干扰素联合健脾补肾方对HBeAg阳性慢性乙型肝炎患者疗效的随机对照研究

Curative effect of Jianpibushen decoction combined with interferon in treating HBeAg positive chronic hepatitis B patients

[目的]探讨干扰素联合健脾补肾方对HBeAg阳性慢性乙型肝炎患者e抗原血清学转换、HBV DNA含量及血清前细胞因子的影响。[方法]将HBeAg阳性慢性乙型肝炎患者,随机分为治疗组和对照组。对照组单用干扰素皮下注射,治疗组在干扰素治疗基础上服用中药复方补肾健脾方。疗程均为48周。比较治疗后2组患者HBeAg血清阴转率及HBeAg/HBeAb转换率,HBV DNA定量水平变化及阴转率,以及血清前细胞因子IL-4、IL-10水平。[结果]治疗组48周时血清HBeAg阴转及HBeAg/HBeAb血清学转换率优于对照组;2组患者治疗24周、48周后血清HBsAg滴度下降水平组内比较均较治疗前好转,治疗48周时治疗组下降程度优于对照组;2组患者治疗24周、48周时血清HBV-DNA定量水平检测组内比较均较治疗前明显下降,治疗48周时治疗组HBVDNA定量水平下降较对照组明显;治疗48周时,治疗组患者HBV-DNA阴转率优于对照组;2组患者治疗24周和48周时IL-4、IL-10水平均较治疗前下降,治疗组治疗48周时细胞因子IL-4、IL-10水平下降较对照组明显,差异均具有统计学意义(P<0.05)。[结论]干扰素联合健脾补肾方能提高HBeAg阳性慢乙肝患者血清的HBeAg阴转率、HBeAg/HBeAb血清学转换率及HBV-DNA阴转率,同时能降低体内Th2型细胞因子IL-4,IL-10。

[Objective]To observe the effect of the Jianpibushen decoction combined with Interferon on serological conversion of E antigen,HBV DNA and cytokines in HBeAg positive chronic hepatitis B patients.[Methods]60patients divided into Jianpibushen Decoction Combined with Interferon treatment group(28cases)and interferon group(32cases).After 48 weeks of treatment,HBeAg serum negative conversion rate and HBeAg/HBeAb conversion rate,changes of HBV DNA,as well as IL-4,IL-10 were observed.[Results]After treatment,the serum HBeAg negative conversion rate and HBeAg/HBeAb serological conversion rate in the treatment group were Higher than those in interferon group;The level of serum HBsAg and HBV DNA were significantly decrease in the two groups after 24 weeks and 48 weeks of treatment and the combined group decreased more significantly at 48 weeks of treatment;The levels of IL-4and IL-10 significantly decrease in the two groups after 48 weeks of treatment and the combined group decreased more significantly compared with the interferon group.[Conclusion]Jianpibushen Decoction combined with interferon can increase the serum HBeAg negative conversion rate,HBeAg/HBeAb serological conversion rate and HBV-DNA negative conversion rate in HBeAg positive chronic hepatitis B patients,and lower the IL-4and IL-10 levels.