基于“肾虚伏邪”理论论治HBeAg阳性慢性无症状乙型肝炎病毒携带者的临床观察  

Randomized,Controlled Clinical Study about Treaing HBeAg Positive Chronic Asymptomatic Hepatitis B Virus Carriers Based on ‘Kidney Deficiency Fuxie'Theory

作　　者：张传涛[1] 扈晓宇[1] 周道杰[2] 范昕建[2] 吴疆[3] 王德莉[4] 

机构地区：[1]成都中医药大学附属医院,成都610072 [2]成都中医药大学,成都610072 [3]成都中医药大学第二附属医院,成都610041 [4]广元市中医院,四川广元628000

出　　处：《中国实验方剂学杂志》2014年第3期175-179,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(81202624;81102720;81072902);教育部重点项目(20120150);成都中医药大学科技发展基金项目(2012005)

摘　　要：目的:研究"肾虚伏邪"理论论治乙肝病毒e抗原(HBeAg)阳性慢性无症状乙型肝炎病毒携带者抗病毒疗效。方法:在"肾虚伏邪"理论指导下拟定中药复方温透解方。采用随机、对照方法,60例HBeAg阳性慢性无症状乙型肝炎病毒携带者随机分为治疗组35例、对照组25例,治疗组采用温补透解方治疗,对照组不给予任何药物,分别在治疗前、24,48周时采血检测肝功、乙肝病毒脱氧核糖核酸(HBVDNA)、乙肝标志物等指标,并观察血常规、尿常规、心电图等安全性指标变化。结果:24,48周时温补透解方降低血清HBVDNA(下降≥2 log10)作用明显强于对照组(P<0.05,P<0.01),且具有时间依赖性(P<0.05),但仅在48周时温补透解方对HBVDNA转阴率高于对照组(P<0.05),未表现出时间依赖性。仅48周时治疗组HBeAg阴转率明显优于对照组,差异有统计学意义(P<0.05)。温补透解方可以升高外周血CD4+T细胞数量、降低CD8+T细胞数量(P<0.05),恢复T细胞亚群比例。肝功、肾功、心电图等未出现明显变化,该方具有较好安全性。结论:温补透解方临床治疗HBeAg阳性慢性无症状乙型肝炎病毒携带者有一定的抗病毒作用,且安全,中医"肾虚伏邪"理论论治HBeAg阳性慢性无症状乙型肝炎病毒携带者安全、可行,可能与升高CD4+T细胞、降低CD8+T细胞有关。Objective： To research the antiviral efficacy of ＇kidney deficiency Fuxie＇ theory on the treatment of hepatitis B virus e antigen （HBeAg） -positive chronic asymptomatic hepatitis B virus carriers. Method： Under the theoretical guidance of ＇ kidney deficiency Fuxie＇ , we developed the herbal compound Wenbu Toujie prescription. A randomized, control methods, 60 HBeAg-positive chronic asymptomatic hepatitis B virus carriers were randomly divided into a treatment group （35） and the control group （25）, the treatment group treated with Wenbu Toujie prescription, the control group was not given any medication, treatment for 48 weeks. Before treatment, 24 weeks, 48 weeks of treatment, collected blood to detect liver function, hepatitis B virus deoxyribonucleic acid （HBVDNA） and HBV markers respectively, and observed the changes of the blood, urine, ECG and other safety indicators. Result： When 24 weeks and 48 weeks, Wenbu Toujie prescription significantly stronger than the control group （P 〈0.05, P 〈0.01 ） in reducing serum of HBVDNA （ ≥21ogl0 decline）, with a time-dependent manner （P 〈 0.05）. Only when 48 weeks Wenbu Toujie prescription stronger than the control group （ P 〈 0.05 ） in the HBVDNA seroconversion rate, without a time-dependent manner （P 〈 0.05 ）. Only when 48 weeks, HBeAg seroconversion rate was significantly better than the control group, the difference was statistically significant （P 〈 0.05） , Wenbu Toujie prescription elevated peripheral blood CD4＋ T cell count, lowered CD8 ＋ T cell count （P 〈 0.05） , thereby restoring the proportion of T cell subsets. No significant changes in liver function, renal function, electrocardiogram, suggesting that the party has a good security. Conclusion： Wenbu Toujie prescription has antiviral activity in clinical treatment in HBeAg-positive chronic asymptomatic hepatitis B virus carriers, and safe, prompting the TCM ＇kidney deficiency Fuxie＇ theory is feasible and safe on the treatment of

关 键 词：肾虚伏邪 慢性无症状乙型肝炎病毒携带者 温补诱解方 

分 类 号：R287.5[医药卫生—中药学]