基于温病邪伏理论探讨慢性乙型肝炎免疫耐受期机制
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摘要
慢性乙型肝炎是我国突出的公共卫生问题之一,严重威胁到公众的健康。笔者根据现代医学对乙型肝炎的微观研究,结合中医学的温病邪伏理论,从正气与致病邪气角度探讨乙肝免疫耐受发生的中医机制,从而丰富了慢性乙型肝炎免疫耐受的理论和温病学说内容。
Chronic hepatitis B is one of the prominent public health problems in China, which seriously threatens the public health. The paper discussed the Chinese medicine mechanism of B immune tolerance of hepatitis from the healthy qi and pathogenic qi based on the microscopic study of hepatitis B in modern medicine, combining the theory of warm disease and latent pathogen in Chinese medicine, which thereby enriched the theory of immune tolerance of hepatitis B as well as the warm disease theory.
Chronic hepatitis B is one of the prominent public health problems in China, which seriously threatens the public health. The paper discussed the Chinese medicine mechanism of B immune tolerance of hepatitis from the healthy qi and pathogenic qi based on the microscopic study of hepatitis B in modern medicine, combining the theory of warm disease and latent pathogen in Chinese medicine, which thereby enriched the theory of immune tolerance of hepatitis B as well as the warm disease theory.
引文
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[2]陈剑锋,马斌,费怡,等.2016年上海市浦东新区高东社区儿童青少年乙肝病毒感染及乙肝疫苗接种状况调查[J].实用预防医学,2018,23(4):344-347.
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[8]刘娜,武琼,徐光华,等.慢性HBV携带状态自然转归的研究[J].肝脏,2016,21(9):755-758.
[9]贾志荣,杨勇,季晖.乙肝免疫耐受分子机制的研究进展[J].抗感染药学,2014,11(2):93-97.
[10]欧强,陈良,孙洪清,等.慢性HBV感染者外周血T淋巴细胞亚群和NK细胞活性变化[J].临床肝胆病杂志,2006,22(4):277-278.
[11]张昭萍,唐勤.慢性乙型肝炎患者外周血淋巴细胞亚群及NK细胞检测的临床意义[J].江苏医药,2010,36(19):2319-2320.
[12]Bojarska-Junak A,Tabarkiewicz J,Rolinski J.NKT cells:their development,mechanisms and effects of action[J].Postepy Hig Med Dosw(Online),2013,67:65-78.
[13]Chan EW,Wong HT,Cheng SC,et al.An immunoglobulin Gbased chimeric protein induced foot-and-mouth diseasespecific immune response in swine[J].Vaccine,2001,19(4/5):538-546.
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[17]邢汉前,辛绍杰,赵景民,等.HBV慢性感染免疫耐受期患者肝组织内NK细胞及Kupffer细胞的研究[J].中国现代医学杂志,2007,1(11):1330-1333.
[18]杨新星,李东升,周继光,等.乙肝病毒感染不同阶段抗原肽特异性细胞毒性T淋巴细胞的初步研究[J].中国免疫学杂志,2016,32(10):1496-1502.
[19]胡珊珊,孙克伟,张茜茜,等.慢性乙肝病毒感染不同免疫状态患者树突状细胞体外刺激后介导的T淋巴细胞功能影响的研究[J].中国中西医结合杂志,2014,34(4):418-422.
[20]Lee WC,Wang HC,Hung CF,et al.Vaccination of advanced hepatocellular carcinoma patients with tumor lysatepulsed dendritic cells:clinical trial[J].J Immunother,2008,28(5):496-504.
[21]Akbar SMF,Onji M,Inaba K,et al.Low responsiveness of hepatitis B virus-transgenic mice in antibody response to T-cell-dependent antigen:defect in antigen-presenting activity of dendritic cells[J].Inmunology,1993,78:468-475.
[22]王茜,何浩,宋文刚.枯否细胞的负向免疫调节作用[J].细胞与分子免疫学杂志,2010,26(6):611-612.
[23]孙庆,邓存良.枯否细胞的生物学功能与肝细胞损伤[J].西南军医,2008,10(2):109-111.
[24]Zoulim F.New insight on hepatitis B virus persistence from the study of intrahepatic viral ccc DNA[J].Hepatol,2005,42(3):302-308.
[25]高红艳,刘娜,卢荣增,等.慢性HBV感染免疫耐受的研究进展[J].肝脏,2017,22(9):848-850.
[26]崔美兰,周海洋,刘杰,等.抗乙肝病毒化学药物研究进展[J].国际药学研究杂志,2012,39(4):280-285,293.
[27]王珊珊,彭桂福,姜普林,等.经垂直传播的乙型肝炎病毒肝外定位与意义[J].现代预防医学,2001,28(3):267-268.
[28]郎振为,闫惠平,黄德庄,等.聚合酶链反应检测乙型肝炎患者肝外组织中乙肝病毒DNA[J].中华内科杂志,1994,33(4):232-236.
