强肾愈肝汤联合恩替卡韦治疗慢性乙型肝炎40例  

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

作　　者：孙良秀 吴晶 蒋荆萍 周忠文 

机构地区：[1]毕节市中医院,贵州毕节551700

出　　处：《中国实验方剂学杂志》2013年第22期287-290,共4页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家中医药管理局"十一五"重点专科(专病)项目(24J2X1L103K107)

摘　　要：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。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 reco

关 键 词：慢性乙型肝炎 自拟强肾愈肝汤 恩替卡韦 白介素-12 白介素-21 

分 类 号：R287[医药卫生—中药学]