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目的观察芪参二莲汤联合恩替卡韦治疗慢性乙型病毒性肝炎的临床疗效。方法将62例慢性乙型病毒性肝炎患者随机分为治疗组(32例)和对照组(30例)。对照组予恩替卡韦片,治疗组在对照组治疗措施基础上加服芪参二莲汤。两组疗程均为1年,随访6个月。观察病毒应答(早期EVR、结束时ETVVR、持续SVR)疗效,比较e抗原转阴率、肝功能(ALT、AST、TBIL)及血清IL-4、IFN-γ水平的变化情况。结果 1治疗组、对照组EVR分别为68.75%、33.33%,差异有统计学意义(P<0.05);ETVR分别为78.13%、50.00%,两组差异有统计学意义(P<0.05);SVR分别为71.88%、36.67%,两组差异有统计学意义(P<0.05)。2治疗后两组比较,e抗原转阴率差异有统计学意义(P<0.05);随访至6个月时两组比较,e抗原转阴率差异有统计学意义(P<0.05)。3治疗前后组内比较,两组AST、ALT、TBIL水平差异有统计学意义(P<0.05);组间治疗后比较,AST、ALT、TBIL水平差异无统计学意义(P>0.05)。4治疗前后组内比较,两组IL-4、IFN-γ水平差异有统计学意义(P<0.05);组间治疗后比较,IL-4、IFN-γ水平差异有统计学意义(P<0.05);组间随访至6个月时比较,IL-4、IFN-γ水平差异有统计学意义(P<0.05)。结论芪参二莲汤联合恩替卡韦治疗慢性乙型病毒性肝炎,可显著抑制HBV-DNA的复制,同时可通过调节IFN-γ与IL-4的平衡,提高机体免疫力。
Objective To observe the curative effect of Qishen Erlian Decoction combined with entecavir in the treatment of chronic hepatitis B virus. Methods Sixty-two patients with chronic hepatitis B were randomly divided into treatment group (32 cases) and control group (30 cases). The control group was given entecavir tablets, and the treatment group added Qishenlianlian decoction on the basis of the control group. The two courses of treatment were 1 year, followed up for 6 months. The effect of viral response (early EVR, end of ETVVR, continuous SVR) was observed. The e antigen negative conversion rate, liver function (ALT, AST, TBIL) and serum IL-4 and IFN-γ levels were compared. Results The EVR of the treatment group and the control group were 68.75% and 33.33%, respectively, with significant difference (P <0.05); the ETVR was 78.13% and 50.00% respectively, with significant difference between the two groups (P <0.05) Respectively, 71.88%, 36.67%, the difference between the two groups was statistically significant (P <0.05). 2 After treatment, the difference of e antigen negative rate was statistically significant (P <0.05). The difference of e antigen negative rate was statistically significant (P <0.05) between the two groups at follow-up to 6 months. There were significant differences in AST, ALT and TBIL levels between the two groups before and after treatment (P <0.05). There was no significant difference in the levels of AST, ALT and TBIL between the two groups after treatment (P> 0.05). The levels of IL-4 and IFN-γ in the two groups were significantly different between before and after treatment (P <0.05). There were significant differences in the levels of IL-4 and IFN-γ between the two groups after treatment (P < 0.05). There were significant differences in IL-4 and IFN-γ levels between the two groups at follow-up of 6 months (P <0.05). Conclusion Treatment of chronic hepatitis B with Qidenglianlian and entecavir can significantly inhibit the replication of HBV-DNA and improve the body immunity by regulating the balance of IFN-γ and IL-4.