清热解毒疏肝法对类风湿关节炎合并乙肝患者应用生物制剂后并发症防控的临床研究

Protective Effect of Qingre Jiedu Shugan Decoction for Patients with Rheumatoid Arthritis and Hepatitis B after Using Biological Agent

目的:观察清热解毒疏肝法对类风湿关节炎合并乙肝患者应用生物制剂后并发症防控的效应。方法:选择类风湿合并乙肝病毒阳性的患者48例随机分为两组,两组均皮下注射益赛普25mg每周两次,连续使用八周;治疗组服用清热解毒疏肝汤每天1剂,连续服用8周。结果:两组患者丙氨酸转氨酶(ALT)、天氨酸转氨酶(AST)、总胆红素(TBIL)及直接胆红素(DBIL)均较治疗前明显降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05),治疗后,两组HBV-DNA水平均明显降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗后治疗组HBV-DNA水平低于对照组,两组比较差异具有统计学意义(P<0.05)。两组治疗后CD3+,CD4+,CD4+/CD8+均较治疗前明显升高(P<0.05),且治疗组治疗CD3+,CD4+,CD4+/CD8+明显高于对照组(P<0.05)。结论:本研究结果明确了中医中药在防控益赛普所致乙肝活动方面的作用,旨在为临床应用生物制剂提供更有效且安全的方法。

Objective： To observe the protective effect of Qingre Jiedu Shugan Decoction for patients with rheumatoid arthritis and hepatitis B after using biological agent. Methods： Choosing 48 patients of rheumatoid arthritis with hepatitis B and dividing into two groups randomly,they were injected with Enternercept 25 mg twice a week for 8 weeks. The treatment group took in Qingre Jiedu Shugan Decoction per day for 8 weeks. Results： The two group＇s AST,ALT and TBIL were significantly lower than before（ P〈0. 05）,the treatment group was significantly lower than those of the controlled group（ P〈 0. 05）. After the treatment,the two group＇s serum HBV-DNA were significantly lower than before（ P 〈0. 05）,the treatment group was significantly lower than the controlled group（ P 〈0. 05）. The two group＇s CD3＋,CD4＋,CD4＋/CD8＋were significantly higher than before（ P〈 0. 05）,the treatment group was significantly lower than those of the controlled group（ P〈0. 05）. Conclusion： The study proves that the protection of TCM was effective to the patients of rheumatoid arthritis and hepatitis B after using biological agent,in order to provide a safe and effective method for using biological agent.