猪苓多糖单用或与乙肝免疫球蛋白联用治疗乙型肝炎病毒感染的疗效比较

A comparison between effects of Zhuling Duotang and its combination with hepatitis B immunoglobulin on treatment of patients with chronic hepatitis B virus infections

目的：比较猪苓多糖单用或与乙肝免疫球蛋白（ＨＢＩＧ）联用治疗乙型肝炎病毒感染的疗效。方法：将病程＞６个月，血清ＨＢＶ－ＤＮＡ和ＨＢｅＡｇ均阳性者９５例随机分为３组：Ⅰ组（ｎ＝３３）：接受ＨＢＩＧ２００ＩＵ每周肌注１次，同时用猪苓多糖４０ｍｇ肌注每日１次，治疗２０ｄ间隔１０ｄ，连续３个月；Ⅱ组（ｎ＝３１）：单用猪苓多糖；Ⅲ组（ｎ＝３１）：单用一般护肝药。治疗前后分别用ＥＬＩＳＡ检测乙肝二对半，用ＰＣＲ法检测ＨＢＶ－ＤＮＡ。结果：Ⅰ组、Ⅱ组和Ⅲ组患者中ＨＢｅＡｇ的转阴率分别为６３．６％、３５．４％和６．５％（Ⅰ组与Ⅱ组、Ⅲ组比较Ｐ＜０．０５，Ｐ＜０．００１，Ⅱ组与Ⅲ组比较Ｐ＝０．０１）；ＨＢＶ－ＤＮＡ转阴率三组分别为１５．２％、６．５％、３．２％，虽亦以Ⅰ组为最高，但未达到统计学意义。治疗前后ＨＢｓＡｇ、抗ＨＢｓ均无变化。结论：ＨＢＩＧ联用猪苓多糖或单用猪苓多糖对慢性ＨＢＶ感染者ＨＢｅＡｇ的转阴有一定效果，且以前者为优。但对ＨＢｓＡｇ转阴无效，未能诱导产生抗ＨＢｓ。

Objective:To compare the effects of hepatitis B immunoglobulin (HBIG) combined with Zhulin Duotang(ZD) and ZD alone on the treatment of patients with chronic HBV infection.Methods:Ninety five patients with chronic HBV infection were randomly divided into three groups:GroupⅠ( n =33)received HBIG combined with ZD;Group Ⅱ( n =31)received ZD alone;and Group Ⅲ( n =31)received some liver protective drugs for three months HBV markers and HBV DNA were detected by ELISA and PCR respectively.Results:After treatment there were significant differences of HBeAg conversion into negative among three groups(63.6%,35.4% and 6.5% in Group Ⅰ,GroupⅡ and GroupⅢ;Group Ⅰ vs Group Ⅱ P< 0.05,Group I vs Group Ⅲ P< 0.001,GroupⅡ vs Group Ⅲ P =0.01,respectively).The rates of HBV DNA conversion into negative were 15.2%,6.5%and 3.2 % in Group Ⅰ,Group Ⅱ and Group Ⅲ,respectively.Although it was the highest in Group Ⅰ,no statistical difference was found among the three groups ( P> 0.05).There were no serum anti HBs and serum HBsAg changes for all of the patients before and after the treatment.Conclusion:[WT5”BZ]The effect of HBIG combined with ZD on cleaning serum HBeAg of chronic HBV infection is better than that of ZD alone.However,the serum detectable anti HBs can not be induced by exogenous HBIG and the effect on cleaning HBV DNA is not desirable.