摘要目的：观察慢性乙型肝炎（CHB）患者接受聚乙二醇干扰素α-2a（PEG-IFNα-2a）治疗后舌脉象参数的变化，探讨其在 PEG-IFNα-2a 治疗慢性乙型肝炎临床疗效评价中的价值。方法选择符合入组标准的CHB 患者120例，接受 PEG-IFNα-2a 抗病毒治疗48周，并随访24周。应用 DS01-A 型舌脉象数字分析仪检测患者舌脉象参数，对治疗前后肝功能、HBV 血清学指标、HBV DNA、舌脉象参数[重搏前波幅度／主波幅度（h3／h1），降中峡幅度／主波幅度（h4／h1），重搏波幅度／主波幅度（h5／h1），W／t 对应于主动脉压力升高的持续时间]等指标的变化进行观察。结果完成48周疗程，停药后24周进行疗效分析。113例患者完成疗程，其中应答46例（应答率40．7％）。各中医证型中，肝郁脾虚组应答率高于瘀血阻络组（95％CI：0．010～0．677，P ＜0．05）。应答组与无应答组之间基线舌脉象参数比较差异均无统计学意义（h3／h1，t ＝1．799，P ＝0．074；h4／h1， t ＝1．383，P ＝0．169；h5／h1，t′＝0．461，P ＞0．05；W／t，t′＝0．688，P ＞0．05；R，t ＝1．317，P ＝0．190；G，t ＝0．346， P ＝0．729；B，t ＝1．720，P ＝0．088）。完成48周疗程，停药后24周检测舌脉象参数，应答组与无应答组的舌脉象参数与同组基线比较，h3／h1、h4／h1下降，R 值、G 值升高，差异均有统计学意义（应答组 h3／h1，t ＝3．004， P ＝0．003；h4／h1，t ＝2．702，P ＝0．008；R，t′＝2．258，P ＜0．05；G，t′＝3．052，P ＜0．05。非应答组 h3／h1，t ＝1．978，P ＝0．049；h4／h1，t ＝2．487，P ＝0．014；R，t′＝2．661，P ＜0．05；G，t′＝2．318，P ＜0．05），但停药后24周，应答组与无应答组之间的舌脉象参数比较差异无统计学意义（h3／h1，t′＝0．191，P ＞0．05；h4／h1，t ＝0．390， P ＝0．697；h5／h1，t′＝0．957，P ＞0．05；W／t，t ＝0．149，P ＝0．881；R，t ＝1．343，P ＝0．181；G，t ＝0．994，P ＝0．322；B，t ＝0．565，P ＝0．572）。结论CHB 患者接受 PEG-IFNα治疗后舌脉象参数变化有改善趋势，但其预测 PEG-IFNα抗病毒疗效的价值可能有限。

abstractsObjective To observe the changes of tongue and pulse parameters in the patients with chronic hepatitis B(CHB)after pegylated interferon alpha-2a(PEG-IFNα-2a)treatment,to investigate its value in evaluation clinical efficacy of PEG-IFNα-2a treatment.Methods 120 patients with CHB who confirmed to the standard received PEG-IFNα-2a antiviral therapy for 48 weeks,and followed up for 24 weeks.The tongue and pulse parameters were detected by DS01-A type digital tongue and pulse presentation analyzer.The changes of liver function,serum HBV markers,HBV DNA,tongue and pulse parameters were observed before and after treatment.Results 113 patients completed the course of treatment,46 cases received complete response(response rate 40.7%).The response rate of liver stagnation and spleen deficiency group was higher than that of blood stasis group(95%CI:0.010-0.677,P <0.05).The baseline of tongue and pulse parameters had no significant difference between response group and non response group(h3 /h1,t =1.799,P =0.074;h4 /h1,t =1.383,P =0.169;h5 /h1,t′=0.461,P >0.05;W/t,t′=0.688,P >0.05;R,t =1.317,P =0.190;G,t =0.346,P =0.729;B,t =1.720,P =0.088).After 48 weeks treat-ment,and followed up for 24 weeks,the tongue and pulse parameters of response group and non response group were&nbsp;compared with baseline,h3 /h1,h4 /h1 decreased,R value and G value increased,the differences were statistically sig-nificant(Response group:h3 /h1,t =3.004,P =0.003;h4 /h1,t =2.702,P =0.008;R,t′=2.258,P <0.05;G,t′=3.052,P <0.05.Non response group:h3 /h1,t =1.978,P =0.049;h4 /h1,t =2.487,P =0.014;R,t′=2.661,P <0.05;G,t′=2.318,P <0.05).But there were no significant differences between the response group and no response group after treatment(h3 /h1,t′=0.191,P >0.05;h4 /h1,t =0.390,P =0.697 2;h5 /h1,t′=0.957,P >0.05;W/t,t =0.149,P =0.881;R,t =1.343,P =0.181;G,t =0.994,P =0.322;B,t =0.565,P =0.572).Conclusion The changes of tongue and pulse parameters have improved after treatment with PEG-IFNαin patients with CHB. However,the value in predicting the efficacy of antiviral therapy may be limited.