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目的研究逍遥散联合α干扰素(interferon-alpha,IFN-α)治疗HBeAg阳性慢性乙型肝炎疗效及对生活质量的影响。方法 193例经肝穿刺活检证实的HBeAg阳性慢性乙型肝炎患者,按照随机数字表法分为单药治疗组(94例)和联合治疗组(99例),单药治疗组给予IFN-α1b,50μg/次,皮下注射,每周3次;联合治疗组在单药治疗组的基础上,配伍逍遥散口服,两组疗程均为24周。通过评价两组ALT复常率、HBeAg阴转率、HBeAg转换率、HBV DNA阴转率、完全应答率、部分应答率以及症状积分变化等观察逍遥散联合IFN-α疗效;采用慢性肝病问卷(chronic liver disease questionnaire,CLDQ)评分进行生活质量评定;观察两组患者的不良反应发生率。结果联合治疗组在ALT复常率、HBeAg阴转率、HBV DNA阴转率、完全应答率、部分应答率、中医症状积分、中医症状总有效率、CLDQ评分和不良反应发生率方面均优于单药治疗组(P<0.05,P<0.01)。结论逍遥散可提高IFN-α治疗HBeAg阳性慢性乙型肝炎的中医症状疗效、抗病毒疗效,改善生活质量,减少IFN-α不良反应。
Objective To study the effect of interferon-alpha (IFN-α) in treating HBeAg-positive chronic hepatitis B and its effect on quality of life. Methods A total of 193 patients with HBeAg-positive chronic hepatitis B confirmed by liver biopsy were divided into monotherapy group (n = 94) and combination therapy group (n = 99) according to random number table. IFN-α1b, 50μg / time, subcutaneous injection, 3 times a week; combination therapy group in the monotherapy group on the basis of compatibility Xiaoyao San oral treatment, the two groups were 24 weeks treatment. The effect of Xiaoyaosan combined with IFN-α was observed by evaluating the ALT normalization rate, HBeAg negative conversion rate, HBeAg conversion rate, HBV DNA negative conversion rate, complete response rate, partial response rate and symptom score changes. The chronic liver disease questionnaire chronic liver disease questionnaire (CLDQ) score for quality of life assessment; adverse reactions were observed in two groups of patients. Results The combined treatment group was superior to the normal ALT normalization rate, HBeAg negative conversion rate, HBV DNA negative conversion rate, complete response rate, partial response rate, TCM symptom score, TCM symptom total efficiency, CLDQ score and adverse reaction rate Monotherapy group (P <0.05, P <0.01). Conclusion Xiaoyao powder can improve the TCM symptoms and curative effect of IFN-α in treating HBeAg-positive chronic hepatitis B, antiviral effect, improve the quality of life, and reduce the adverse reaction of IFN-α.