慢性乙型肝炎干扰素α治疗相关不良反应的研究进展与管理策略

Research Progress and Management Strategies for Adverse Reactions Associated with Interferon Alpha Therapy for Chronic Hepatitis B

摘要: 慢性乙型病毒性肝炎是全球流行的重大公共卫生问题(后续慢性乙型病毒性肝炎简称CHB)。中国作为CHB的高发国家之一，自1992年将乙肝疫苗纳入新生儿免疫规划后，HBV传播得到有效控制，但由于人口基数庞大，感染形式仍较为严峻。目前CHB治疗以抗病毒治疗为主、保肝治疗为辅，其中抗病毒治疗主要分为核苷类似物(NAs)治疗和干扰素(IFN)治疗。干扰素α的临床疗效已得到全球学界认可，但治疗过程中伴随的各类副作用严重影响患者治疗依从性及生活质量，甚至限制其临床应用。本文系统综述了现阶段干扰素α治疗CHB的常见副作用、发生特点，分析了副作用的影响因素，结合中医理论探讨其发病机制，系统阐述中西医结合治疗优势，并提出针对性优化治疗策略，为临床规范管理干扰素治疗副作用、改善患者预后提供理论依据与实践参考。

Abstract: Chronic hepatitis B is a major public health problem worldwide (referred to as CHB in the following text). As one of the countries with a high incidence of CHB, China has effectively controlled the spread of HBV since 1992 when the hepatitis B vaccine was included in the newborn immunization program. However, due to the large population base, the infection situation remains rather severe. Currently, the treatment of CHB mainly focuses on antiviral therapy and liver-protective therapy. Antiviral therapy is mainly divided into nucleoside analogues (NAs) therapy and interferon (IFN) therapy. The clinical efficacy of interferon α has been recognized by the global academic community, but the various side effects accompanying the treatment seriously affect the treatment compliance and quality of life of patients, and even limit its clinical application. This article systematically reviews the common side effects and occurrence characteristics of interferon α treatment for CHB, analyzes the influencing factors of the side effects, combines traditional Chinese medicine theory to explore the pathogenesis, systematically elaborates the advantages of integrated traditional Chinese and Western medicine treatment, and proposes targeted optimization treatment strategies, providing theoretical basis and practical reference for the clinical standardized management of side effects of interferon treatment and improving patient prognosis.