Th17能促进CHB炎症反应，Treg诱导免疫耐受，两者生物学效应相反，但在某种条件下又可相互转化。研究证实ALT水平与Th17的活化程度呈正相关。前期工作中用"温肾方"治疗超高ALT水平（20ULN≤ALT≤30ULN）CHB疗效满意,部分患者实现了完全应答，未见不良反应。据此,我们提出"从温肾论治超高ALT水平的CHB是通过Th17/Treg介导的免疫反应来实现"的科学假说。现拟以RCT临床设计治疗超高ALT水平的CHB，进一步观察其疗效,分离、采集不同时相患者、健康志愿者的外周血PBMCs和肝穿刺标本，检测HBVcccDNA及Foxp3 mRNA、T-bIFNAR、PBMCsmRNA、RORCmRNA、IL-6、IL-17、IL-21、IL-22、IL-23、TGF-β等相关信号。全面探讨温肾方Th17/Treg信号网络调控机制及病毒清除机制，为寻求新的中药治疗CHB策略提供新思路。

Th17 can promote the inflammatory response of CHB while Treg may induce immune tolerance. Both play opposite roles in the biological effects, but convert with each other under certain conditions. It was confirmed in previous researches that ALT level was positively related to Th17 activation degree.During preliminary work, warming kidney prescription treated CHB with superelevation ALT levels(20ULN≤ALT≤30ULN) could get satisfactory effects,make some cases achieve complete responses and have no significant adverse reactions.Therefore,we raise a scientific hypothesis that the molecular mechanism of warming kidney therapy treated CHB with superelevation ALT levels realted to immune response mediated through Th17/Treg.Based on the theory,we would design a RCT clinical trial to further observe the efficacy of warming kidney prescription treated CHB with superelevation ALT levels,including separating and collecting peripheral blood PBMCs in the different periods and biopsy specimens before and after liver puncture of patients and healthy volunteers to detect HBV cccDNA and IFNAR,Foxp3 mRNA,T-bet mRNA,PBMCsmRNA,RORCmRNA,IL-6,IL-8,IL-21,IL-22,IL-23,IL-17A,IL-17F,IL-17RA,IL-17RC,TGF-βand so on.Comprehensive study of Th17/Treg signal network control mechanisms and protein clearance mechanisms aims to provide new program seeking new Chinese medicine treatment strategy in CHB.