替比夫定联合补肾方治疗HBeAg阳性慢性乙型肝炎临床观察

发布时间：2018-04-19 00:24

本文选题：慢性乙型肝炎 + @补肾方　；参考：《湖北中医药大学》2014年硕士论文

【摘要】：目的：观察替比夫定联合补肾方治疗HBeAg阳性慢性乙型肝炎的疗效，为临床实践提供有益的参考。方法：本研究所选取的70病例均来源于2012年6月至2013年12月在湖北省中医院肝病科门诊治疗的HBeAg阳性慢性乙型肝炎患者（诊断符合《慢性乙型肝炎防治指南(2010年版)》），按照随机分配原则，，分为治疗组和对照组各35例。两组患者均给予替比夫定片(商品名素比伏，北京诺华制药有限公司生产)口服，每次600mg，每日一次，治疗时间为24周。治疗组同时予以中药补肾方，药物组成及用量为：肉桂6g、熟地黄20g、牡丹皮20g、生黄芪20g，采用中药配方颗粒剂(深圳市三九现代中药有限公司生产)，每日一剂，开水冲服，分两次口服。在实验第0、12、24周，检测HBV-DNA、HBV-M、肝功能、AFP、肝胆脾彩超及相关安全性指标并对结果进行统计学处理。结果：治疗总体疗效方面，治疗组、对照组治疗前后组内比较有统计学差异(P 0.05)。治疗组治疗12周和24周的总有效率分别为42.87%和85.71%高于对照组的34.29%和71.43%，无统计学差异(P0.05)。将治疗组与对照组进行组内比较治疗第0和12周、第0和24周HBeAg定量结果，均有统计学差异(P 0.05)；组间比较治疗组和对照组治疗第12周HBeAg定量结果有统计学差异(P0.05)，而比较第24周结果时无统计学差异(P0.05)。在HBV-DNA定量及阴转率、HBeAg阴转率、HBeAg血清学转换率、HBsAg定量及阴转率、肝功能等方面，治疗组与对照组进行组内比较，治疗第0和12周、第0和24周结果，均有统计学差异(P0.05)；组间比较治疗组和对照组治疗第12周和第24周结果，无统计学差异(P0.05)。结论：补肾中药联合替比夫定抗病毒的治疗HBeAg阳性慢性乙型肝炎,有助于在治疗早期促使HBeAg滴度下降，远期效果尚待进一步研究验证；对于总体疗效、HBV-DNA定量及阴转率、HBeAg阴转率、HBeAg血清学转换率、HBsAg阴转率的检测指标的改善上与单一西药治疗相比虽然在数值上呈现出优势，但无统计学差异。
[Abstract]:Objective: to observe the curative effect of tibivudine combined with tonifying kidney prescription in the treatment of HBeAg positive chronic hepatitis B, and to provide useful reference for clinical practice.Methods: from June 2012 to December 2013, 70 patients with HBeAg positive chronic hepatitis B were selected from the Department of Hepatology, Hubei Provincial Hospital of traditional Chinese Medicine. The diagnosis was in accordance with the guidelines for the Prevention and treatment of chronic Hepatitis B (2010).According to the principle of random distribution,The patients were divided into treatment group (35 cases) and control group (35 cases).Two groups of patients were given tibivudine tablets (commercial name of Subivot, Beijing Novartis Pharmaceutical Co., Ltd.) oral, 600 mg, once a day, treatment time is 24 weeks.The treatment group was also treated with traditional Chinese medicine Bushen recipe. The composition and dosage of the medicine were: cinnamon 6g, cooked Rehmannia 20g, peony 20g, ShengHuangqi 20g. The prescription granules of traditional Chinese medicine (Shenzhen Sanjiu Modern Chinese Medicine Co., Ltd.) were produced by Shenzhen Sanjiu Modern Chinese Medicine Co., Ltd., one dose a day, one dose per day, and one dose of boiled water.There are two oral doses.HBV-DNA was detected in HBV-DNA, liver function, liver function, liver, gallbladder and spleen color ultrasound and related safety indexes were detected in the 24th week of the experiment and the results were statistically analyzed.Results: there was significant difference in the total curative effect between the treatment group and the control group before and after treatment (P 0.05).The total effective rates in the treatment group were 42.87% and 85.71% at 12 and 24 weeks, respectively, which were higher than those in the control group (34.29% and 71.43%, respectively). There was no significant difference between the two groups (P 0.05).The quantitative results of HBeAg were compared between the treatment group and the control group at 0 and 12 weeks, 0 and 24 weeks after treatment.The quantitative results of HBeAg in the treatment group and the control group were significantly different at the 12th week of treatment (P 0.05), but there was no statistical difference between the two groups at the 24th week (P 0.05).The quantitative and negative conversion rate of HBV-DNA and the serological conversion rate of HBeAg in the treatment group were compared with those in the control group at the 0 and 12 weeks, the 0 and 24 weeks after treatment, and the quantitative and negative conversion rates of HBeAg and liver function were compared between the treatment group and the control group, and the results were compared between the treatment group and the control group at the 0 and 12 weeks and the 0 and 24 weeks after treatment.There was no statistical difference between the treatment group and the control group at the 12th week and the 24th week, there was no statistical difference between the treatment group and the control group at the 12th week and the 24th week, there was no statistical difference between the two groups (P 0.05).Conclusion: the combination of tonifying kidney Chinese medicine and tibivudine in the treatment of HBeAg positive chronic hepatitis B is helpful to promote the decrease of HBeAg titer in the early stage of treatment, and the long-term effect needs to be further studied and verified.The quantitative and negative conversion rate of HBV-DNA and HBeAg seroconversion rate of HBeAg seroconversion rate and HBsAg negative conversion rate were improved in comparison with western medicine alone, but there was no statistical difference between the two groups in the value of HBV-DNA and HBeAg negative conversion rate.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R512.62

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