干扰素治疗HBeAg阳性慢性乙型肝炎湿热中阻证临床研究

Clinical Study on the Treatment of HBeAg Positive Chronic Hepatitis B with Retention of Damp-Heat in the Interior Syndrome with Interferon

目的:观察干扰素治疗HBe Ag阳性慢性乙型肝炎湿热中阻证的临床疗效。方法:47例HBe Ag阳性慢性肝炎湿热中阻证患者给予聚乙二醇干扰素α-2a 180μg皮下注射,每周一次,治疗前、治疗24周和治疗48周时分别检测ALT水平、HBe Ag滴度、HBV-DNA定量及CD4+T、CD8+T淋巴细胞计数。结果:湿热中阻型HBe Ag阳性慢性乙型肝炎患者体内免疫状态接近正常;治疗结束时HBe Ag血清学转换率(57.45%)、HBV-DNA转阴率(72.34%)均高于既往文献报道。结论:干扰素抗病毒作用机制早期可能以调节免疫为主,后期则可能通过细胞间信号传递、细胞凋亡等其他途径直接抑制病毒复制发挥作用。

Objective：To observe the clinical curative effect of interferon HBeAg positive Chronic Hepatitis B with retenuon of damp- heat in the interior syndrome. Methods：Forty-seven patients were treated with pegylated interferon alpha -2a 180ug 1H QW antiviral treatment. Before the treatment, on the 24th week and 48th week respectively, ALT level, HBeAg titer, HBV-DNA ration, CD4 ＋ T and CD8 ＋ T lymphocyte count were detected. Results ： The body＇s immune status of patients with HBeAg positive chronic hepatitis B with retention of damp- heat in the interior syndrome is close to normal. At the end of treatment, the rate of HBeAg se- roconversion was 57.45% ,and HBV-DNA negative-transforming rate was 72. 34%, which were higher than those previously re- ported in the literature. Conclusion ：The detection of patients with chronic hepatitis B immune function can provide a certain refer- ence for TCM quantitative indicators. TCM syndrome differentiation typing combined with immune function in the body not only can predict the antiviral efficacy, but also can provide a reference for individual treatment of patients with chronic hepatitis B.