补肝汤加味治疗慢性乙型病毒性肝炎临床疗效及其对免疫功能的影响

Clinical effect of Bugan decoction on chronic viral hepatitis B and its influence on immune function

目的研究补肝汤加味治疗慢性乙型病毒性肝炎的临床效果及对免疫功能的影响。方法选择2013年1月-2015年12月在我院感染科诊治的慢性乙型病毒性肝炎患者97例,随机分为2组,观察组48例,对照组49例。2组均给予恩替卡韦分散片和注射用还原型谷胱甘肽进行治疗,观察组联合服用补肝汤加味治疗。比较2组临床治疗效果,治疗前后的CD4^+、CD3^+、CD8^+以及CD4^+/CD8^+等细胞免疫功能指标,层黏连蛋白、透明质酸、Ⅲ型前胶原蛋白肽以及Ⅳ型胶原等肝纤维化指标,并比较2组HBeAg转阴率以及HBV-DNA转阴率。结果观察组有效率明显高于对照组(P<0.05);治疗后对照组和观察组细胞免疫功能变化、血清肝纤维化变化差异均有统计学意义(P<0.05);观察组HBeAg转阴率、HBV-DNA转阴率显著高于对照组(P<0.05)。结论补肝汤加味治疗慢性乙型病毒性肝炎具有较好的临床效果,可有效对抗肝纤维化,促进HBeAg、HBV-DNA转阴,其机制与补肝汤促进肝细胞修复再生、增强机体的免疫功能相关。

Objective To investigate the clinical effect of Bugan decoction on chronic viral hepatitis B and its influence on immune function. Methods Selected 97 cases of patients with chronic hepatitis B who were treated in our hospital from January 2013 to December 2015, divided into observation group（48 cases） and control group（49 cases） randomly. The two groups were treated with entecavir dispersal tablets and reduced glutathione for injection, the observation group combined with Bu Gan Tang. The clinical therapeutic effect of two groups were compared, CD4^＋, CD3^＋, CD8^＋ and CD4^＋/CD8^＋, laminin, hyaluronic acid, type III procollagen peptide and type IV collagen were compared between before and after treatment. HBeAg negative conversion rate and HBV-DNA negative rate of two groups were compared. Results After treatment, the effective rate of the observation group was significantly higher than control group（P〈0.05）; After treatment, the changes of immune function and serum hepatic fibrosis in the control group and the observation group were statistically significant difference（P〈0.05）. The HBeAg negative conversion rate and HBV-DNA negative conversion rate in the observation group were significantly higher than control group（P〈0.05）. Conclusion Bugan decoction has obvious clinical effect in the treatment of chronic hepatitis B, it can effectively resist liver fibrosis, promote the negative conversion of HBeAg and HBV-DNA, and its mechanism is related to the promotion of liver cell regeneration and the enhancement of immune function.