国际流行病学传染病学杂志
國際流行病學傳染病學雜誌
국제류행병학전염병학잡지
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY AND INFECTIOUS DISEASE
2012年
4期
222-225
,共4页
邱源旺%黄利华%华海涌%牛雪花%吴鹏飞%吴杭源%朱宏英%杨小娟%姚上志%李燚光
邱源旺%黃利華%華海湧%牛雪花%吳鵬飛%吳杭源%硃宏英%楊小娟%姚上誌%李燚光
구원왕%황리화%화해용%우설화%오붕비%오항원%주굉영%양소연%요상지%리일광
血吸虫病%肝炎病毒,乙型%肝纤维化%大黄蛰虫丸%治疗效果
血吸蟲病%肝炎病毒,乙型%肝纖維化%大黃蟄蟲汍%治療效果
혈흡충병%간염병독,을형%간섬유화%대황칩충환%치료효과
Schistosomiasis%Hepatitis B virus%Hepatic fibrosis%Dahuangzhechong pill%Therapeutic effects
目的 观察大黄蛰虫丸治疗晚期血吸虫病合并HBV感染患者的疗效及安全性.方法 将确诊的90例晚期血吸虫病患者作为研究对象,其中合并HBV感染且HBV DNA阴性患者按数字表法随机分为A、B组各30例,将合并HBV感染且HBV DNA阳性患者设为C组,A组采用常规护肝治疗,B、C组均在常规护肝治疗基础上加用大黄蛰虫丸抗纤维化治疗,疗程均为52周,观察治疗前后患者肝功能、肝纤维化指标、凝血酶原时间(PT)、Child-pug评分及肝脏B超影像学的变化.结果 与治疗前相比,3组治疗后ALT和TBil水平均有明显改善(t=3.011、3.821、3.152和3.672、3.760、3.234,P＜0.05).B组治疗后透明质酸、Ⅳ型胶原、层黏连蛋白、门静脉内径及门静脉血流量分别为(283.6±56.2) ng/mL、( 145.9±57.2) ng/mL、(156.8±48.6) ng/mL、(1.27±0.42) cm、(0.48±0.21) L/min,与治疗前比较差异均有统计学意义(t=3.786、4.254、3.012、3.411、3.152,P＜0.05)；B组治疗后上述指标改善明显优于与A、C两组(F=3.951、3.758、3.282、3.169、3.054,P＜0.05).而A、C两组肝纤维化及B超指标均无明显改善.B组采用大黄蛰虫丸治疗过程中未出现严重不良反应.C组3例患者出现肝功能损害进行性加重及出现重型肝炎表现.结论 大黄蛰虫丸治疗晚期血吸虫病合并HBV感染且HBV DNA阴性患者安全有效,但治疗晚期血吸虫病合并HBV感染且HBV DNA阳性患者无显著疗效.
目的 觀察大黃蟄蟲汍治療晚期血吸蟲病閤併HBV感染患者的療效及安全性.方法 將確診的90例晚期血吸蟲病患者作為研究對象,其中閤併HBV感染且HBV DNA陰性患者按數字錶法隨機分為A、B組各30例,將閤併HBV感染且HBV DNA暘性患者設為C組,A組採用常規護肝治療,B、C組均在常規護肝治療基礎上加用大黃蟄蟲汍抗纖維化治療,療程均為52週,觀察治療前後患者肝功能、肝纖維化指標、凝血酶原時間(PT)、Child-pug評分及肝髒B超影像學的變化.結果 與治療前相比,3組治療後ALT和TBil水平均有明顯改善(t=3.011、3.821、3.152和3.672、3.760、3.234,P＜0.05).B組治療後透明質痠、Ⅳ型膠原、層黏連蛋白、門靜脈內徑及門靜脈血流量分彆為(283.6±56.2) ng/mL、( 145.9±57.2) ng/mL、(156.8±48.6) ng/mL、(1.27±0.42) cm、(0.48±0.21) L/min,與治療前比較差異均有統計學意義(t=3.786、4.254、3.012、3.411、3.152,P＜0.05)；B組治療後上述指標改善明顯優于與A、C兩組(F=3.951、3.758、3.282、3.169、3.054,P＜0.05).而A、C兩組肝纖維化及B超指標均無明顯改善.B組採用大黃蟄蟲汍治療過程中未齣現嚴重不良反應.C組3例患者齣現肝功能損害進行性加重及齣現重型肝炎錶現.結論 大黃蟄蟲汍治療晚期血吸蟲病閤併HBV感染且HBV DNA陰性患者安全有效,但治療晚期血吸蟲病閤併HBV感染且HBV DNA暘性患者無顯著療效.
