大黄蛰虫丸联合拉米夫定治疗晚期血吸虫病合并HBV感染的临床观察  

Clinical Observation of Dahuang Zhechong Pills Combined with Lamivudine in the Treatment of Advanced Schistosomiasis Complicating with HBV Infection

作　　者：邱源旺[1] 黄利华[1] 华海涌[2] 牛雪花[3] 吴鹏飞[3] 吴杭源[1] 朱宏英[1] 杨小娟[1] 姚上志[1] 李燚光[1] 

机构地区：[1]无锡市第五人民医院,江苏无锡214000 [2]江苏省寄生虫病防治研究所,江苏无锡214000 [3]昆山市第三人民医院,江苏昆山215316

出　　处：《中国药房》2012年第12期1094-1096,共3页China Pharmacy

基　　金：江苏省卫生厅血地寄防应用性科研课题(X200913)

摘　　要：目的:观察大黄蛰虫丸联合拉米夫定治疗合并乙型肝炎病毒(HBV)感染的晚期血吸虫病的疗效及安全性。方法:将60例合并HBV感染的晚期血吸虫病患者随机分为治疗组和对照组,2组在病原治疗后,对照组在常规治疗基础上加用大黄蛰虫丸治疗,治疗组在对照组的基础上加用拉米夫定抗病毒治疗,2组疗程均为52周。观察2组患者肝纤维化指标、肝功能、乙型肝炎病毒标记物(HBV-M)、HBV DNA的变化及不良反应。结果:治疗后,治疗组肝纤维化指标、丙氨酸氨基转移酶(ALT)水平、HBV DNA水平、Child-Pugh评分、ALT复常率、HBV DNA在检测水平以下的比率均较治疗前显著改善(P<0.05),对照组玻璃酸(HA)、ALT水平较治疗前显著改善(P<0.05),其他指标较治疗前虽有所改善,但差异无统计学意义(P>0.05)。治疗后,2组间ALT水平、HBV DNA水平、Child-pugh评分、ALT复常率、HBV DNA在检测水平以下的比率比较,差异均有统计学意义(P<0.05)。治疗组治疗过程中未出现严重不良反应,对照组有1例因肝功能损害加重死亡。结论:大黄蛰虫丸联合拉米夫定治疗合并HBV感染的晚期血吸虫病患者近期安全、有效。OBJECTIVE： To evaluate therapeutic efficacy and safety of Dahuang zhechong pills combined with lamivudine in the treatment of advanced schistosomiasis complicating with HBV infection. METHODS ： 60 patients with advanced schistosomiasis complicating with HBV infection were randomly divided into treatment group and control group. Patients in control group received Dahuang zhechong pills on the basis of conventional treatment, and Patients in treatment group received in Dahuang zhechong pills combined with lamivudine on the basis of conventional treatment for 52 weeks. The changes of hepatic fibrosis, liver fimction, hep- atitis B virus markers （HBV-M）, HBV DNA and adverse drug reactions were all observed. RESULTS： The ALT normalization rate, undetectable rate of HBV DNA, hepatic fibrosis index, Child-Pugh score, the rate of ALT returned to normal and the rate of HBV DNA below the level of detection of treatment group were all improved significantly after treatment, there were statistical sig- nificance （P〈0.05）. The HA, ALT of control group was improved significanty （P〈0.05）, other indicators have improved, but the difference was not statistical significance （P〉0.05）. After treatment in 2 groups, the ALT, HBV DNA, Child-Pugh score, the rate of ALT returned to normal and the rate of HBV DNA below the level of detection was statistly significanty. In addition, there was no severe adverse drug reaction in treatment group during the treatment （P〉0.05）. 1 death case caused by liver function damage aggravation was found in control group. CONCLUSION： Dahuang zhechong pills combined with lamivudine is safe and effective therapy for the patients with advanced schistosomiasis complicating with HBV infection.

关 键 词：晚期血吸虫病 乙型肝炎 大黄蛰虫丸 拉米夫定 

分 类 号：R969.4[医药卫生—药理学] R978.7[医药卫生—药学]