苦参素联合中药对慢性丙型肝炎患者免疫功能及病毒应答的影响

Effects of "Kurorinone Injection" Combined with Herbal Prescription on Immunity and Virological Responses of Patients with Chronic Hepatitis C

目的观察苦参素联合疏肝健脾方对肝郁脾虚证慢性丙型肝炎患者免疫功能及病毒应答的影响。方法将43例肝郁脾虚证慢性丙型肝炎患者随机分为2组。治疗组25例,予苦参素联合疏肝健脾方治疗48周;对照组18例,予IFNα-2b联合利巴韦林治疗48周。观察治疗前后T细胞亚群、病毒应答和临床疗效。结果治疗组治疗后CD4+水平明显上升,与治疗前比较有显著性差异(P<0.01);CD8+水平明显下降,与治疗前比较具显著性差异(P<0.05)。对照组完全应答率和部分应答率分别为55.56%和33.33%均较治疗组的48.00%和32.00%高;停药24周时,治疗组持续应答率(40.00%)高于对照组(38.89%),差异无统计学意义(P>0.05)。结论苦参素联合疏肝健脾方治疗可改善慢性丙型肝炎患者免疫失调状态,抑制HCV-RNA复制。

Objective To observe the effects of ＂Kurorinone Injection＂ in combination with ＂Shugan Jianpi Decoction＂ on patients with chronic hepatitis C in syndrome of liver-stagnation and spleen-defficiency. Methods Forty-three patients were randomly divided into two groups. Twenty-five patients in treatment group received ＂Kurorinone Injection＂ plus ＂Shugan Jianpi Decoction＂ for 48 weeks, and 18 patients in control group were treated with interferon-alpha（2b） and ribavirin for 48 weeks. Virological responses were evaluated and T cells subgroups were detected. Results Levels of CD4^＋ T cells increased after treatment in treatment group, and there was a significant difference between before and after treatment （P〈0.01）. Levels of CD8^＋ T cells decreased after treatment in treatment group and there was a significant difference （P〈0.05）. The rates of complete responce and partial response were 48.00% and 32.00% respectively in treatment group, and 55.56% and 33.33% in control group. There were no significant differences between them（P〉0.05）. Conclusions ＂Kurorinone Injection＂ combined with ＂Shugan Jianpi Decoction＂ may improve immune state of HCV-infected patients and suppress HCV RNA replication.