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复方芪术汤联合替比夫定治疗慢性乙型肝炎临床疗效()

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《西部中医药》[ISSN:2096-9600/CN:62-1204/R]

Title:: Curative Effects of Compound QiZhu Decoction Jointed with Tibivudine in Treating Chronic Hepatitis B

作者:: 陆云飞1，叶佩燕2，孙剑勇3，陈晓蓉2，陈建杰1△; 1 上海中医药大学附属曙光医院，上海 201203； 2 上海市公共卫生临床中心； 3 复旦大学附属中山医院

Author(s):: LU Yunfei1, YE Peiyan2, SUN Jianyong3, CHEN Xiaorong2, CHEN Jianjie1△; 1 Shanghai Shuguang Hospital Affiliated with Shanghai University of TCM, Shanghai 201203, China; 2 Shanghai Public Health Clinical Center; 3 Zhongshan Hospital Affiliated to Fudan University

Keywords:: chronic hepatitis B; HBeAg; creatine kinase; compound QiZhu decoction; tibivudine

摘要:: 目的：观察复方芪术汤联合替比夫定治疗乙型肝炎e抗原(HBeAg)阳性慢性乙型肝炎(CHB)疗效。方法：将HBeAg阳性CHB初治患者126例随机分为治疗组65例和对照组61例，2组均予替比夫定600 mg/d基础治疗，治疗组加用复方芪术汤治疗，疗程2年，分析比较治疗前后HBeAg、HBV-DNA、肌酸激酶(CK)等变化情况。结果：1)治疗后，治疗组与对照组HBV-DNA转阴率分别为90.77%和83.61%；丙氨酸氨基转移酶(ALT)复常率分别为84.62%和86.88%(P＞0.05)；治疗组HBeAg转阴率为32.31%，高于对照组的24.59%，但差异无统计学意义(P＞0.05)。2)治疗后治疗组CK＞2ULN的患者为9.23%，低于对照组的16.67%（P＜0.05)。结论：复方芪术汤联合替比夫定可增加HBeAg阳性慢性乙型肝炎患者HBeAg血清学转换率，降低CK升高发生率。

Abstract:: Objective: To observe clinical effects of compound QiZhu decoction and tibivudine in the treatment for positive hepatitis B e antigen (HBeAg) chronic hepatitis B (CHB). Methods: All 126 positive HBeAg CHB patients who accepted initial treatment were randomized into 65 cases of the treatment group and 61 cases of the control group, both groups accepted basic therapy of tibivudine, 600mg/d, the treatment group took compound QiZhu decoction, the course was two years, the changes of HBeAg, HBV-DNA, creatine kinase (CK) and others were analyzed and compared before and after the treating. Results: 1) After treating, HBV DNA negative-conversion rates of the treatment group and the control group were 90.77% and 83.61%; ALT normal-returning rates were 84.62% and 86.88% respectively (P>0.05); HBeAg negative-conversion rate of the treatment group was 32.31%, higher than 24.59% of the control group, while the difference had no statistical meaning (P＞0.05). 2) The rate of CK>2ULN of the treatment group after treating was 9.23%, lower than 16.67% of the control group(P＜0.05). Conclusion: Compound QiZhu decoction and tibivudine could increase HBeAg conversion rate and decrease the incidence of CK rising in the treatment for positive HBeAg CHB.

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备注/Memo:: 收稿日期：2017-04-10 *基金项目：上海市卫生局中医药科研基金课题(编号2012QL020A)。作者简介：陆云飞(1978—)，女，硕士学位，副主任医师。研究方向：肝病的中西医结合诊治。 △通讯作者：陈建杰(1952—)，男，博士研究生导师，主任医师。研究方向：肝病的诊治。

更新日期/Last Update: 2018-09-15