三种疗法对慢性乙型肝炎的疗效观察

为进一步验证猪苓多糖合用乙型肝炎疫苗（乙肝疫苗）、ＬＡＫ细胞回输治疗和潘生丁合用卡介苗三种疗法对慢性乙型肝炎的疗效，探讨其疗效机制，将１５８例慢性乙型肝炎患者分为３组，分别用上述三种方法治疗，另选１２８例慢性乙型肝炎患者以干扰素治疗和１０％葡萄糖液静脉点滴分别作为对照组。并用垂直传播鸭乙型肝炎病毒（ＤＨＢＶ）麻鸭，分别注射猪苓多糖合用乙肝疫苗、猪苓多糖，以注射生理盐水作对照，观察鸭血清ＤＨＢＶ及鸭肝脏病变。结果发现，猪苓多糖合用乙肝疫苗、ＬＡＫ细胞治疗和潘生丁合用卡介苗使ＡＬＴ复常率分别为６４％、３５％和５７％。乙型肝炎ｅ抗原（ＨＢｅＡｇ）和乙型肝炎病毒（ＨＢＶ）ＤＮＡ阴转率，近期疗效分别为４３％和４４％、３４％和３０％、５７％和６１％。远期疗效分别为５９％和５８％、６１％和５５％及７０％和６０％。猪苓多糖合用乙肝疫苗和单用猪苓多糖均可使鸭血清ＤＨＢＶ阴转及肝脏病变改善，尤以前者为优。提示三种疗法治疗慢性乙型肝炎病人可使ＡＬＴ复常，抑制ＨＢＶ复制。与干扰素的疗效相似。猪苓多糖合用乙肝疫苗及单用猪苓多糖均可使垂直传播ＤＨＢＶ的麻鸭血清ＤＨＢＶ阴转及改善肝脏病变，以前者的疗效更好。

A STUDY ON THE EFFECTS OF THREE KINDS OF TREATMENT IN CHRONIC HEPATITIS B

To study the effects of three kinds of treatment: Zhuling polysaccharides combined with hepatitis B vaccine (group I), LAK cells, induced by interleukin-2 (IL-2) in vitro, transfusion therapy, (group II), bacille Calmette-Guerin (BCG) combined with persatin (group III) in chronic hepatitis B and the mechanism of their effects, we observed 286 patients with chronic hepatitis B, diagnosed according to the criteria made by The 6th National Meeting for Viral Hepatitis and Substantiated by the results of liver biopsy. The patients were divided into 3 treatment groups randomly, with interferon 3 MIU, thrice a week and 10% glucose 500 ml (i.v.) dripping everyday as two different control groups. The ALT recovery rates in group I, II, III were 64%, 35% and 57%, respectively. At the end of the treatment, the HBeAg and HBV DNA clearence rates in group I, II, III were 43% and 44%, 34% and 30%, 57% and 61%, respectively. After one year of follow up, the HBeAg and HBV DNA clearence rates in group I, II, III were 59%, 58%, 61% and 55%, 70%, 60%, respectively. The effects of these kinds of treatment were similar to these of interferon. We also injected Zhuling polysaccharides combined with hepatitis B vaccine, Zhuling polysaccharides alone and normal saline as control to DHBV vertical transmission duck. It was shown that serum DHBV DNA was cleared and the results were also proved by liver histologic change in the two treatment groups. According to these data, it is suggested that the three kinds of treatment for hepatitis B could restore the ALT level, suppress the replication of HBV and improve the liver histologic change. Their effects were similar to those of interferon.