干扰素α联合苦参素注射液治疗慢性病毒性乙型肝炎的疗效与对肝纤维化及免疫功能的影响

EInterferon α combined with oxymatrine injection for treatment of chronic viral hepatitis B: Efficacy and effect on hepatic fibrosis and immune function

目的探讨干扰素α(interferon-α,IFN-α)联合苦参素注射液治疗慢性病毒性乙型肝炎的疗效与对肝纤维化及免疫功能的影响.方法将2015-03/2017-06于诸暨市中心医院治疗的96例慢性乙型肝炎患者为研究对象,按照随机数表法平均分为实验组与参照组,各48例.参照组患者给予IFN-α治疗,实验组患者给予IFN-α联合苦参素注射液治疗.持续治疗半年,观察比较两组患者肝功能疗效、肝纤维化和细胞免疫指标水平以及不良反应发生情况.结果经治疗后,实验组患者乙型肝炎病毒脱氧核糖核酸转阴率显著高于参照组(83.33%vs 47.92%,P<0.05).两组患者治疗前谷草转氨酶(aspartate transaminase,AST)、谷氨酸转氨酶(alanine transaminase,ALT)、前层黏连蛋白(laminin,LN)、透明质酸(hyaluronic acid,HA)和Ⅲ型前胶原(procollagenⅢ,PCⅢ)水平比较无明显差异(P>0.05);经治疗干预后,两组患者AST、ALT、LN、HA和PCIII水平均有所降低(P<0.05),且实验组患者降低程度明显高于参照组(P<0.05).两组患者治疗前自然杀伤细胞(natural killer cell,NK)、CD4^+和CD8^+水平比较无明显差异(P>0.05);经治疗后,两组患者NK和CD4^+水平均有所提高,实验组患者CD8^+水平降低(P<0.05),但参照组患者CD8^+水平无明显变化(P>0.05);治疗后实验组患者NK、CD4^+和CD8^+水平改善程度均明显优于参照组(均P<0.05).实验组患者服药后不良反应发生率为10.42%,参照组患者不良反应发生率为8.33%,两组比较无明显差异(P>0.05).结论IFN-α联合苦参素治疗慢性乙型肝炎患者具有较好的临床效果,可以明显改善患者的肝功能,控制纤维化并提高细胞免疫功能.

AIM To evaluate the efficacy of interferon α（IFN-α）combined with oxymatrine injection in the treatment of chronic viral hepatitis B and its effect on hepatic fibrosis and immune function.Ninety-six patients with chronic hepatitis B treated at the Zhuji Central Hospital from March 2015 to June 2017 were randomly divided into either an experimental group or a control group,with 48 cases in each group.Patients in the control group were treated with IFN-α alone,while patients in the experimental group were given IFN-α combined with oxymatrine injection.After 6 mo of continuous treatment,liver function,liver fibrosis,cellular immunity,and the incidence of adverse reactions were compared between the two groups.After treatment,the negative rate of HBV DNA was 83.33% in the experimental group,which was significantly higher than that of the control group（47.92%,P 〈 0.05）.There was no significant difference in the levels of aspartate transaminase（AST）,alanine transaminase（ALT）,laminin（LN）,hyaluronic acid（HA）,or procollagen Ⅲ（PC Ⅲ）between the two groups before treatment（P 〉 0.05）.After treatment,the levels of AST,ALT,LN,HA,and PC III significantly decreased in both groups（P 〈 0.05）,and the decrease in the experimental group was significantly greater than that in the control group（P 〈 0.05）.There was no significant difference in the levels of NK cells,CD4＋ T cells,or CD8＋ T cells between the two groups before treatment（P 〉 0.05）.After treatment,the levels of NK cells and CD4＋ T cells in both groups were increased,and the level of CD8＋ T cells in the experimental group was significantly decreased（P 〈 0.05）,but there was no significant change in the level of CD8＋ in the control group（P 〉 0.05）.After treatment,the levels of NK cells,CD4＋ T cells,and CD8＋ T cells in the experimental group were significantly better than those in the control group（P 〈 0.05）.The incidence of adverse reactions was 10.42% in the experimental group and 8.33% in the control group,there was no significant difference between the two groups（P 〉 0.05）.IFN-α combined with oxymatrine has good efficacy in the treatment of chronic hepatitis B patients and can significantly improve liver function,fibrosis,and cellular immune function.