[2]陈剑锋,马斌,费怡,等.2016年上海市浦东新区高东社区儿童青少年乙肝病毒感染及乙肝疫苗接种状况调查[J].实用预防医学,2018,23(4):344-347.
[3]Cohen C,Evans AA,Huang P,et al.Hepatitis B knowledge amongkey stakeholders in Haimen City,China:implications for addressingchronic HBV infection[J].Hepatol Med Policy,2016,1(1):4.
[4]白萧萧,东冰,徐光华.慢性HBV感染免疫控制期与免疫逃逸期研究进展[J].肝脏,2018,23(4):344-347.
[5]武琼,刘娜,徐光华.慢性乙型肝炎免疫耐受期的新认识[J].肝脏,2014,19(2):154-156.
[6]吴凤萍,党双锁.慢性HBV感染免疫耐受研究进展[J].临床肝胆病杂志,2017,33(5):949-953.
[7]邢汉前,辛绍杰,张欣,等.慢性乙型肝炎病毒感染免疫耐受期患者的临床病理特征[J].世界华人消化杂志,2006,14(14):1425-1429.
[8]刘娜,武琼,徐光华,等.慢性HBV携带状态自然转归的研究[J].肝脏,2016,21(9):755-758.
[9]贾志荣,杨勇,季晖.乙肝免疫耐受分子机制的研究进展[J].抗感染药学,2014,11(2):93-97.
[10]欧强,陈良,孙洪清,等.慢性HBV感染者外周血T淋巴细胞亚群和NK细胞活性变化[J].临床肝胆病杂志,2006,22(4):277-278.
[11]张昭萍,唐勤.慢性乙型肝炎患者外周血淋巴细胞亚群及NK细胞检测的临床意义[J].江苏医药,2010,36(19):2319-2320.
[12]Bojarska-Junak A,Tabarkiewicz J,Rolinski J.NKT cells:their development,mechanisms and effects of action[J].Postepy Hig Med Dosw(Online),2013,67:65-78.
[13]Chan EW,Wong HT,Cheng SC,et al.An immunoglobulin Gbased chimeric protein induced foot-and-mouth diseasespecific immune response in swine[J].Vaccine,2001,19(4/5):538-546.
[14]Alatrakchi N,Koziel MJ.Antiviral T-cell responses and therapy in chronic hepatitis B[J].Journal of Hepatology,2003,39(4):631-634.
[15]Shimizu Y.T cell immunopathogenesis and immuno-therapeutic strategies for chronic hepatitis B virusinfection[J].World JGastroenterol,2012,18(20):2443-2451.
[16]Chisari FV,Isogawa M,Wieland SF.Pathogenesis of hepatitis B virus infection[J].Pathol Biol(Paris),2010,58(4):258-266.
[17]邢汉前,辛绍杰,赵景民,等.HBV慢性感染免疫耐受期患者肝组织内NK细胞及Kupffer细胞的研究[J].中国现代医学杂志,2007,1(11):1330-1333.
[18]杨新星,李东升,周继光,等.乙肝病毒感染不同阶段抗原肽特异性细胞毒性T淋巴细胞的初步研究[J].中国免疫学杂志,2016,32(10):1496-1502.
[19]胡珊珊,孙克伟,张茜茜,等.慢性乙肝病毒感染不同免疫状态患者树突状细胞体外刺激后介导的T淋巴细胞功能影响的研究[J].中国中西医结合杂志,2014,34(4):418-422.
[20]Lee WC,Wang HC,Hung CF,et al.Vaccination of advanced hepatocellular carcinoma patients with tumor lysatepulsed dendritic cells:clinical trial[J].J Immunother,2008,28(5):496-504.
[21]Akbar SMF,Onji M,Inaba K,et al.Low responsiveness of hepatitis B virus-transgenic mice in antibody response to T-cell-dependent antigen:defect in antigen-presenting activity of dendritic cells[J].Inmunology,1993,78:468-475.
[22]王茜,何浩,宋文刚.枯否细胞的负向免疫调节作用[J].细胞与分子免疫学杂志,2010,26(6):611-612.
[23]孙庆,邓存良.枯否细胞的生物学功能与肝细胞损伤[J].西南军医,2008,10(2):109-111.
[24]Zoulim F.New insight on hepatitis B virus persistence from the study of intrahepatic viral ccc DNA[J].Hepatol,2005,42(3):302-308.
[25]高红艳,刘娜,卢荣增,等.慢性HBV感染免疫耐受的研究进展[J].肝脏,2017,22(9):848-850.
[26]崔美兰,周海洋,刘杰,等.抗乙肝病毒化学药物研究进展[J].国际药学研究杂志,2012,39(4):280-285,293.
[27]王珊珊,彭桂福,姜普林,等.经垂直传播的乙型肝炎病毒肝外定位与意义[J].现代预防医学,2001,28(3):267-268.
[28]郎振为,闫惠平,黄德庄,等.聚合酶链反应检测乙型肝炎患者肝外组织中乙肝病毒DNA[J].中华内科杂志,1994,33(4):232-236.