7): 710- 713. DOI: 10.3969/j.issn.1005-0264.2009.05.004.
    [29]
    ZHANG J, ZHOU ZH, SUN XH, et al. Research progress of monocyte macrophages and hepatitis B virus infection[J]. Chin J Integr Tradit West Med Liver Dis, 2017, 27( 3): 185- 189. DOI: 10.3969/j.issn.1005-0264.2017.03.022.

    张洁, 周振华, 孙学华, 等. 单核巨噬细胞与乙型肝炎病毒感染的研究进展[J]. 中西医结合肝病杂志, 2017, 27( 3): 185- 189. DOI: 10.3969/j.issn.1005-0264.2017.03.022.
    [30]
    YANG JH, LIN M, SUN J, et al. Expression and significance of monocyte-macrophage polarization in chronic active hepatitis B patients[J]. Chin J Immunol, 2016, 32( 10): 1503- 1506. DOI: 10.3969/j.issn.1000-484X.2016.10.020.

    杨江华, 林敏, 孙静, 等. 单核巨噬细胞极化在慢性活动性乙型肝炎中的表达及意义[J]. 中国免疫学杂志, 2016, 32( 10): 1503- 1506. DOI: 10.3969/j.issn.1000-484X.2016.10.020.
    [31]
    LIN H, MEI QX. Effects of Shehuang Ganyan Composition medicated serum on immunologic functions in immunosupressive rats[J]. Chin J Hosp Pharm, 2016, 36( 20): 1763- 1766. DOI: 10.13286/j.cnki.chinhosppharmacyj.2016.20.10.

    林慧, 梅全喜. 蛇黄肝炎汤含药血清对免疫抑制大鼠免疫功能的调节作用[J]. 中国医院药学杂志, 2016, 36( 20): 1763- 1766. DOI: 10.13286/j.cnki.chinhosppharmacyj.2016.20.10.
    [32]
    FANG PP, LI JE, HUANG SS, et al. Lentinan relieves hepatitis B surface antigen induced functional impairment of monocytes/macrophages[J]. Trop J Pharm Res, 2018, 17( 4): 583. DOI: 10.4314/tjpr.v17i4.3.
    [33]
    NIE HM, CHEN JJ, GAO YQ, et al. Experimental study of sophoridine against hepatitis B virus in vitro[J]. Beijing J Tradit Chin Med, 2007, 26( 10): 678- 680.

    聂红明, 陈建杰, 高月求, 等. 槐定碱体外抗乙肝病毒的实验研究[J]. 北京中医, 2007, 26( 10): 678- 680.
    [34]
    ZHOU Y, WANG NP, ZHAO JN, et al. Effects of sophoridine on the function of peritoneal macrophages in mice[J]. Liaoning J Tradit Chin Med, 2000, 27( 2): 84- 86. DOI: 10.13192/j.ljtcm.2000.02.38.zhouy.031.

    周娅, 王宁萍, 赵建宁, 等. 槐定碱对小鼠腹腔巨噬细胞功能的影响[J]. 辽宁中医杂志, 2000, 27( 2): 84- 86. DOI: 10.13192/j.ljtcm.2000.02.38.zhouy.031.
    [35]
    MEI ZH, NIE HM, WANG R, et al. Balance among Th1, Th2, Th17 and Treg in mild to moderate chronic hepatitis B patients with immune imbalance of CD4+ T cells[J]. Chin Hepatol, 2017, 22( 6): 513- 516, 522. DOI: 10.14000/j.cnki.issn.1008-1704.2017.06.011.

    梅昭荷, 聂红明, 汪蓉, 等. 从Th1/Th2、Treg/Th17之间的平衡研究轻、中度慢性乙型肝炎患者CD4+T淋巴细胞的免疫失衡状态[J]. 肝脏, 2017, 22( 6): 513- 516, 522. DOI: 10.14000/j.cnki.issn.1008-1704.2017.06.011.
    [36]
    WANG BR, ZHANG LP, GUO ZN, et al. Regulating effect of Fuzheng Qudu Decoction on cellular immunity of mice carrying chronic hepatitis B virus[J]. China Med Her, 2020, 17( 35): 19- 22.

