逍遥散联合拉米夫定治疗慢性乙型肝炎39例预后分析
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摘要
目的探讨逍遥散联合核苷类抗病毒药物治疗的慢性乙型肝炎患者的生存质量及预后。方法选取2010年2月至2011年2月在医院确诊为乙型肝炎并接受住院治疗的患者78例,根据治疗方法的不同分为观察组和对照组,各39例。两组患者住院期间均给予相同的综合护理,观察组患者接受逍遥散联合核苷类抗病毒药物拉米夫定治疗,对照组患者仅接受拉米夫定治疗。结果治疗1年及2年后观察组健康调查简表(SF-36量表)、慢性肝病量表(CLDQ)评分改善均较明显(P<0.05);治疗1年后,观察组除SF-36量表的生理职能、情感职能2个维度外,其他6个维度评分均明显优于对照组(P<0.05),且观察组CLDQ量表各类评分均明显优于对照组(P<0.05);治疗2年后,观察组SF-36量表的8个维度得分均显著优于对照组(P<0.05),CLDQ量表除活动、系统症状2个类别外,其他4个类别评分均高于对照组(P<0.05);6年内观察组癌变率为17.95%,明显低于对照组的38.46%。结论逍遥散联合核苷类抗病毒药物拉米夫定治疗慢性乙型肝炎,患者生存质量明显改善,且可有效降低肝癌发生率。
Objective To investigate the clinical effect of Xiaoyao Powder combined with nucleoside antiviral drugs for treating patients with chronic hepatitis B and its effect on the quality of life and prognosis. Methods Totally 78 patients with chronic hepatitis B admitted to our hospital from February 2010 to February 2011 were selected and divided into the observation group and the control group according to the different treatment methods,39 cases in each group. The two groups were given the same comprehensive nursing during hospitalization. The observation group received Xiaoyao Powder combined with nucleoside antiviral drugs( lamivudine),while the control group only received lamivudine. Results After 1 year and 2 years of treatment,the scores of SF-36 scale and CLDQ in the observation group improved significantly( P < 0. 05). After 1 year of treatment,in addition to the 2 dimensions of physiological function and emotional function,the scores of the other 6 dimensions in the SF-36 scale of the observation group were significantly better than those of the control group( P < 0. 05),and the scores of CLDQ were better than those of the control group( P < 0. 05). After 2 years of treatment,the scores of SF-36 scale in all dimensions of the observation group were better than those of the control group( P < 0. 05),in addition to 2 categories of activity( AC) and systemic symptoms( SS),the scores of the other 4 categories in the CLDQ scale of the observation group were higher than those of the control group( P < 0. 05). Within 6 years,the rate of carcinogenesis in the observation group was 17. 95%,which was significantly lower than 38. 46% in the control group( P < 0. 05). Conclusion Xiaoyao Powder combined with nucleoside antiviral drugs( lamivudine) for treating patients with chronic hepatitis B can significantly improve the patients' quality of life and effectively reduce the occurrence rate of liver cancer.
Objective To investigate the clinical effect of Xiaoyao Powder combined with nucleoside antiviral drugs for treating patients with chronic hepatitis B and its effect on the quality of life and prognosis. Methods Totally 78 patients with chronic hepatitis B admitted to our hospital from February 2010 to February 2011 were selected and divided into the observation group and the control group according to the different treatment methods,39 cases in each group. The two groups were given the same comprehensive nursing during hospitalization. The observation group received Xiaoyao Powder combined with nucleoside antiviral drugs( lamivudine),while the control group only received lamivudine. Results After 1 year and 2 years of treatment,the scores of SF-36 scale and CLDQ in the observation group improved significantly( P < 0. 05). After 1 year of treatment,in addition to the 2 dimensions of physiological function and emotional function,the scores of the other 6 dimensions in the SF-36 scale of the observation group were significantly better than those of the control group( P < 0. 05),and the scores of CLDQ were better than those of the control group( P < 0. 05). After 2 years of treatment,the scores of SF-36 scale in all dimensions of the observation group were better than those of the control group( P < 0. 05),in addition to 2 categories of activity( AC) and systemic symptoms( SS),the scores of the other 4 categories in the CLDQ scale of the observation group were higher than those of the control group( P < 0. 05). Within 6 years,the rate of carcinogenesis in the observation group was 17. 95%,which was significantly lower than 38. 46% in the control group( P < 0. 05). Conclusion Xiaoyao Powder combined with nucleoside antiviral drugs( lamivudine) for treating patients with chronic hepatitis B can significantly improve the patients' quality of life and effectively reduce the occurrence rate of liver cancer.
