【摘要】：目的：復(fù)方芪術(shù)湯聯(lián)合替比夫定治療e抗原(Hepatitis B e antigen, HBeAg)陽(yáng)性慢性乙型肝炎(chronic hepatitis B, CHB)患者,評(píng)價(jià)其對(duì)HBeAg陽(yáng)性慢性乙型肝炎患者HBeAg血清學(xué)轉(zhuǎn)換作用。方法：納入104例HBeAg陽(yáng)性CHB初治患者,隨機(jī)分為實(shí)驗(yàn)組和對(duì)照組,均接受替比夫定600mg/日為基礎(chǔ)治療,實(shí)驗(yàn)組加用中藥復(fù)方芪術(shù)湯,療程1年,分析比較0、4、12、24及52周時(shí)HBeAg、HBV DNA.肝腎功能及細(xì)胞免疫變化情況。結(jié)果：①12、24、52周時(shí),實(shí)驗(yàn)組HBeAg血清學(xué)轉(zhuǎn)換率分別為8.33%、33.33%、43.75%；對(duì)照組分別為3.57%、12.5%、32.14%,實(shí)驗(yàn)組HBeAg血清學(xué)轉(zhuǎn)換率均高于對(duì)照組,但差別無(wú)統(tǒng)計(jì)學(xué)意義。②療程結(jié)束時(shí),實(shí)驗(yàn)組CD4+T和CD8+T細(xì)胞水平較對(duì)照組升高(P0.05)；實(shí)驗(yàn)組與對(duì)照組HBV DNA轉(zhuǎn)陰率分別為68.75%和64.29%；丙氨酸氨基轉(zhuǎn)移酶(alanine transaminase,ALT)復(fù)常率分別為77.08%和75%(P0.05),差別無(wú)統(tǒng)計(jì)學(xué)意義；③實(shí)驗(yàn)組患者療程結(jié)束后CD4+T及CD8+T細(xì)胞計(jì)數(shù)分別為750(685.50,953)和527(474,651.50),較開(kāi)始治療前升高(P0.05),對(duì)照組CD4+T及CD8+T細(xì)胞分別為628.50(557.50,712)和467.50(421,537),在治療前后無(wú)明顯變化(P0.05)。結(jié)論：復(fù)方芪術(shù)湯聯(lián)合替比夫定治療可能通過(guò)提高細(xì)胞免疫功能增加HBeAg陽(yáng)性慢性乙型肝炎患者HBeAg血清學(xué)轉(zhuǎn)換率。
[Abstract]:Objective: to evaluate the effect of compound Qizhutang combined with tibivudine on HBeAg serological conversion in patients with HBeAg positive chronic hepatitis B (chronic hepatitis B, CHB). Methods: 104 patients with HBeAg positive CHB were randomly divided into two groups: the experimental group and the control group. All patients received tibivudine 600mg/ day as the basic treatment. The experimental group was treated with traditional Chinese medicine compound Qizu decoction. The course of treatment was 1 year. The HBeAg,HBV DNA. was analyzed and compared at 24 and 52 weeks after treatment. Changes of liver and kidney function and cellular immunity. Results the serological conversion rate of HBeAg in the experimental group was 8.33 and 33.33 respectively at the 52nd week of the control group, and that in the control group was 3.57 and 12.55.The serological conversion rate of HBeAg in the experimental group was higher than that in the control group, but there was no significant difference at the end of the course of treatment. The levels of CD4 T and CD8 T cells in the experimental group were higher than those in the control group (P0.05), the negative rates of HBV DNA in the experimental group and the control group were 68.75% and 64.29 respectively, and the relapse rates of alanine aminotransferase (alanine transaminase,ALT) were 77.08% and 75% (P0.05), respectively. 3After the course of treatment, the counts of CD4 T and CD8 T cells were 750 (685.50953) and 527 (474651.50), respectively, which were higher than those before treatment (P0.05). The CD4 T and CD8 T cells in the control group were 628.50 (557.50712) and 467.50 (421537), respectively. There was no significant change before and after treatment (P0.05). Conclusion: compound Qizhutang combined with tibivudine may increase the HBeAg serological conversion rate in patients with HBeAg positive chronic hepatitis B by improving the cellular immune function.
【學(xué)位授予單位】：復(fù)旦大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R512.62

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