中西医结合治疗慢性乙型肝炎对肝纤维化和免疫功能的影响  

Effect of Combination of Traditional Chinese and Western Medicine on Liver Fibrosis and Immune Function in the Treatment of Chronic Hepatitis B

作　　者：高爱华[1] 王新丽[1] 孙艳芹 姜清河 刘霞 张梅 张凤朝[1] GAO Ai-hua;WANG Xin-li;SUN Yan-qin;JIANG Qing-he;LIU Xia;ZHANG Mei;ZHANG Feng-chao(Department of Hepatology,Infectious Disease Hospital of Cangzhou,Cangzhou,Hebei 061001,China;Department of Customer Service,Infectious Disease Hospital of Cangzhou,Cangzhou,Hebei 061001,China;Department of Tuberculosis,Infectious Disease Hospital of Cangzhou,Cangzhou,Hebei 061001,China)

机构地区：[1]沧州市传染病医院肝病科,河北沧州061001 [2]沧州市传染病医院客户服务部,河北沧州061001 [3]沧州市传染病医院结核科,河北沧州061001

出　　处：《解放军医药杂志》2020年第5期66-68,77,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河北省中医药管理局基金项目(2019310)。

摘　　要：目的观察中西医结合治疗慢性乙型肝炎对肝纤维化和免疫功能的影响。方法选择2017年3月-2019年3月我院收治的首诊慢性乙型肝炎患者130例。按治疗方法分为对照组和观察组,每组65例。2组均给予常规保肝治疗;对照组给予恩替卡韦口服,观察组在对照组基础上加用中药肝苏片。治疗4个月后,比较2组免疫功能、肝纤维化程度和不良反应发生情况。结果与治疗前相比,2组治疗后白介素-12和白介素-18、CD4+、CD4+/CD8+值升高,且观察组上述指标高于对照组(P<0.05)。2组治疗后CD8+值、血清Ⅳ型胶原、Ⅲ型前胶原、层黏连蛋白、透明质酸、转化生长因子β1均较治疗前降低,且观察组上述指标均低于对照组(P<0.05)。2组均未发生严重药物不良反应。结论中西医结合治疗慢性乙型肝炎能有效抑制慢性乙型肝炎患者肝纤维化进程,可增加机体免疫能力及抗病毒疗效。Objective To observe the effect of combination of Traditional Chinese and Western Medicine on liver fibrosis and immune function of patients with chronic hepatitis B(CHB). Methods From March 2017 to March 2019, 130 patients with CHB were selected. According to different treatment methods, the patients were divided into control group and observation group, with 65 cases in each group. Two groups were given conventional and liver protection treatment. The control group was given oral Entecavir, while the observation group was given Gansu tablet on the basis of the control group. After 4 months of treatment, the immune function, liver fibrosis and adverse reactions were compared between the two groups. Results After treatment, the levels of Interleukin-12, Interleukin-18, CD4+, CD4+/CD8+ were increased, which were higher in the observation group than in the control group(P<0.05). The levels of CD8+, serum type Ⅳ collagen, type Ⅲ procollagen, laminin, hyaluronic acid, and transforming growth factor β1 in both groups were lower than those before treatment, and the above levels were lower in the observation group than in the control group(P<0.05). No serious adverse drug reactions occurred in the two groups. Conclusion The combination of traditional Chinese and Western medicine in the treatment of CHB can effectively inhibit the progress of liver fibrosis in patients with CHB, increase the immunity of the body and enhance the antiviral effect.

关 键 词：乙型肝炎 慢性 恩替卡韦 肝苏片 白介素-12 白介素-18 转化生长因子Β1 层黏连蛋白 透明质酸 

分 类 号：R512.62[医药卫生—内科学]