本文選題：慢性乙型肝炎 + @補(bǔ)腎方�。� 參考：《湖北中醫(yī)藥大學(xué)》2014年碩士論文

【摘要】：目的：觀察替比夫定聯(lián)合補(bǔ)腎方治療HBeAg陽(yáng)性慢性乙型肝炎的療效，為臨床實(shí)踐提供有益的參考。 方法：本研究所選取的70病例均來(lái)源于2012年6月至2013年12月在湖北省中醫(yī)院肝病科門診治療的HBeAg陽(yáng)性慢性乙型肝炎患者（診斷符合《慢性乙型肝炎防治指南(2010年版)》），按照隨機(jī)分配原則，，分為治療組和對(duì)照組各35例。兩組患者均給予替比夫定片(商品名素比伏，北京諾華制藥有限公司生產(chǎn))口服，每次600mg，每日一次，治療時(shí)間為24周。治療組同時(shí)予以中藥補(bǔ)腎方，藥物組成及用量為：肉桂6g、熟地黃20g、牡丹皮20g、生黃芪20g，采用中藥配方顆粒劑(深圳市三九現(xiàn)代中藥有限公司生產(chǎn))，每日一劑，開水沖服，分兩次口服。在實(shí)驗(yàn)第0、12、24周，檢測(cè)HBV-DNA、HBV-M、肝功能、AFP、肝膽脾彩超及相關(guān)安全性指標(biāo)并對(duì)結(jié)果進(jìn)行統(tǒng)計(jì)學(xué)處理。 結(jié)果：治療總體療效方面，治療組、對(duì)照組治療前后組內(nèi)比較有統(tǒng)計(jì)學(xué)差異(P 0.05)。治療組治療12周和24周的總有效率分別為42.87%和85.71%高于對(duì)照組的34.29%和71.43%，無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。將治療組與對(duì)照組進(jìn)行組內(nèi)比較治療第0和12周、第0和24周HBeAg定量結(jié)果，均有統(tǒng)計(jì)學(xué)差異(P 0.05)；組間比較治療組和對(duì)照組治療第12周HBeAg定量結(jié)果有統(tǒng)計(jì)學(xué)差異(P0.05)，而比較第24周結(jié)果時(shí)無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。在HBV-DNA定量及陰轉(zhuǎn)率、HBeAg陰轉(zhuǎn)率、HBeAg血清學(xué)轉(zhuǎn)換率、HBsAg定量及陰轉(zhuǎn)率、肝功能等方面，治療組與對(duì)照組進(jìn)行組內(nèi)比較，治療第0和12周、第0和24周結(jié)果，均有統(tǒng)計(jì)學(xué)差異(P0.05)；組間比較治療組和對(duì)照組治療第12周和第24周結(jié)果，無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論：補(bǔ)腎中藥聯(lián)合替比夫定抗病毒的治療HBeAg陽(yáng)性慢性乙型肝炎,有助于在治療早期促使HBeAg滴度下降，遠(yuǎn)期效果尚待進(jìn)一步研究驗(yàn)證；對(duì)于總體療效、HBV-DNA定量及陰轉(zhuǎn)率、HBeAg陰轉(zhuǎn)率、HBeAg血清學(xué)轉(zhuǎn)換率、HBsAg陰轉(zhuǎn)率的檢測(cè)指標(biāo)的改善上與單一西藥治療相比雖然在數(shù)值上呈現(xiàn)出優(yōu)勢(shì)，但無(wú)統(tǒng)計(jì)學(xué)差異。
[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.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R512.62

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