督灸联合长效干扰素α-2a治疗慢性乙型肝炎疗效观察
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摘要
目的观察督灸联合长效干扰素治疗慢性乙型肝炎患者的临床疗效,评估在此治疗过程中督灸治疗的减毒、增效作用,并探讨其作用机制。方法将符合纳入标准的慢性乙型肝炎患者60例随机分为督灸联合长效干扰素α-2a组(治疗组)和长效干扰素组α-2a组(对照组),每组各30例。观察2组患者治疗12周、24周、48周谷丙转氨酶(ALT)、HBV DNA阴转情况、HBeAg血清学转换情况以及干扰素不良反应发生情况。结果治疗组疗效明显优于对照组(P <0. 05)。治疗12周、24周时,治疗组ALT水平均明显低于对照组(P均<0. 05),治疗48周时2组ALT水平均正常且组间比较差异无统计学意义(P>0. 05);治疗24周、48周时,治疗组HBV DNA阴转率及HBeAg阴转率均明显高于对照组(P均<0. 05);治疗组发热、头痛、全身酸痛、乏力、纳差不良反应发生率均明显低于对照组(P均<0. 05)。结论督灸联合长效干扰素α-2a治疗慢性乙型肝炎在改善患者肝功能、提高HBV DNA阴转率和HBeAg转换率以及降低干扰素不良反应发生率方面疗效明显优于单纯应用长效干扰素组α-2a治疗,为督灸治疗慢性乙型肝炎的推广应用提供了依据。
Objective It is to observe the clinical efficacy of Du-moxibustion combined with long-acting interferon on chronic hepatitis B,to evaluate the attenuation and synergism of moxibustion therapy in this treatment,and to explore its mechanism of action. Methods Sixty patients with chronic hepatitis B who met the inclusion criteria were randomly divided into the moxibustion combined with long-acting interferon α-2a group(treatment group) and the long-acting interferon groupα-2a group(control group),30 cases in each group. Liver function(ALT),HBV-DNA negative conversion,HBe Ag seroconversion,and occurrence of interferon adverse reactions were observed in the two groups after 12,24,and 48 weeks of treatment. Results The curative effect of treatment group was better than that of control group(P < 0. 05). After 12 and 24 weeks of treatment,the levels of ALT in the treatment group were significantly higher than those in the control group(P <0. 05),after treatment for 48 week,the levels were normal and there was no significant difference between the two groups(P > 0. 05). After treatment for 24 and 48 weeks,the rates of HBV-DNA and HBe Ag negative conversion in the treatment group were significantly higher than those in the control group(P < 0. 05). The incidence of adverse reactions such as fever,headache,body aches,fatigue,anorexia in the treatment group was significantly lower than those in the control group(P < 0. 05). Conclusion The curative effect of Du-moxibustion combined with long-acting interferon α-2a is better than long-acting interferon α-2a used alone on chronic hepatitis B in improving liver function,increasing HBV-DNA negative conversion rate,increasing serological HBe Ag conversion rate and reducing the incidence of interferon adverse reactions,these results provide some evidences for the promotion and application of Du-moxibustion for chronic hepatitis B.
Objective It is to observe the clinical efficacy of Du-moxibustion combined with long-acting interferon on chronic hepatitis B,to evaluate the attenuation and synergism of moxibustion therapy in this treatment,and to explore its mechanism of action. Methods Sixty patients with chronic hepatitis B who met the inclusion criteria were randomly divided into the moxibustion combined with long-acting interferon α-2a group(treatment group) and the long-acting interferon groupα-2a group(control group),30 cases in each group. Liver function(ALT),HBV-DNA negative conversion,HBe Ag seroconversion,and occurrence of interferon adverse reactions were observed in the two groups after 12,24,and 48 weeks of treatment. Results The curative effect of treatment group was better than that of control group(P < 0. 05). After 12 and 24 weeks of treatment,the levels of ALT in the treatment group were significantly higher than those in the control group(P <0. 05),after treatment for 48 week,the levels were normal and there was no significant difference between the two groups(P > 0. 05). After treatment for 24 and 48 weeks,the rates of HBV-DNA and HBe Ag negative conversion in the treatment group were significantly higher than those in the control group(P < 0. 05). The incidence of adverse reactions such as fever,headache,body aches,fatigue,anorexia in the treatment group was significantly lower than those in the control group(P < 0. 05). Conclusion The curative effect of Du-moxibustion combined with long-acting interferon α-2a is better than long-acting interferon α-2a used alone on chronic hepatitis B in improving liver function,increasing HBV-DNA negative conversion rate,increasing serological HBe Ag conversion rate and reducing the incidence of interferon adverse reactions,these results provide some evidences for the promotion and application of Du-moxibustion for chronic hepatitis B.
