長效干擾素（α-2a）聯(lián)合無煙艾灸治療慢性乙型肝炎的臨床觀察
發(fā)布時間：2018-08-05 18:30
【摘要】：目的：觀察長效干擾素(α-2a)聯(lián)合無煙艾灸治療慢性乙型肝炎的臨床療效及其安全性,并與單獨(dú)應(yīng)用長效干擾素(α-2a)治療慢性乙型肝炎進(jìn)行比較。 方法：將符合入選標(biāo)準(zhǔn)的慢性乙型肝炎患者60例隨機(jī)分為以下2組：長效干擾素(α-2a)組(對照組)30例和長效干擾素(α-2a)聯(lián)合無煙艾灸組(治療組)30例。兩組患者分別于治療前及治療12周、24周、48周時進(jìn)行肝功能（ALT）、HBeAg定性、HBV-DNA應(yīng)答情況及血常規(guī)（外周血中性粒細(xì)胞計數(shù)）檢測，并對檢查結(jié)果進(jìn)行分析比較。 結(jié)果： 一、兩組患者治療前后ALT的比較： 治療前，治療組、對照組間患者ALT均異常，比較無顯著性差異（P0.05）；治療12周時，治療組及對照組患者ALT較治療前明顯下降（P0.05）；治療24周時，治療組患者ALT基本正常，與對照組比較有顯著性差異（P0.05）；治療48周時，治療組與對照組患者ALT均正常，兩組間比較無顯著性差異（P0.05）。 二、兩組患者治療前后HBV-DNA應(yīng)答情況的比較： 治療前，治療組、對照組間患者HBV-DNA定量均陽性，比較無顯著性差異（P0.05）；治療12周時，兩組患者均無HBV-DNA陰轉(zhuǎn)，比較無顯著性意義（P0.05）；治療24周時，兩組患者均無HBV-DNA陰轉(zhuǎn)，比較無顯著性意義（P0.05）；治療48周時，兩組患者HBV-DNA轉(zhuǎn)陰率比較差異無顯著性意義（P0.05）,但兩組患者HBV-DNA下降超過103IU/mL的比率分別為70.00%(21/30)和93.33%(28/30),差異有顯著性意義(P0.05)。 三、兩組患者治療前后HBeAg陰轉(zhuǎn)率的比較： 治療前，治療組、對照組間患者HBeAg均陽性；治療12周時，治療組及對照組患者均無HBeAg陰轉(zhuǎn)；治療24周時，部分治療組患者HBeAg陰轉(zhuǎn)，與對照組比較有顯著性差異（P0.05）；治療48周時，治療組與對照組患者HBeAg陰轉(zhuǎn)率分別為46.67%、23.33%，兩組間比較有顯著性差異（P0.05）。 四、不良反應(yīng)： 1．兩組患者治療前后外周血中性粒細(xì)胞計數(shù)的比較： 治療前，治療組、對照組間患者外周血中性粒細(xì)胞計數(shù)均正常，比較無顯著性差異（P0.05）；治療12周時，治療組及對照組患者外周血中性粒細(xì)胞數(shù)較治療前明顯下降（P0.05）；治療24周時，治療組患者外周血中性粒細(xì)胞計數(shù)上升，與對照組比較有顯著性差異（P0.05）；治療48周時，治療組與對照組外周血中性粒細(xì)胞計數(shù)較24周時無顯著性差異（P0.05）,兩組患者外周血中性粒細(xì)胞計數(shù)比較差異有顯著性意義（P0.05）。 2.除骨髓抑制外，，兩組患者均未見發(fā)生嚴(yán)重不良反應(yīng)：治療組患者18例發(fā)熱，對照組患者19例發(fā)熱，2例失眠�；颊卟涣挤磻�(yīng)發(fā)生率，兩組間比較無顯著性差異(P0.05)。 結(jié)論： 長效干擾素(α-2a)聯(lián)合無煙艾灸治療慢性乙型肝炎能更快促進(jìn)肝功能恢復(fù)、抑制HBV-DNA復(fù)制、提高HBeAg轉(zhuǎn)陰率、增強(qiáng)患者對干擾素骨髓抑制不良反應(yīng)的耐受性，療效優(yōu)于單純應(yīng)用長效干擾素(α-2a)抗HBV治療。
[Abstract]:Objective: to observe the clinical efficacy and safety of long-term interferon (偽 -2a) combined with smokeless moxibustion in the treatment of chronic hepatitis B (CHB), and to compare the efficacy and safety of long-term interferon (偽 -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 (偽 -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 (偽 -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 (偽-2 a) alone in the treatment of HBV.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R512.62
本文編號：2166633
[Abstract]:Objective: to observe the clinical efficacy and safety of long-term interferon (偽 -2a) combined with smokeless moxibustion in the treatment of chronic hepatitis B (CHB), and to compare the efficacy and safety of long-term interferon (偽 -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 (偽 -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 (偽 -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 (偽-2 a) alone in the treatment of HBV.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R512.62
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