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目的观察中医疏肝健脾方联合α干扰素(IFN-α)治疗慢性乙型肝炎患者的疗效。方法 180例经肝组织活检证实的HBe Ag阳性慢性乙型肝炎患者被分成两组,每组90例。给予90例患者IFNα-1b联合中医疏肝健脾方(柴胡6 g、枳壳6 g、郁金10 g、白芍10 g、茯苓10 g、白术10 g、陈皮6 g、黄连5 g、甘草3 g)治疗,煎服中药3个月;另90例接受IFN-α单药治疗。两组干扰素的疗程个体化,即6~12个月,直至达到完全应答或治疗无效而退出。在治疗结束后随访12个月。结果联合治疗组在治疗结束时,血清ALT和HBV DNA水平分别为(97.6±54.7)U/L和(2.6±1.7)lg IU/ml,在随访48 w时分别为(107±62.2)U/L和(2.8±1.9)lg IU/ml,均显著优于IFN-α治疗组[分别为(95.7±52.3)U/L和(4.9±1.9)lg IU/ml,及(135.6±69.8)U/L和(5.4±1.9)lg IU/ml,P<0.05];联合治疗组骨髓移植发生率为38.9%,显著低于干扰素治疗组的58.9%(P<0.05)。结论疏肝健脾方联合IFN-α比IFN-α单药治疗能提高HBe Ag阳性慢性乙型肝炎患者的临床疗效,明显减少副作用。
Objective To observe the curative effect of Shuganjianpi Recipe combined with interferon-α (IFN-α) on chronic hepatitis B patients. Methods 180 patients with HBeAg-positive chronic hepatitis B confirmed by liver biopsy were divided into two groups, 90 cases in each group. 90 patients were given IFNα-1b combined with Chinese medicine Shuganjianpi (Bupleurum 6 g, Citrus aurantium 6 g, turmeric 10 g, white peony root 10 g, Poria 10 g, Atractylodes 10 g, dried tangerine peel 6 g, berberine 5 g , Licorice 3 g) treatment, decoction of traditional Chinese medicine 3 months; the other 90 patients received IFN-α monotherapy. Interferon treatment of two groups of individualized, that is 6 to 12 months, until the complete response or withdrawal of treatment ineffective. Followed up for 12 months after the end of treatment. Results At the end of treatment, serum ALT and HBV DNA levels in the combined treatment group were (97.6 ± 54.7) U / L and (2.6 ± 1.7) lg IU / ml, respectively, and were 107 ± 62.2 U / L and (2.8 ± 1.9) lg IU / ml were significantly better than IFN-α treatment group (95.7 ± 52.3 U / L and 4.9 ± 1.9 Ig IU / ml, and 135.6 ± 69.8 U / L and (5.4 ± 1.9) lg IU / ml respectively, P <0.05]. The incidence of bone marrow transplantation in combination therapy group was 38.9%, which was significantly lower than that in interferon therapy group (58.9%, P <0.05). Conclusion Shuganjianpi combined with IFN-α than IFN-α monotherapy can improve the clinical efficacy of HBeAg-positive chronic hepatitis B patients and significantly reduce the side effects.