Study On The Relationship Between Traditional Chinese Medical Type Of Syndrome And Response To Interferon-alpha In Chronic Hepatitis B

Objective:To investigate the relationship between the effect of IFNαand treatment of traditional Chinese medicine(TCM) type of syndrome in chronic hepatitis B(CHB),trying to identify appropriate candidate for IFNαtherapy by means of the relationship in the future.Methods:Two hundred and six histologically proven RBeAg-positive CHB patients with inflammatory activity grade 2 or 3 were enrolled in this study from October,2006 to July, 2007 in Hepatology Unit,XiaMen Hospital of TCM.Of all the 206 patients,55 patients were classified as Moist-heat Accumulation type(group A),53 as Liver-depression and Spleen-asthenia type(group B),49 as Liver-kidney Yin Deficiency type(group C) and 49 as Blood Stasis in Collateral type(group D).All patients were treated with IFNα1b subcutaneously at a dose of 5 MU thrice weekly for 6 months.Patients were monitored monthly for serum alanine transaminase(ALT) activity,HBV DNA by a fluorescent-quantitative PCR with a detection limit of 10~3 copies/mL and HBeAg by an Abbott enzymimmunoassay kits(Abbott Laboratories,U.S.A.).Normalization of ALT,loss of HBeAg and undetectable HBV DNA all three treatment end-points together was considered as combined response,any one or two as partial response and non-response should be defined if none of the treatment end-points mentioned above was achieved.An intention-to-treat analysis was used in this paper in which all the 206 patients were included.Results:1.All the four groups had similar demography and baseline characteristics including gender,age,serum ALT and HBV DNA levels.One in group A and one in group C, respectively,dropped-out due to adverse effects of IFNαwho were classified as non-response. As a result,combined response was achieved in 23(41.8%) in group A,in 20(37.7%) in group B,in 10(20.4%) in group C and in 8(16.3%) in group D,respectively.There was very significant difference in the response status constituent ratio and overall situation of each TCM type of syndrome(P＜0.01).2.The data were analyzed statistically between two of four TCM types of syndrome and from inflammatory activity grade 2 or 3:both of the response of IFNαin group A and group B were better than group C and group D(P＜0.01);but there were no statistical difference between group A and group B as well as between group C and group D(P＞0.05).Conclusion:The results of this study was that both of group A and group B were better than group C or group D.It indicated that the initial TCM types of syndrome may offer a reference index to the effect of IFNαin HBeAg-positive CHB patients.