摘要
目的:观察护肝抑毒系列方治疗慢性乙型肝炎(CHB)免疫耐受期及免疫清除期患者的临床疗效。方法:免疫耐受期:治疗组684例口服护肝抑毒Ⅰ号方激活免疫耐受,待ALT>正常值上限5～10倍(<20倍)后改用护肝抑毒Ⅱ号方;对照组326例口服香菇菌多糖片及叶下珠胶囊。免疫清除期:治疗组[免疫耐受期患者经上述治疗后肝功能未复常,乙肝病毒标志物(HBV-M)未阴转者]282例口服护肝抑毒Ⅲ号方;对照组(免疫耐受期对照组中未显效者及新增病例)228例口服双虎清肝颗粒。免疫耐受期及免疫清除期病例治疗均3个月为1个疗程,连续观察6个疗程,疗程结束后治疗组中完全应答者随访1年。观察患者症状、体征、肝功能及HBV-M的变化。结果:免疫耐受期治疗中不同时段ALT上升率治疗组明显高于对照组(P<0.05或P<0.01)。两组患者治疗前后血清HBV-M变化比较差异有显著性意义(P<0.01)。免疫耐受期治疗组中完全应答者经1年随访,持久应答率稳定(P>0.05)。免疫清除期两组患者治疗前后肝功能变化差异有显著性意义(P<0.05或P<0.01)。两组患者治疗后血清HBV-M阴转率比较差异有显著性意义(P<0.05或P<0.01)。免疫清除期治疗组完全应答者经1年随访,持久应答率稳定(P>0.05),应答率明显高于免疫耐受期(P<0.05),但持久应答率两组相近,差异无统计学意义(P>0.05)。结论:护肝抑毒Ⅰ号方能有效激活CHB患者的免疫耐受,护肝抑毒Ⅱ、Ⅲ号方可显著抑制HBV复制,使HBV-M阴转率明显提高,并可达到较好的持久应答效果。
Objective： To observe clinical effects of a series of Protecting Liver ＆ Inhibiting Virus decoction （PLIVD） on patients with CHB in the term of immunologic tolerance and elimination. Methods： Immunological tolerance period ： 684 patients of treatment group received PLIVD Ⅰ to activate immunologic tolerance, one time a day, after ALT 〉 5 - 10 times of upper limit of natural numeric （limited 〈 20 times）, the patients received PLIVD Ⅱ, and the patients of control group received Xianggujun Duotang troche, at the same time, the patients received Yexiazhu capsule. Immunologic elimination period： 282 patients of treatment group （ the patient whose liver function was not natural and whose HBV sign was not still aherative after immunological tolerance period were treated） received PLIVD m; 228 patients of control group （the patient whose therapeutic effects was not notable and was new） received Shuanghuqinggan granule. The 3 months were one course of treatment after the patients of immunological tolerance period and immunologic climination period were treated, they were observed for 6 courses of treatment, the patients of complete response in immunological tolerance period and immunologic elimination period will all be visited for one year after one course of treatment was over. It will be observed that patient＇s clinical symptom, body character, main index of liver function, and the variety of HBV index. Results： The ALT ascending ratio of treatment group at different time was higher than control group obviously during they were treated （ P 〈 0. 05, P 〈 0. 01 ） . The change of HBV marks at two groups of immunological tolerance phase was compared before and after treatment, the complete response ratio of treatment group and the ratio of control group had very obviously difference （P 〈 0. 01 ） . The patients whose HBV marks had been complete responsive were visitey for one year in treatment group of immunological tolerance phase, the ratio of sustaining response was stable （P 〉 0. 05 ） . The variety of the main index of liver function was different obviousely in two group of immunologic elimination phase before and ＇after treatment （P 〈 0. 05, P 〈 0. 01 ） . The variety ratio of HBV mark was different was obviously （P 〈 0. 05, P 〈 0. 01 ） . We compared HBV marks with itself after the patients who were complete responsive and were visited for one year in treatment group of group B, and the ratio of sustaining response was stable （P 〉 0. 05） . We compared immunological tolerance phase with immunologic ehmination phase on the ratio of complete response, the ratio of complete response of immunologic elimination phase was higher than the ratio of complete response of immunological tolerance phase obviously （ P 〈 0. 05 ）, and the ratio of sustaining response of two phase were respective percentage, and had no statistic difference （ P 〉 0. 05 ） . Conclusion ： PLIVD Ⅰ can effectively activate the immunologic tolerance of patients, and PLIVD Ⅱ ＆ Ⅲ can obviously inhibit HBV replication to improve the variety ration of HBV marks evidently, and they can achieve well effect of sustaining response.
出处
《中西医结合肝病杂志》
CAS
2009年第6期323-326,330,共5页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
基金
新疆兵团自然科学基金资助(No.NKB02SDXNK33XY)
关键词
肝炎
乙型
慢性
免疫耐受期
免疫清除期
病毒载量
护肝抑毒方/治疗观察
病例对照研究
hepatitis B
chronic
immune tolerance phase
immune clearance phase
HBV DNA load
Protecting Liver ＆amp
Inhibiting Virus decoction/treatment observation
case-control study
