长效干扰素（α-2a）联合无烟艾灸治疗慢性乙型肝炎的临床观察
发布时间：2018-08-05 18:30
【摘要】：目的：观察长效干扰素(α-2a)联合无烟艾灸治疗慢性乙型肝炎的临床疗效及其安全性,并与单独应用长效干扰素(α-2a)治疗慢性乙型肝炎进行比较。 方法：将符合入选标准的慢性乙型肝炎患者60例随机分为以下2组：长效干扰素(α-2a)组(对照组)30例和长效干扰素(α-2a)联合无烟艾灸组(治疗组)30例。两组患者分别于治疗前及治疗12周、24周、48周时进行肝功能（ALT）、HBeAg定性、HBV-DNA应答情况及血常规（外周血中性粒细胞计数）检测，并对检查结果进行分析比较。 结果： 一、两组患者治疗前后ALT的比较： 治疗前，治疗组、对照组间患者ALT均异常，比较无显著性差异（P0.05）；治疗12周时，治疗组及对照组患者ALT较治疗前明显下降（P0.05）；治疗24周时，治疗组患者ALT基本正常，与对照组比较有显著性差异（P0.05）；治疗48周时，治疗组与对照组患者ALT均正常，两组间比较无显著性差异（P0.05）。 二、两组患者治疗前后HBV-DNA应答情况的比较： 治疗前，治疗组、对照组间患者HBV-DNA定量均阳性，比较无显著性差异（P0.05）；治疗12周时，两组患者均无HBV-DNA阴转，比较无显著性意义（P0.05）；治疗24周时，两组患者均无HBV-DNA阴转，比较无显著性意义（P0.05）；治疗48周时，两组患者HBV-DNA转阴率比较差异无显著性意义（P0.05）,但两组患者HBV-DNA下降超过103IU/mL的比率分别为70.00%(21/30)和93.33%(28/30),差异有显著性意义(P0.05)。 三、两组患者治疗前后HBeAg阴转率的比较： 治疗前，治疗组、对照组间患者HBeAg均阳性；治疗12周时，治疗组及对照组患者均无HBeAg阴转；治疗24周时，部分治疗组患者HBeAg阴转，与对照组比较有显著性差异（P0.05）；治疗48周时，治疗组与对照组患者HBeAg阴转率分别为46.67%、23.33%，两组间比较有显著性差异（P0.05）。 四、不良反应： 1．两组患者治疗前后外周血中性粒细胞计数的比较： 治疗前，治疗组、对照组间患者外周血中性粒细胞计数均正常，比较无显著性差异（P0.05）；治疗12周时，治疗组及对照组患者外周血中性粒细胞数较治疗前明显下降（P0.05）；治疗24周时，治疗组患者外周血中性粒细胞计数上升，与对照组比较有显著性差异（P0.05）；治疗48周时，治疗组与对照组外周血中性粒细胞计数较24周时无显著性差异（P0.05）,两组患者外周血中性粒细胞计数比较差异有显著性意义（P0.05）。 2.除骨髓抑制外，，两组患者均未见发生严重不良反应：治疗组患者18例发热，对照组患者19例发热，2例失眠。患者不良反应发生率，两组间比较无显著性差异(P0.05)。 结论： 长效干扰素(α-2a)联合无烟艾灸治疗慢性乙型肝炎能更快促进肝功能恢复、抑制HBV-DNA复制、提高HBeAg转阴率、增强患者对干扰素骨髓抑制不良反应的耐受性，疗效优于单纯应用长效干扰素(α-2a)抗HBV治疗。
[Abstract]:Objective: to observe the clinical efficacy and safety of long-term interferon (伪 -2a) combined with smokeless moxibustion in the treatment of chronic hepatitis B (CHB), and to compare the efficacy and safety of long-term interferon (伪 -2a) alone in the treatment of chronic hepatitis B (CHB). Methods: sixty patients with chronic hepatitis B were randomly divided into the following two groups: the control group (30 cases) and the moxibustion group (30 cases) with long-term interferon (伪 -2a) combined with smokeless moxibustion (treatment group). The HBV-DNA response and blood routine (neutrophil count) of the patients with (ALT) and HBeAg were detected before treatment and after 12 weeks and 24 weeks and 48 weeks after treatment, and the results were analyzed and compared. Results: first, the comparison of ALT before and after treatment: before treatment, the ALT of patients in treatment group and control group were abnormal, there was no significant difference between them (P0.05); 12 weeks after treatment, The ALT of the treatment group and the control group was significantly lower than that of the control group (P0.05); after 24 weeks of treatment, the ALT of the treatment group was basically normal, which was significantly different from that of the control group (P0.05); at 48 weeks of treatment, the ALT of the treatment group and the control group were all normal. There was no significant difference between the two groups (P0.05). Two groups of patients before and after treatment of HBV-DNA response comparison: before treatment, the treatment group, the control group between patients with HBV-DNA quantitative positive, there was no significant difference (P0.05); 12 weeks after treatment, the two groups of patients have no negative HBV-DNA, There was no significant difference between the two groups (P0.05); after 24 weeks of treatment, there was no HBV-DNA negative change in both groups (P0.05); at 48 weeks of treatment, there was no significant change of HBV-DNA in both groups. There was no significant difference in HBV-DNA negative rate between the two groups (P0.05), but the rate of HBV-DNA decreasing over 103IU/mL was 70.00% (21 / 30) and 93.33% (28 / 30) in two groups (P0.05). Before and after treatment, the