强肾愈肝汤联合恩替卡韦治疗慢性乙型肝炎40例

目的: 探讨自拟强肾愈肝汤联合恩替卡韦治疗慢性乙型肝炎(CHB)的临床疗效及对白细胞介素-12、-21(IL-12, IL-21)的影响。 方法: 将80例CHB患者随机按数字法分为对照组和观察组各40例。两组均口服恩替卡韦,0.5 mg/次,1次/d, 观察组加用自拟强肾愈肝汤,1剂/d。疗程24周。监测血清乙肝病毒基因(HBV-DNA),乙型肝炎血清免疫标志物(HBV-M)水平,检测血清IL-12,IL-21水平,检测肝功能,观察临床症状、体征。 结果: 观察组应答率85.0%优于对照组的55.0%(P<0.05);治疗后24周,观察组HBV-DNA拷贝数明显下降,并低于对照组(P<0.05),HBV-DNA阴转率达82.5%,高于对的52.5%(P<0.05);观察组HBeAg阴转率42.5%,高于对照组的20.5%(P<0.05);观察组治疗天冬氨酸转移酶(AST),丙氨酸转氨酶(ALT),谷氨酰转肽酶(GGT)及总胆红素(TBil)水平均低于对照组(P<0.01),ALT复常率85.0%,高于对照组52.5%(P<0.05);观察组血清IL-12,IL-21水平均明显上升并高于对照组(P<0.05,P<0.01);治疗第8周至疗程结束,观察组临床、症状评分均明显下降,处于较低水平,且低于同期对照组(P<0.01)。 结论: 自拟强肾愈肝汤能抑制HBV复制,降低HBeAg表达,能改善患者临床症状、体征,促进肝功能的恢复,其作用机制可能与升高CHB患者IL-12,IL-21水平、调节免疫功能有关。

Qiangshen Yugan Decoction Combined Entecavir Treatment for Chronic Hepatitis B 40 Cases

Objective: To discuss the clinical efficacy of Self-made Qiangshen Yugan decoction combined with entecavir on treating chronic hepatitis B(CHB) and the influence on(IL-12),(IL-21). Method: Eighty patients with chronic pyelonephritis were randomly divided into observation group (n=40) and control group (n=40). Patients in the two groups were both treated with entecavir. Self-made Qiangshen Yugan decoction was used in the observation group (one dose per times, 24 weeks as one cycle). Levels of serum hepatitis B virus-DNA(HBV-DNA),Hepatitis B virus markers(HBV-M),interleukin-12(IL-12) and interleukin-21(IL-21) were tested, liver function and clinical symptoms and signs were also observed. Result: Response rate of observation group (85.0%) was better than the control group (55.0%)(P<0.05);after treatment, HBV-DNA copy number of the observation group was significantly decreased, and lower than the control group (P<0.05). HBV-DNA negative conversion rate of observation was 82.5%, higher than the control group(52.5%)(P<0.05);HBeAg negative rate of observation group was 42.5%, higher than the the control group(20.5%) (P<0.05);aspartate aminotransferase (AST), alanine aminotransferase (ALT), glutamyl transpeptidase (GGT) and total bilirubin(TBil) levels of observation group were low than control group (P<0.01), ALT normalization normalization rate of observation group was 85.0%, higher than the control group(52.5%) (P<0.05);Serum IL-12, IL-21 levels of observation weeks treatment, group were significantly increased and higher than the control group (P<0.05,P<0.01);after 8 weeks treatment, symptom scores of observation group were significantly decreased, at a low level, and was lower than the control group (P<0.01). Conclusion: Self-made Qiangshen Yugan decoction can inhibit HBV replication, reduce HBeAg expression, it also can improve clinical symptoms and signs, promote the recovery of liver function. Its mechanism may be able to increase CHB patients IL-12, IL-21 levels, immune function and it is worth further study.