    王炳然, 张立平, 郭子宁, 等. 扶正祛毒方对慢性乙型肝炎病毒携带小鼠细胞免疫水平的调节作用[J]. 中国医药导报, 2020, 17( 35): 19- 22.
    [37]
    LI M, SUN XH, ZHOU ZH, et al. Beneficial therapeutic effect of Chinese herbal Bushen formula on CHB patients with mildly elevated alanine aminotransferase by down-regulating CD4+ CD25+ T cells[J]. J Ethnopharmacol, 2013, 146( 2): 614- 622. DOI: 10.1016/j.jep.2013.01.038.
    [38]
    JI LS, GAO QT, GUO RW, et al. Immunomodulatory effects of combination therapy with Bushen formula plus entecavir for chronic hepatitis B patients[J]. J Immunol Res, 2019, 2019: 8983903. DOI: 10.1155/2019/8983903.
    [39]
    WANG YF, ZHOU X, WANG JY. Clinical study on Jianpi Rougan Recipe combined with entecavir in the treatment of chronic hepatitis B with hepatic fibrosis[J]. Acad J Shanghai Univ Tradit Chin Med, 2019, 33( 6): 17- 21. DOI: 10.16306/j.1008-861x.2019.06.004.

    王一凤, 周想, 王见义. 健脾柔肝方联合恩替卡韦治疗慢性乙型病毒性肝炎肝纤维化的临床研究[J]. 上海中医药大学学报, 2019, 33( 6): 17- 21. DOI: 10.16306/j.1008-861x.2019.06.004.
    [40]
    LIU YM, GUO XB. Effect of Shugan Jianpi Bushen recipe on splenic T lymphocytes and virus load in hepatitis B virus transgenic mice[J]. Chin J Integr Tradit West Med, 2011, 31( 7): 937- 940.

    刘亚梅, 郭兴伯. 疏肝健脾补肾方对乙型肝炎病毒转基因小鼠脾T淋巴细胞及病毒载量的影响[J]. 中国中西医结合杂志, 2011, 31( 7): 937- 940.
    [41]
    ZHANG SJ, CHEN ZX, LAO SX, et al. Effect of Hejie Decoction on T cell immune state of chronic hepatitis B patients[J]. World J Gastroenterol, 2004, 10( 10): 1436- 1439. DOI: 10.3748/wjg.v10.i10.1436.
    [42]
    CAI Y, YIN WW. The multiple functions of B cells in chronic HBV infection[J]. Front Immunol, 2020, 11: 582292. DOI: 10.3389/fimmu.2020.582292.
    [43]
    LI M, ZHOU ZH, BAO T, et al. Beneficial effects of Bushen formula combined with enticavir on chronic hepatitis B patients with suboptimal response to enticavir by regulating B-cell differentiation[J]. Cell Physiol Biochem, 2018, 48( 2): 633- 643. DOI: 10.1159/000491891.
    [44]
    TSENG TC, KAO JH. Clinical utility of quantitative HBsAg in natural history and nucleos(t)ide analogue treatment of chronic hepatitis B: New trick of old dog[J]. J Gastroenterol, 2013, 48( 1): 13- 21. DOI: 10.1007/s00535-012-0668-y.
    [45]
    BONI C, LACCABUE D, LAMPERTICO P, et al. Restored function of HBV-specific T cells after long-term effective therapy with nucleos(t)ide analogues[J]. Gastroenterology, 2012, 143( 4): 963- 973.e9. DOI: 10.1053/j.gastro.2012.07.014.
    [46]
    LIAW YF, CHU CM. Hepatitis B virus infection[J]. Lancet, 2009, 373( 9663): 582- 592. DOI: 10.1016/S0140-6736(09)60207-5.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索
    Get Citation
    PDF
    XML

    Article Metrics

    Article views (214) PDF downloads(37) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return