抗病毒药物联合中医药治疗对慢性乙型肝炎e抗原血清转化率的影响

Antivirals therapy combined with traditional Chinese medicine effects on HBeAg seroconversion rate in patients with chronic hepatitis B

目的探讨抗病毒基础上联合中医药治疗对乙型肝炎e抗原(hepatitis B e antigen,HBe Ag)阳性的慢性乙型肝炎患者HBe Ag血清转换率的影响。方法将符合纳入标准的679名HBe Ag阳性慢性乙型肝炎的患者,根据是否联合应用中医药治疗分为抗病毒西药组(209例)和中西药联合组(470例),观察治疗1年后HBe Ag血清学转换率,分层分析联合治疗的优势人群。结果治疗1年后,抗病毒西药组和中西药联合组HBe Ag血清学转换率分别为11. 5%和12. 8%(P=0. 66);应用课题组前期建立的评分模型分层分析显示,评分0～1分的患者,抗病毒西药组和中西药联合组HBe Ag血清学转换率分别为2. 6%和8. 1%(P=0. 04)。结论抗病毒基础上联合中医药治疗能够提高评分为0～1分的慢性乙型肝炎患者HBe Ag血清学转换率。

Objective To investigate the effect of antivirals therapy combined with traditional Chinese medicine therapy on hepatitis B e antigen(HBeAg)seroconversion rate in patients with HBeAg-positive chronic hepatitis B.Methods The679HBeAg-positive chronic hepatitis B patients who met the inclusion criteria were divided into the antiviral western medicine group(209patients)and the Chinese and western medicine combination group(470patients)according to whether or not they were treated with traditional Chinese medicine.The HBeAg seroconversion rate was observed after1year of treatment,and stratified sampling was applied to identify the dominant population of combined therapy.Results After1year of the treatment,the seroconversion rate of HBeAg in the antiviral western medicine group and the combined group was11.5%and12.8%,respectively,with P=0.66.The patients were scored with the scoring model that our group established in the early stage.For those patients with a score of0-1in the antiviral western medicine group and combined therapy group,HBeAg conversion rates were2.6%and8.1%,respectively,with P=0.04.Conclusion On the basis of antiviral treatment,combined Chinese medicine treatment can improve the HBeAg seroconversion rate of chronic hepatitis B patients with a score of0-1.