引文
[1]王常松,周嘉鹤,吴银盘,等.从慢性乙型肝炎治疗总策略看中医治疗优势与存在的问题[J].辽宁中医,2010,37(4):636-638
[2]国家中医药管理局.中药新药临床研究指导原则(试行)[S].北京:中国医药科技出版社,2002:143-151
[3]肖素芬,张光荣. a-2b干扰素与香菇多糖合用治疗乙型肝炎的疗效观察[J].实用临床医学,2009,10(3):34
[4]金涛,游运轲,李清秀.肝康合剂联合干扰素治疗慢性乙型肝炎54例[J].中医杂志,2007,48(3):220-222
[5]杨育林,施维群.慢性乙型肝炎中医外治法探究[J].中医外治杂志,2009,18(3):54-56
[6]崇桂琴,马元,孙洪胜,等.督灸治疗强直性脊柱炎的临床与镇痛机理研究[J].针灸临床杂志,1999,15(6):46-47
[7]杨莉,杨金生,李亮,等.灸法作用机理的研究现状与分析[J].光明中医,2010,25(5):160-161
[8]陈向华,张国有,周美启,等.艾灸的现代药学与药理学研究探析[J].中国针灸,2009,29(5):88-90
[9]高希言,封丽华,李卫红,等.艾灸督脉穴对亚急性衰老小鼠自由基与免疫器官的影响[J].河南中医学院学报,2003,18(5):22
[10]张传英,唐照亮.艾灸调节机体免疫功能研究概况[J].安徽中医学院学报,2009,28(2):62-64
[11]苏李,李亮,杨金生,等.艾灸对机体功能影响的现代研究[J].中国中医药信息杂志,2010,17(2):101-103
[2]国家中医药管理局.中药新药临床研究指导原则(试行)[S].北京:中国医药科技出版社,2002:143-151
[3]肖素芬,张光荣. a-2b干扰素与香菇多糖合用治疗乙型肝炎的疗效观察[J].实用临床医学,2009,10(3):34
[4]金涛,游运轲,李清秀.肝康合剂联合干扰素治疗慢性乙型肝炎54例[J].中医杂志,2007,48(3):220-222
[5]杨育林,施维群.慢性乙型肝炎中医外治法探究[J].中医外治杂志,2009,18(3):54-56
[6]崇桂琴,马元,孙洪胜,等.督灸治疗强直性脊柱炎的临床与镇痛机理研究[J].针灸临床杂志,1999,15(6):46-47
[7]杨莉,杨金生,李亮,等.灸法作用机理的研究现状与分析[J].光明中医,2010,25(5):160-161
[8]陈向华,张国有,周美启,等.艾灸的现代药学与药理学研究探析[J].中国针灸,2009,29(5):88-90
[9]高希言,封丽华,李卫红,等.艾灸督脉穴对亚急性衰老小鼠自由基与免疫器官的影响[J].河南中医学院学报,2003,18(5):22
[10]张传英,唐照亮.艾灸调节机体免疫功能研究概况[J].安徽中医学院学报,2009,28(2):62-64
[11]苏李,李亮,杨金生,等.艾灸对机体功能影响的现代研究[J].中国中医药信息杂志,2010,17(2):101-103