patients in the treatment group and the control group were all positive for HBeAg, the patients in the treatment group and the control group had no HBeAg negative conversion after 12 weeks of treatment, and the patients in the treatment group and the control group had no HBeAg negative conversion after 24 weeks of treatment. After 48 weeks of treatment, the negative conversion rate of HBeAg in the treatment group and the control group was 46.67 and 23.33, respectively. There was significant difference between the two groups (P0.05). Comparison of peripheral blood neutrophil count before and after treatment: before treatment, the neutrophil count in peripheral blood of patients in treatment group and control group were all normal. After 12 weeks of treatment, the number of peripheral blood neutrophils in the treatment group and control group decreased significantly (P0.05); after 24 weeks of treatment, the peripheral blood neutrophil count increased in the treatment group. There was a significant difference between the control group and the control group (P0.05), 48 weeks after treatment, There was no significant difference in neutrophil count between the treatment group and the control group at 24 weeks (P0.05), but there was significant difference in the peripheral blood neutrophil count between the two groups (P0.05). Except for bone marrow suppression, there were no serious adverse reactions in both groups: 18 cases of fever in the treatment group and 2 cases of insomnia in the control group. There was no significant difference in the incidence of adverse reactions between the two groups (P0.05). Conclusion: Long-term interferon (伪 -2a) combined with smokeless moxibustion in the treatment of chronic hepatitis B can accelerate the recovery of liver function, inhibit the replication of HBV-DNA, increase the negative rate of HBeAg, and enhance the patient's tolerance to the adverse reaction of interferon bone marrow inhibition. The therapeutic effect was better than that of long acting interferon (伪-2 a) alone in the treatment of HBV.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R512.62
本文编号：2166633
[Abstract]:Objective: to observe the clinical efficacy and safety of long-term interferon (伪 -2a) combined with smokeless moxibustion in the treatment of chronic hepatitis B (CHB), and to compare the efficacy and safety of long-term interferon (伪 -2a) alone in the treatment of chronic hepatitis B (CHB). Methods: sixty patients with chronic hepatitis B were randomly divided into the following two groups: the control group (30 cases) and the moxibustion group (30 cases) with long-term interferon (伪 -2a) combined with smokeless moxibustion (treatment group). The HBV-DNA response and blood routine (neutrophil count) of the patients with (ALT) and HBeAg were detected before treatment and after 12 weeks and 24 weeks and 48 weeks after treatment, and the results were analyzed and compared. Results: first, the comparison of ALT before and after treatment: before treatment, the ALT of patients in treatment group and control group were abnormal, there was no significant difference between them (P0.05); 12 weeks after treatment, The ALT of the treatment group and the control group was significantly lower than that of the control group (P0.05); after 24 weeks of treatment, the ALT of the treatment group was basically normal, which was significantly different from that of the control group (P0.05); at 48 weeks of treatment, the ALT of the treatment group and the control group were all normal. There was no significant difference between the two groups (P0.05). Two groups of patients before and after treatment of HBV-DNA response comparison: before treatment, the treatment group, the control group between patients with HBV-DNA quantitative positive, there was no significant difference (P0.05); 12 weeks after treatment, the two groups of patients have no negative HBV-DNA, There was no significant difference between the two groups (P0.05); after 24 weeks of treatment, there was no HBV-DNA negative change in both groups (P0.05); at 48 weeks of treatment, there was no significant change of HBV-DNA in both groups. There was no significant difference in HBV-DNA negative rate between the two groups (P0.05), but the rate of HBV-DNA decreasing over 103IU/mL was 70.00% (21 / 30) and 93.33% (28 / 30) in two groups (P0.05). Before and after treatment, the patients in the treatment group and the control group were all positive for HBeAg, the patients in the treatment group and the control group had no HBeAg negative conversion after 12 weeks of treatment, and the patients in the treatment group and the control group had no HBeAg negative conversion after 24 weeks of treatment. After 48 weeks of treatment, the negative conversion rate of HBeAg in the treatment group and the control group was 46.67 and 23.33, respectively. There was significant difference between the two groups (P0.05). Comparison of peripheral blood neutrophil count before and after treatment: before treatment, the neutrophil count in peripheral blood of patients in treatment group and control group were all normal. After 12 weeks of treatment, the number of peripheral blood neutrophils in the treatment group and control group decreased significantly (P0.05); after 24 weeks of treatment, the peripheral blood neutrophil count increased in the treatment group. There was a significant difference between the control group and the control group (P0.05), 48 weeks after treatment, There was no significant difference in neutrophil count between the treatment group and the control group at 24 weeks (P0.05), but there was significant difference in the peripheral blood neutrophil count between the two groups (P0.05). Except for bone marrow suppression, there were no serious adverse reactions in both groups: 18 cases of fever in the treatment group and 2 cases of insomnia in the control group. There was no significant difference in the incidence of adverse reactions between the two groups (P0.05). Conclusion: Long-term interferon (伪 -2a) combined with smokeless moxibustion in the treatment of chronic hepatitis B can accelerate the recovery of liver function, inhibit the replication of HBV-DNA, increase the negative rate of HBeAg, and enhance the patient's tolerance to the adverse reaction of interferon bone marrow inhibition. The therapeutic effect was better than that of long acting interferon (伪-2 a) alone in the treatment of HBV.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R512.62
【参考文献】
相关期刊论文 前10条
1 胡九东;刘洋;李莹;张玮;邢练军;;中西医结合抗病毒治疗慢乙肝研究进展[J];中医药临床杂志;2011年03期
2 张传英;唐照亮;;艾灸调节机体免疫功能研究概况[J];安徽中医学院学报;2009年02期
3 徐春军;刘燕玲;李秀惠;戚团结;刘敏;林凌云;;益气凉血解毒类中药对拉米夫定诱发乙肝病毒YMDD变异的干预作用[J];中华中医药杂志;2008年12期
4 顾锡炳;杨小娟;王栋;朱银芳;丁虹;张波;徐月琴;;苦参素治疗慢性乙型肝炎患者T细胞亚群和细胞毒性T淋巴细胞的变化[J];实用肝脏病杂志;2010年02期
5 张玉强;郑超;杨峗;刘敏;徐麟;符小发;;中草药提取物体外抗乙型肝炎病毒活性的筛选[J];中国医药科学;2013年05期
6 吴芬芬;吴国营;;近十年乙肝病毒携带者的中医治疗概况与展望[J];环球中医药;2009年05期
7 肖素芬;张光荣;;α-2b干扰素与香菇多糖合用治疗乙型肝炎的疗效观察[J];实用临床医学;2009年03期
8 王常松;周嘉鹤;吴银盘;刘清华;;从慢性乙型肝炎治疗总体策略看中医治疗优势与存在的问题[J];辽宁中医杂志;2010年04期
9 王政;冯全生;何彬毓;陈岚;;慢性乙型肝炎中医药治疗现状[J];辽宁中医药大学学报;2011年10期
10 胡冬青;曹志群;;穴位贴敷疗法在消化系统疾病中的应用[J];河南中医;2012年09期
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