中西医结合治疗慢性乙型肝炎68例临床观察

目的:观察中医辨证联合干扰素-(IFN-)治疗HBeAg阳性慢性乙型肝炎的疗效和安全性。方法:将137例HBeAg阳性慢性乙型肝炎患者按前瞻性队列研究方法分为中医辨证联合IFN-治疗组、IFN-对照组。结果:治疗48周,治疗组和对照组ALT复常率分别为54.8%和42.7%(P>0.05),HBV-DNA低于检测值下限患者比例分别为47.06%和34.78%(P>0.05);HBeAg阴转率分别为50.0%和34.8%(P>0.05);HBeAg血清学转换率分别为50.0%和30.4%(P<0.05);两组患者不良事件的发生率基本相似,但乏力、食欲下降发生率治疗组和对照组分别为15.5%和28.9%(P<0.05)。结论:中医辨证联合IFN-治疗能提高HBeAg阳性慢性乙型肝炎患者的HBeAg血清学转换率,且能改善IFN-所致乏力、食欲下降等不良反应。

Clinical Observation of Integrated Chinese and Western Medines on 68 Cases of Chronic Hepatitis

Objective: To observe the efficacy and safety of the TCM differentiation treatment combined with IFN-for chronic hepatitis B with HBeAg-positive.Methods: According to the method of the prospective cohort study,137 patients with the disease were divided into TCM combined with IFN-treatment group and IFN-control group.Results: After 48 weeks of treatment in both treatment and control group,the normalization rates of ALT were 54.8% and 42.7%respectively(P>0.05);the patients proportion of HBV-DNA below the detection value were 47.06% and 34.78% respectively(P>0.05);the HBeAg negative conversion rates were 50.0% and 34.8% respectively(P>0.05);and the HBeAg seroconversion rates were 50.0% and 30.4% respectively(P<0.05).The incidence of adverse events in both groups were similar,but the incidence of fatigue and decreased appetite were 15.5% and 28.9% respectively(P<0.05).Conclusion: The therapy of differentiation in TCM combined with IFN-can increase HBeAg seroconversion rate of the chronic hepatitis B patients with HBeAg-positive and improve IFN-induced fatigue,decreased appetite and other adverse reactions.