归芍六君子汤联合恩替卡韦对乙型病毒性肝炎患者经阿德福韦酯治疗后肾损伤的改善作用
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摘要
目的:观察归芍六君子汤联合恩替卡韦对乙型病毒性肝炎患者经阿德福韦酯治疗后肾损伤的改善作用。方法:选取80例经阿德福韦酯治疗后肾损伤的乙型病毒性肝炎患者为研究对象,随机分为观察组与对照组各40例。观察组给予归芍六君子汤联合恩替卡韦分散片治疗,对照组单纯以恩替卡韦分散片治疗,比较2组的临床疗效,HBe Ag阴转率、HBe Ag/-HBe Ab血清学转换率、HBV DNA阴转率,血肌酐、肾小球滤过率等肾功能指标及不良反应发生情况。结果:观察组总有效率(95.00%)高于对照组(80.00%),差异有统计学意义(P<0.05)。观察组HBe Ag阴转率、HBe Ag/-HBe Ab血清学转换率及HBV DNA阴转率均高于对照组,差异均有统计学意义(P<0.05)。治疗12周、24周后,观察组血肌酐低于对照组,肾小球滤过率高于对照组,差异均有统计学意义(P<0.05)。治疗24周后,观察组中医证候积分低于对照组(P<0.05)。治疗期间,2组患者均未发生不良反应。结论:中西医联合用药能有效抑制病毒复制,病毒学应答较好,疗效显著,可降低患者的血肌酐水平,提高肾小球滤过率,改善肾功能,且无不良反应发生,安全可靠。
Objective:To observe the improving effect of Guishao Liujunzi tang combined with entecavir on renal injury of patients with hepatitis B after being treated with adefovir dipivoxil. Methods: Selected 80 cases of renal injury patients with hepatitis B after being treated with adefovir dipivoxil as study objects, and divided them into the observation group and the control group,40 cases in each group. The observation group was treated with Guishao Liujunzi tang combined with entecavir tablets,while the control group was only treated with entecavir tablets. Compared the clinical effect,some indexes such as the negative conversion rate of HBe Ag,the conversion rate of HBe Ag/HBe Ab serological,the negative conversion rate of HBe Ag DNA, the serum creatinine and the glomerular filtration rate and adverse reaction between two groups. Results: The total effective rate of the observation group(95.00%) was higher than that of the control group(80.00%)(P < 0.05). The negative conversion rate of HBe Ag,the conversion rate of HBe Ag/HBe Ab serological and the negative conversion rate of HBe Ag DNA in the observation group were all higher than those in the control group(P < 0.05). While 12 weeks and 24 weeks after treatment,in the observation group,the serum creatinine was lower than that in the control group,but the glomerular filtration rate was higher than that in the control group(P < 0.05). While 24 weeks after treatment,Chinese medicine symptom scores in the observation group were lower than those in the control group(P < 0.05). No adverse reaction was found in both groups during the treatment. Conclusion: Integrated Chinese and western medicine therapy can effectively inhibit virus replication and has better viral response and evident curative effect. It can reduce levels of serum creatinine, increase glomerular filtration rate and improve renal function. It doesn't cause any adverse reaction,which is safe and reliable.
Objective:To observe the improving effect of Guishao Liujunzi tang combined with entecavir on renal injury of patients with hepatitis B after being treated with adefovir dipivoxil. Methods: Selected 80 cases of renal injury patients with hepatitis B after being treated with adefovir dipivoxil as study objects, and divided them into the observation group and the control group,40 cases in each group. The observation group was treated with Guishao Liujunzi tang combined with entecavir tablets,while the control group was only treated with entecavir tablets. Compared the clinical effect,some indexes such as the negative conversion rate of HBe Ag,the conversion rate of HBe Ag/HBe Ab serological,the negative conversion rate of HBe Ag DNA, the serum creatinine and the glomerular filtration rate and adverse reaction between two groups. Results: The total effective rate of the observation group(95.00%) was higher than that of the control group(80.00%)(P < 0.05). The negative conversion rate of HBe Ag,the conversion rate of HBe Ag/HBe Ab serological and the negative conversion rate of HBe Ag DNA in the observation group were all higher than those in the control group(P < 0.05). While 12 weeks and 24 weeks after treatment,in the observation group,the serum creatinine was lower than that in the control group,but the glomerular filtration rate was higher than that in the control group(P < 0.05). While 24 weeks after treatment,Chinese medicine symptom scores in the observation group were lower than those in the control group(P < 0.05). No adverse reaction was found in both groups during the treatment. Conclusion: Integrated Chinese and western medicine therapy can effectively inhibit virus replication and has better viral response and evident curative effect. It can reduce levels of serum creatinine, increase glomerular filtration rate and improve renal function. It doesn't cause any adverse reaction,which is safe and reliable.
引文
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[11]戴以顺,齐兴江.中西医结合治疗慢性黄疸型乙型肝炎的临床观察及中药对肝功能转归的影响[J].实用药物与临床,2013,16(10):902-904.
[2]赵亚娟,王丽.恩替卡韦治疗失代偿期乙型肝炎肝硬化的临床观察[J].河北医药,2012,34(13):1987-1988.
[3]尹燕耀,林云华,宗亚力,等.柴芍六君子汤加减对肝郁脾虚型慢性乙型肝炎免疫介导发病机制的干预研究[J].辽宁中医杂志,2014,41(11):2394-2396.
[4]中华医学会传染病与寄生虫病学分会、肝病学分会.病毒性肝炎防治方案[J].中华内科杂志,2001,40(1):62-68.
[5]中国中医药学会内科肝病专业委员会.病毒性肝炎中医辨证标准(试行)[J].中医杂志,1992,33(5):39-40.
[6]占伯林,张来,陈亮,等.中药联合阿德福韦酯治疗HBe Ag阳性慢性乙型肝炎的临床研究[J].中西医结合肝病杂志,2013,23(4):196-198.
[7]何丽萍.茵陈白术汤联合阿德福韦酯治疗慢性乙型肝炎的临床观察[J].中国医药导报,2013,10(20):66-68.
[8]王恩成,唐琳,王健,等.慢性乙型肝炎中医证候聚类分析研究[J].中国中西医结合杂志,2014,34(1):39-42.
[9]刘如秀,刘宇,汪艳丽,等.当归的药理作用[J].西部中医药,2014,27(11):153-156.
[10]张利.白芍的药理作用及现代研究进展[J].中医临床研究,2014,6(29):25-26.
[11]戴以顺,齐兴江.中西医结合治疗慢性黄疸型乙型肝炎的临床观察及中药对肝功能转归的影响[J].实用药物与临床,2013,16(10):902-904.