引文
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[3]贾云飞,杨晋翔,王宪波,等.中医药联合抗病毒治疗对乙型肝炎相关性肝硬变患者肝癌发生情况的影响[J].中医学报,2017,32(10):1814-1820.
[4]袁平戈.2010年慢性乙型肝炎防治指南解读[J].现代医药卫生,2011,27(19):2881-2883.
[5]段春青,景育娟.护理干预对慢性乙肝患者治疗依从性及生活质量的影响[J].大家健康,2015,18(1):190.
[6]李传珍,董先芳.慢性乙肝患者护理干预对治疗依从性及生活质量的影响[J].中国实用医药,2015,10(14):269-270.
[7]翟清华,郑蔚,张利霞,等.PDCA循环式护理干预对慢性乙型肝炎患者生存质量的影响[J].实用医学杂志,2013,29(22):3768-3770.
[8]胡华祥,倪雪琴,王磊.中医药治疗乙型肝炎86例临床观察[J].光明中医,2010,25(1):37-38.
[9]蒋映明.中医药治疗乙型肝炎并肝硬化的研究进展[J].右江民族医学院学报,2012,34(4):533-535.
[10]斯崇文.对当前慢性乙型肝炎抗病毒治疗的看法[J].中华传染病杂志,2005,23(2):73-74.
[11]李勇,林爱花.西药抗病毒疗法与传统中药联合治疗慢性乙型肝炎的新进展[J].中国现代药物应用,2010,4(15):17-19.
[12]冯建英,邵建国.中药复方联合西药抗病毒药物治疗慢性乙型肝炎研究进展[J].山西医药杂志,2012,41(3):245-248.
[13]中华医学会肝病学分会、感染病学会.慢性乙型肝炎防治指南2010年更新版[J].中华实验和临床感染病杂志(电子版),2011,5(1):50-60.
[14]万崇华,方积乾,汤学良,等.SF-36量表用于肝癌患者生活质量测定的效果评价[J].肿瘤,2005,25(5):492-494.
[15]Khairullah S,Mahadeva S.Translation,adaptation and validation of two versions of the Chronic Liver Disease Questionnaire in Malaysian patients for speakers of both English and Malay languages:a cross-sectional study[J].BMJ Open,2017,7(5):e013873.
[16]耿明凡.慢乙肝发生HBe Ag血清转换预测模型的建立及中医药的治疗作用[D].北京:北京中医药大学,2016.
[17]曾秀忠,麦群娣,曹丽红,等.肺结核合并慢性乙型肝炎使用抗病毒药物疗效观察[J].当代医学,2012,18(20):72-73.
[18]柳志原,肖寒.慢性乙型肝炎抗病毒药物联合治疗研究进展[J].现代医药卫生,2015,31(2):212-215.
[19]贾云飞.慢乙肝发生肝癌风险预测模型的建立及中西医结合治疗对乙肝肝硬化患者肝癌发病的影响[D].北京:北京中医药大学,2017.
[20]胡鑫才,张华,林彦,等.慢性肝病量表在乙型肝炎肝硬化中的应用评价[J].中华肝脏病杂志,2012,20(8):621-627.
