本文關(guān)鍵詞：HBeAg陽性慢性乙型肝炎患者恩替卡韋治療早期應(yīng)答與中醫(yī)體質(zhì)的相關(guān)性研究　出處：《福建中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 慢性乙型肝炎 中醫(yī)體質(zhì) 恩替卡韋

【摘要】：目的:通過觀察HBeAg陽性慢性乙型肝炎患者恩替卡韋治療早期應(yīng)答情況與中醫(yī)體質(zhì)類型的相關(guān)性,探討中醫(yī)體質(zhì)因素在恩替卡韋治療應(yīng)答中的作用,以期從中醫(yī)體質(zhì)角度指導(dǎo)對HBeAg陽性慢性乙型肝炎患者的治療。方法:選取2015年10月至2016年7月期間南京軍區(qū)福州總醫(yī)院感染科住院或門診規(guī)律隨訪的HBeAg陽性慢性乙型肝炎患者,經(jīng)中醫(yī)體質(zhì)辨識,判定為濕熱質(zhì)、氣郁質(zhì)、氣虛質(zhì)、陰虛質(zhì)者各20例為研究對象。所有患者均接受恩替卡韋抗病毒治療。在治療前、治療12周、治療24周時檢測血清谷丙轉(zhuǎn)氨酶水平、乙肝兩對半定量和HBVDNA定量。乙肝兩對半定量檢測采用化學(xué)發(fā)光法;HBVDNA定量采用熒光PCR法。在治療12周、24周時觀察各體質(zhì)間的應(yīng)答情況,并比較各體質(zhì)間療效的差異。使用SPSS13.0軟件包對相應(yīng)數(shù)據(jù)統(tǒng)計分析,以P0.05為差異具有統(tǒng)計學(xué)意義,假設(shè)檢驗取雙側(cè)檢驗。結(jié)果:隨訪至24周時納入統(tǒng)計的病例有76例,其中濕熱質(zhì)19例,氣郁質(zhì)18例,氣虛質(zhì)19例,陰虛質(zhì)20例。在接受恩替卡韋治療12周時,各體質(zhì)組患者在HBVDNA低于不可檢測水平率、ALT復(fù)常率、HBeAg陰轉(zhuǎn)或血清學(xué)轉(zhuǎn)換率方面兩兩比較差異均無統(tǒng)計學(xué)意義,P0.05。在接受恩替卡韋治療24周時,各體質(zhì)組患者在ALT復(fù)常率、HBeAg陰轉(zhuǎn)或血清學(xué)轉(zhuǎn)換率方面兩兩比較差異無統(tǒng)計學(xué)意義,P＞0.05;在HBV DNA低于不可檢測水平率方面,濕熱質(zhì)、氣郁質(zhì)分別與氣虛質(zhì)、陰虛質(zhì)比較差異具有統(tǒng)計學(xué)意義(P0.05),而濕熱質(zhì)和氣郁質(zhì)之間、氣虛質(zhì)和陰虛質(zhì)之間的比較差異無統(tǒng)計學(xué)意義CP＞0.05)。結(jié)論:濕熱質(zhì)、氣郁質(zhì)HBeAg陽性CHB患者抗病毒應(yīng)答趨勢優(yōu)于氣虛質(zhì)、陰虛質(zhì)者,提示中醫(yī)體質(zhì)類型與恩替卡韋治療療效之間存在著一定的相關(guān)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.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

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