加味八珍汤改善聚乙二醇干扰素α-2b相关白细胞减少的临床观察OA

Objective To investigate the therapeutic effect of Modified Bazhen Decoction on leukopenia and clinical symptoms induced by pegylated interferon alpha-2b(PEG-IFN α-2b,hereinafter referred to as interferon)in the treatment of chronic hepatitis B(CHB).Methods A total of 76 CHB patients of qi and blood deficiency type who developed leukopenia after interferon treatment at the Department of Hepatology,Bao'an Traditional Chinese Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine(Shenzhen Bao'an Traditional Chinese Medicine Hospital)from July 1,2023 to May 30,2025 were enrolled.According to the treatment protocol,76 patients were divided into an trial group(39 cases)and a control group(37 cases).The control group received nucleos(t)ide analogues and batilol combined with interferon treatment,while the trial group received Modified Bazhen Decoction in addition to the control group's regimen.Both groups were treated for 8 weeks.Changes in blood routine parameters[white blood cell count(WBC),neutrophil count(NE),and platelet count(PLT)],hepatitis B surface antigen(HBsAg)levels,chronic liver disease questionnaire(CLDQ)scores,and traditional Chinese medicine(TCM)syndrome scores were compared between the two groups before and after treatment.Adverse events during treatment were observed,and the efficacy of leukopenia improvement and medication safety were evaluated.Results(1)Regarding dropout,4 patients in the trial group and 2 patients in the control group were excluded due to missing primary data during the study,resulting in 70 patients finally included,with 35 cases in each group.(2)In terms of leukopenia improvement efficacy,after 8 weeks of treatment,the total effective rate in the trial group was 57.14%(20/35),significantly higher than 34.43%(11/35)in the control group(by chi-square test,P＜0.05).(3)Regarding blood routine parameters,after treatment,WBC and NE levels in both groups and PLT levels in the trial group were significantly increased compared with before treatment(P＜0.05),while PLT levels in the control group showed no statistically significant difference before and after treatment(P＞0.05).Intergroup comparison after treatment showed that the trial group had significantly greater increases in WBC and PLT levels than the control group(P＜0.05).(4)Regarding HBsAg levels,after treatment,serum HBsAg levels in both groups were significantly decreased compared with before treatment(P＜0.05),but there was no statistically significant difference between the two groups(P＞0.05).(5)Regarding CLDQ scores,after treatment,the trial group showed significant improvements in the scores of all six dimensions of the CLDQ scale,including abdominal symptoms,fatigue,systemic symptoms,activity,emotional function,and anxiety(P＜0.05),while the control group only showed improvement in anxiety scores(P＜0.05).Intergroup comparison after treatment demonstrated that the trial group had significantly greater improvements in the scores of all six dimensions of the CLDQ scale than the control group(P＜0.05).(6)Regarding TCM syndromes,after treatment,TCM syndrome scores in the trial group were significantly decreased compared with before treatment(P＜0.05),while no significant decrease was observed in the control group(P＞0.05).Intergroup comparison after treatment showed that the trial group had a significantly greater reduction in TCM syndrome scores than the control group(P＜0.05).(7)Regarding safety,during treatment,the frequency of gastrointestinal symptoms such as poor appetite and psychiatric symptoms such as anxiety and low mood in the trial group was significantly lower than that in the control group(P＜0.05).There were no significant differences between the two groups in rash,thyroid dysfunction,alopecia,or weight loss(P＞0.05).Conclusion Modified Bazhen Decoction can improve interferon-induced leukopenia and clinical symptoms in CHB patients,enhance patients'quality of life,and provide evidence-based medical evidence for the integrated traditional Chinese and western medicine treatment of CHB.