[21]熊静悦,曾南,张崇燕,等.逍遥散抗抑郁作用研究[J].中药药理与临床,2007,23(1):3-5.
[22]田凌云,张承军,王英.逍遥散治疗慢性乙肝38例疗效观察[J].中医药信息,2013,30(1):92-93.
[2]李洪.逍遥散联合核苷类抗病毒药物对慢性乙肝患者生存质量的影响[J].光明中医,2012,27(10):1993-1994.
[3]贾云飞,杨晋翔,王宪波,等.中医药联合抗病毒治疗对乙型肝炎相关性肝硬变患者肝癌发生情况的影响[J].中医学报,2017,32(10):1814-1820.
[4]袁平戈.2010年慢性乙型肝炎防治指南解读[J].现代医药卫生,2011,27(19):2881-2883.
[5]段春青,景育娟.护理干预对慢性乙肝患者治疗依从性及生活质量的影响[J].大家健康,2015,18(1):190.
[6]李传珍,董先芳.慢性乙肝患者护理干预对治疗依从性及生活质量的影响[J].中国实用医药,2015,10(14):269-270.
[7]翟清华,郑蔚,张利霞,等.PDCA循环式护理干预对慢性乙型肝炎患者生存质量的影响[J].实用医学杂志,2013,29(22):3768-3770.
[8]胡华祥,倪雪琴,王磊.中医药治疗乙型肝炎86例临床观察[J].光明中医,2010,25(1):37-38.
[9]蒋映明.中医药治疗乙型肝炎并肝硬化的研究进展[J].右江民族医学院学报,2012,34(4):533-535.
[10]斯崇文.对当前慢性乙型肝炎抗病毒治疗的看法[J].中华传染病杂志,2005,23(2):73-74.
[11]李勇,林爱花.西药抗病毒疗法与传统中药联合治疗慢性乙型肝炎的新进展[J].中国现代药物应用,2010,4(15):17-19.
[12]冯建英,邵建国.中药复方联合西药抗病毒药物治疗慢性乙型肝炎研究进展[J].山西医药杂志,2012,41(3):245-248.
[13]中华医学会肝病学分会、感染病学会.慢性乙型肝炎防治指南2010年更新版[J].中华实验和临床感染病杂志(电子版),2011,5(1):50-60.
[14]万崇华,方积乾,汤学良,等.SF-36量表用于肝癌患者生活质量测定的效果评价[J].肿瘤,2005,25(5):492-494.
[15]Khairullah S,Mahadeva S.Translation,adaptation and validation of two versions of the Chronic Liver Disease Questionnaire in Malaysian patients for speakers of both English and Malay languages:a cross-sectional study[J].BMJ Open,2017,7(5):e013873.
[16]耿明凡.慢乙肝发生HBe Ag血清转换预测模型的建立及中医药的治疗作用[D].北京:北京中医药大学,2016.
[17]曾秀忠,麦群娣,曹丽红,等.肺结核合并慢性乙型肝炎使用抗病毒药物疗效观察[J].当代医学,2012,18(20):72-73.
[18]柳志原,肖寒.慢性乙型肝炎抗病毒药物联合治疗研究进展[J].现代医药卫生,2015,31(2):212-215.
[19]贾云飞.慢乙肝发生肝癌风险预测模型的建立及中西医结合治疗对乙肝肝硬化患者肝癌发病的影响[D].北京:北京中医药大学,2017.
[20]胡鑫才,张华,林彦,等.慢性肝病量表在乙型肝炎肝硬化中的应用评价[J].中华肝脏病杂志,2012,20(8):621-627.
[21]熊静悦,曾南,张崇燕,等.逍遥散抗抑郁作用研究[J].中药药理与临床,2007,23(1):3-5.
[22]田凌云,张承军,王英.逍遥散治疗慢性乙肝38例疗效观察[J].中医药信息,2013,30(1):92-93.