HBeAg阳性慢性乙型肝炎患者恩替卡韦治疗早期应答与中医体质的相关性研究

发布时间：2018-01-09 12:14

本文关键词：HBeAg阳性慢性乙型肝炎患者恩替卡韦治疗早期应答与中医体质的相关性研究　出处：《福建中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过观察HBeAg阳性慢性乙型肝炎患者恩替卡韦治疗早期应答情况与中医体质类型的相关性,探讨中医体质因素在恩替卡韦治疗应答中的作用,以期从中医体质角度指导对HBeAg阳性慢性乙型肝炎患者的治疗。方法:选取2015年10月至2016年7月期间南京军区福州总医院感染科住院或门诊规律随访的HBeAg阳性慢性乙型肝炎患者,经中医体质辨识,判定为湿热质、气郁质、气虚质、阴虚质者各20例为研究对象。所有患者均接受恩替卡韦抗病毒治疗。在治疗前、治疗12周、治疗24周时检测血清谷丙转氨酶水平、乙肝两对半定量和HBVDNA定量。乙肝两对半定量检测采用化学发光法;HBVDNA定量采用荧光PCR法。在治疗12周、24周时观察各体质间的应答情况,并比较各体质间疗效的差异。使用SPSS13.0软件包对相应数据统计分析,以P0.05为差异具有统计学意义,假设检验取双侧检验。结果:随访至24周时纳入统计的病例有76例,其中湿热质19例,气郁质18例,气虚质19例,阴虚质20例。在接受恩替卡韦治疗12周时,各体质组患者在HBVDNA低于不可检测水平率、ALT复常率、HBeAg阴转或血清学转换率方面两两比较差异均无统计学意义,P0.05。在接受恩替卡韦治疗24周时,各体质组患者在ALT复常率、HBeAg阴转或血清学转换率方面两两比较差异无统计学意义,P＞0.05;在HBV DNA低于不可检测水平率方面,湿热质、气郁质分别与气虚质、阴虚质比较差异具有统计学意义(P0.05),而湿热质和气郁质之间、气虚质和阴虚质之间的比较差异无统计学意义CP＞0.05)。结论:湿热质、气郁质HBeAg阳性CHB患者抗病毒应答趋势优于气虚质、阴虚质者,提示中医体质类型与恩替卡韦治疗疗效之间存在着一定的相关性。
[Abstract]:Objective: to investigate the relationship between the early response of entecavir treatment and TCM physique type in patients with chronic hepatitis B (HBeAg) positive, and to explore the role of TCM physique factors in the response to entecavir therapy. In order to guide the treatment of HBeAg positive patients with chronic hepatitis B. methods:. Patients with HBeAg positive chronic hepatitis B who were followed up from October 2015 to July 2016 by infection department of Fuzhou General Hospital of Nanjing military region were selected. According to TCM physique identification, 20 cases were identified as dampness and heat, qi stagnation, qi deficiency and yin deficiency. All patients were treated with entecavir antiviral therapy. Before treatment, the treatment was 12 weeks. The levels of serum alanine aminotransferase (alt), hepatitis B (HBV) and HBVDNA were measured at 24 weeks after treatment. HBVDNA was measured by fluorescence PCR method. The responses of different physiques were observed at 12 weeks and 24 weeks after treatment. Using SPSS13.0 software package to the statistical analysis of the corresponding data, with P0.05 as the difference has statistical significance. Results: after 24 weeks of follow-up, 76 cases were included in the statistics, including 19 cases of dampness and heat, 18 cases of qi stagnation and 19 cases of deficiency of qi. There were 20 cases of yin deficiency. After 12 weeks of treatment with entecavir, the patients in each physique group were lower than the undetectable level of HBVDNA and the rate of recovery of alt was lower than that of non-detectable level. There was no significant difference in HBeAg negative conversion or serological conversion rate between the two groups (P 0.05). After 24 weeks of treatment with entecavir, the recovery rate of ALT was found in all physique groups. There was no significant difference in HBeAg negative conversion or serological conversion rate (P > 0.05). In the aspect of HBV DNA lower than the undetectable level rate, the difference between damp heat quality, qi stagnation quality and deficiency of qi and yin deficiency was statistically significant (P 0.05), and the difference between damp heat quality and qi stagnation was statistically significant (P < 0.05). There was no significant difference between deficiency of qi and yin deficiency. Conclusion: the tendency of anti-virus response in HBeAg positive CHB patients with dampness and heat is better than that in patients with deficiency of qi and deficiency of yin. It is suggested that there is a certain correlation between TCM physique type and the therapeutic effect of entecavir.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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