목적 관찰대황칩충환치료만기혈흡충병합병HBV감염환자적료효급안전성.방법 장학진적90례만기혈흡충병환자작위연구대상,기중합병HBV감염차HBV DNA음성환자안수자표법수궤분위A、B조각30례,장합병HBV감염차HBV DNA양성환자설위C조,A조채용상규호간치료,B、C조균재상규호간치료기출상가용대황칩충환항섬유화치료,료정균위52주,관찰치료전후환자간공능、간섬유화지표、응혈매원시간(PT)、Child-pug평분급간장B초영상학적변화.결과 여치료전상비,3조치료후ALT화TBil수평균유명현개선(t=3.011、3.821、3.152화3.672、3.760、3.234,P＜0.05).B조치료후투명질산、Ⅳ형효원、층점련단백、문정맥내경급문정맥혈류량분별위(283.6±56.2) ng/mL、( 145.9±57.2) ng/mL、(156.8±48.6) ng/mL、(1.27±0.42) cm、(0.48±0.21) L/min,여치료전비교차이균유통계학의의(t=3.786、4.254、3.012、3.411、3.152,P＜0.05)；B조치료후상술지표개선명현우우여A、C량조(F=3.951、3.758、3.282、3.169、3.054,P＜0.05).이A、C량조간섬유화급B초지표균무명현개선.B조채용대황칩충환치료과정중미출현엄중불량반응.C조3례환자출현간공능손해진행성가중급출현중형간염표현.결론 대황칩충환치료만기혈흡충병합병HBV감염차HBV DNA음성환자안전유효,단치료만기혈흡충병합병HBV감염차HBV DNA양성환자무현저료효.
Objective To evaluate the therapeutic effects and safety of Dahuangzhechong pill on patients with advanced schistosomiasis and HBV infection.Methods Ninty patients with advanced schistosomiasis were selected.Among the patients,60 cases with HBV co-infection and HBV DNA negative were divided randomly into two groups:group A and group B.The other 30 patients with HBV co-infection and HBV DNA positive were group C.In group A,patients were treated with routine hepatoprotective therapy.In group B and group C,all patients received Dahuangzhechong pill and routine hepatoprotective therapy.The course of treatment was 52 weeks in three groups.Before and after 52-week treatment,the level of liver function,hepatic fibrosis,prothrombin time(PT),Child-pugh score and changes of B-type ultrasonic images were detected for all the patients.Results After 52-week treatment,the ALT,TBil level in 3 groups decreased significantly (t =3.011,3.821,3.152 and 3.672,3.760,3.234,P ＜ 0.05).The level of hyaluronic acid,Ⅳ collagen,laminin,portal venous inside diameter and portal venous flow in group B after treatment were (283.6±56.2)ng/mL,(145.9±57.2)ng/mL,(156.8±48.6)ng/mL,(1.27±0.42)cm,(0.48±0.21)L/min,and decreased significantly comparing with the level before treatment (t =3.786,4.254,3.012,3.411,3.152,P ＜ 0.05),and were better than those in group A and C ( F =3.951,3.758,3.282,3.169,3.054,P ＜ 0.05).The changes of hepatic fibrosis and B-type ultrasonic images in group A and C had no statistical differences before and after treatment.In addition,there was no obvious adverse reaction during the treatment in group B,and there were 3 patients with liver progressive dysfunction and severe hepatitis in group C.Conclusions Dahuangzhechong pill is safe and effective for the patients of advanced schistosomiasis with HBV infection and HBV DNA negative,but Dahuangzhechong pill is not safe and effective for the patients of advanced schistosomiasis with HBV infection and HBV DNA positive.
