柴胡解毒汤对慢性乙肝患者免疫功能的影响及其安全性分析

Influence of Chaihu Jiedu Decoction on Immune Function in Patients with Chronic Hepatitis B and Its Safety Analysis

目的:探讨柴胡解毒汤对慢性乙肝患者免疫功能的影响,并分析其安全性。方法:选取我院收治的158例慢性乙肝患者,随机分为治疗组(79例)和对照组(79例)。两组患者均给予阿德福韦酯片治疗,治疗组在此基础上增加柴胡解毒汤治疗,两组均连续治疗12个月。比较两组治疗后HBV-DNA转阴率、临床疗效及治疗前后肝功能、免疫功能,并记录两组不良反应发生情况。结果:治疗后,治疗组HBV-DNA转阴率及总有效率明显高于对照组(P<0.05或P<0.01)。治疗后两组患者血清中ALT、AST、TBIL及ALP水平较治疗前降低,且治疗组较对照组明显降低(P<0.01)。与治疗前比较,治疗后对照组患者全血中CD3^+比例及治疗组患者全血中CD3^+、CD4^+比例和CD4^+/CD8^+均明显升高,且治疗组明显高于对照组(P<0.05或P<0.01);治疗组患者全血中CD8^+及CD19^+比例均明显降低,且治疗组明显低于对照组(P<0.01)。两组总不良反应发生率无明显差异(P>0.05)。结论:在阿德福韦酯治疗基础上增加柴胡解毒汤,可有效调节慢性乙肝患者机体免疫功能,提高HBV-DNA转阴率,改善患者肝功能,安全有效,建议临床推广。

Objective: To explore the influence of Chaihu Jiedu Decoction to immune function in patients with chronic hepatitis B, and to analyze its safety. Methods: 158 cases of chronic hepatitis B were randomly divided into the study group( n =79) and the control group( n =79). The control group was treated with Adefovir Dipivoxil, on which basis, the study group was also treated with Chaihu Jiedu Decoction. The two groups were treated continuously for twelve months. The HBV-DNA negative conversion ratio, the clinical efficacy, and the liver function and immune function before and after the treatment were compared between the two groups;also, the incidence of adverse reactions was recorded. Results: After the treatment, the HBV-DNA negative conversion rate and the total effective rate were significantly higher in the study group than those in the control group( P <0.05, P <0.01). Compared to those before the treatment, the serum levels of TBIL, ALT, AST and ALP were significantly decreased;of which the decreases in the study group were more significant than those in the control group( P <0.01). The proportion of CD3^+ of the whole blood in the control group, the proportion of CD3^+, CD4^+ and CD4^+/CD8^+ of the whole blood in the study group were significantly increased;of which the increases in the study group were more significant( P <0.05, P <0.01). The proportion of CD8^+ and CD19^+ of the whole blood were significantly lowered in the study group;which were lower than those in the control group( P <0.01). There were no statistical differences in the incidence of total adverse reactions between the two groups( P >0.05). Conclusion: Chaihu Jiedu Decoction on the basis of Adefovir Dipivoxil can effectively regulate the immune function of patients with chronic hepatitis B, improve the HBV-DNA negative conversion rate, and enhance the liver function of patients. The therapy is safe and effective, which is recommend to use in clinic.