摘要
目的:评估茵枝汤联合恩替卡韦治疗HBeAg阳性慢性乙型肝炎的临床疗效。方法:纳入HBeAg阳性慢性乙型肝炎患者120例,随机分为治疗组和对照组,每组60例。治疗组采用茵枝汤联合恩替卡韦治疗,对照组采用恩替卡韦治疗,治疗周期为18个月。评价两组患者的中医证候疗效,比较两组患者的HBeAg阴转率、HBeAg/抗HBe血清转换率、ALT复常率及HBV-DNA定量。结果:治疗18个月时,治疗组的中医证候疗效总有效率为86.67%,对照组为60.00%,治疗组的疗效优于对照组(P<0.01)。治疗18个月及随访12个月时,治疗组患者的HBeAg阴转率、HBeAg/抗HBe血清转换率明显高于对照组(P<0.05);治疗3个月、6个月、12个月时,治疗组患者的ALT复常率均明显高于对照组(P<0.05)。治疗后,两组患者的HBV-DNA定量较治疗前均显著降低(P<0.01),且治疗3个月及随访12个月时,治疗组患者的HBV-DNA定量明显低于对照组(P<0.05)。结论:茵枝汤联合恩替卡韦治疗HBeAg阳性慢性乙型肝炎能有效抑制乙型肝炎病毒复制,提高HBeAg阴转率及HBeAg/抗HBe血清转换率,改善患者的临床证候。
Objective： To evaluate the clinical efficacy of ＂Yinzhi Decoction＂ combined with entecavir in the treatment of HBeAg positive chronic hepatitis B. Methods： A total of 120 patients with HBeAg positive chronic hepatitis B were randomly divided into treatment group and control group, with 60 cases in each group. The patients in treatment group were treated with ＂Yinzhi Decoction＂ combined with entecavir and the patients in control group were treated with enteeavir, with a course of 18 months. The clinical effect of Chinese medical syndrome was evaluated, and the HBeAg negative rate, HBeAg/antiHBe serological response rate, ALT recovery rate and the log value of HBV-DNA were tested. Results： Eighteen months after treatment, the total effective rates of treatment group and control group were 86.67% and 60.00% respectively on the Chinese medical syndrome, and the effect of treatment group was better than that of control group （ P 〈 0.01 ）. Eighteen months after treatment and twelve months after follow-up, the HBeAg negative rate and HBeAg/antiHBe serological response rate of treatment group were higher than those of control group （ P 〈 0.05 ）. Three months, six months and twelve months after treatment, the ALT recovery rate of treatment group was higher than that of control group （ P 〈 0.05 ）. After treatment, the log values of HBV-DNA in both groups were obviously decreased （P 〈0.01 ）, and three months after treatment and twelve months after follow-up the log value of HBV-DNA of treatment group was lower than that of control group （ P 〈 0.05 ）. Conclusion： ＂Yinzhi Decoction＂ combined with entecavir can inhibit the HBV-DNA replication, enhance the HBeAg negative rate and HBeAg/antiHBe serological response rate, and improve the clinical syndrome in treating HBeAg positive chronic hepatitis B.
出处
《上海中医药大学学报》
CAS
2014年第5期29-32,共4页
Academic Journal of Shanghai University of Traditional Chinese Medicine
基金
上海市浦东新区中医继承型人才培养项目(PW2010A-29)
上海公共卫生体系建设新三年行动计划中西医结合传染病临床基地建设项目
陈建杰名中医工作室项目(ZYSNXD-CC-MZY003)
关键词
慢性乙型肝炎
HBEAG阳性
茵枝汤
恩替卡韦
中西医结合
chronic hepatitis B
HBeAg positive
＂ Yinzhi Decoction＂
entecavir
integrated Chinese and western medicine
作者简介
薛建华，男，硕士，主治医师，主要从事中西医结合治疗传染性疾病临床研究。
[通讯作者]陈建杰，主任医师，博士生导师。E—mail：jianjie_chen@hotmail．com
