摘要
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HBVDNA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HBVDNA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（Pr）、Child-pugh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、（I．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HBVDNA阴性患者安全有效，但治疗晚期血吸虫病合并HBV感染且HBVDNA阳性患者无显著疗效。
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 Dahuangzhe- chong 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, pmthrombin 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 trealment 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.
出处
《国际流行病学传染病学杂志》
CAS
2012年第4期222-225,共4页
International Journal of Epidemiology and Infectious Disease
基金
江苏省卫生厅血地寄防应用性科研课题（X200913）
关键词
血吸虫病
肝炎病毒
乙型
肝纤维化
大黄蛰虫丸
治疗效果
Schistosomiasis
Hepatitis B virus
Hepatic fibrosis
Dahuangzhechong pill
Therapeutic effects
