Objective There are many clinical reports on traditional Chinese medicine(TCM)combined with nucleoside(acid)analogues(NAs)for the treatment of chronic hepatitis B(CHB),but its efficacy and safety are not completely cl...Objective There are many clinical reports on traditional Chinese medicine(TCM)combined with nucleoside(acid)analogues(NAs)for the treatment of chronic hepatitis B(CHB),but its efficacy and safety are not completely clear.This meta-analysis aims to evaluate the clinical efficacy and safety thus providing evidence for clinical applications.Methods We searched Chinese databases the China National Knowledge Infrastructure(CNKI),Wanfang Data,and China Science and Technology Journal Database(VIP),as well as English databases Pub Med and Cochrane Library,from time of establishment to April 14,2021.Literature quality was evaluated according to the bias risk assessment criteria of Cochrane Collaboration network.Rev Man 5.3 and Stata 12.0 software were used to perform this research.Results A total of 23 articles,3282 patients,and 25 TCM prescriptions were included in this study.NAs plus TCM remarkably improved the clinical total effective rate[Odds ratio(OR)=3.92,P<0.00001],TCM syndrome score(Mean difference=-3.73,P<0.00001),hepatitis B virus(HBV)DNA negative conversion rate(OR=1.49,P=0.0001),hepatitis Be antigen(HBe Ag)negative conversion rate(OR=2.03,P<0.00001),alanine aminotransferase levels[Std mean difference(SMD)=-0.95,P<0.00001],and aspartate aminotransferase levels(SMD=-0.70,P=0.0004).Adverse reaction rates did not increase in the combined treatment group(OR=0.97,P=0.84).A comprehensive analysis of the 25 TCM prescriptions suggested that the combination of spleen-strengthening prescriptions with NAs showed better effects than other prescriptions.Conclusion TCM in combination with NAs,demonstrated better clinical efficacy against CHB than NAs alone.In addition,the combination of spleen-strengthening prescriptions and NAs was identified as the best therapeutic strategy.However,more randomized controlled trials of high quality are needed to provide more reliable clinical basis for the application of TCM.展开更多
A series of novel L-amino acid esters prodrugs of acyclic nucleoside phosphonates was synthesized and their anti-HBV activity was evaluated in HepG2 2.2.15 cells. Compound 1d exhibited more potent anti-HBV activity an...A series of novel L-amino acid esters prodrugs of acyclic nucleoside phosphonates was synthesized and their anti-HBV activity was evaluated in HepG2 2.2.15 cells. Compound 1d exhibited more potent anti-HBV activity and lower cytotoxicity than those of adefovir dipivoxil with EC50 and CC50 values of 0.207 μmol/L and 2530 μmol/L, respectively.展开更多
目的:了解解放军第302医院(以下简称"我院")住院药房抗乙型肝炎病毒(hepatitis B virus,HBV)核苷(酸)类似物的使用情况及趋势,为临床合理用药提供参考。方法:采用回顾性分析法,通过住院药房信息管理系统,提取2014—2016年我院...目的:了解解放军第302医院(以下简称"我院")住院药房抗乙型肝炎病毒(hepatitis B virus,HBV)核苷(酸)类似物的使用情况及趋势,为临床合理用药提供参考。方法:采用回顾性分析法,通过住院药房信息管理系统,提取2014—2016年我院抗HBV核苷(酸)类似物的使用量、销售金额,对用药频度及限定日费用等进行统计分析。结果:2014—2016年我院抗HBV核苷(酸)类似物的使用量、销售金额总体呈逐年递增趋势,2015年其销售金额增长率高达11.23%(2014年为342.99万元,2015年为363.71万元)。恩替卡韦和替诺福韦的使用量均呈逐年递增趋势,而拉米夫定、阿德福韦酯和替比夫定的使用量有所降低;3年来,恩替卡韦和替比夫定的药品销售金额排序/用药频度排序的比值均为1,表明其用药人数与销售金额的同步性良好。结论:核苷(酸)类似物已经成为抗HBV的首选药物,临床上更倾向于选择高效低耐药率的阿德福韦酯、恩替卡韦和替诺福韦。临床医师应进一步规范应用核苷(酸)类似物,根据患者个体情况制订合理的治疗方案,降低耐药率。展开更多
目的观察核苷(酸)类药物联合CIK治疗慢性乙型肝炎患者Th1/Th2类细胞功能变化,为维持持久免疫应答,减少核苷(酸)类药物停药后复发提供理论依据。方法15例慢性乙型肝炎患者在核苷(酸)类药物治疗达到HBV DNA检测水平下限时给予CIK治疗,分...目的观察核苷(酸)类药物联合CIK治疗慢性乙型肝炎患者Th1/Th2类细胞功能变化,为维持持久免疫应答,减少核苷(酸)类药物停药后复发提供理论依据。方法15例慢性乙型肝炎患者在核苷(酸)类药物治疗达到HBV DNA检测水平下限时给予CIK治疗,分别在核苷(酸)类药物治疗前、HBV DNA达到检测水平下限以及CIK治疗后2周3个时间点采用流式细胞术检测Th1/Th2类细胞功能,10例单独接受CIK治疗和10例单独接受核苷(酸)类药物治疗的慢性乙型肝炎患者作为对照组。结果无论是观察组还是对照组,当接受核苷(酸)类药物并HBV DNA水平达到不可检测水平以下时,CD4细胞产生IFN-γ水平明显升高(1.511±1.026 vs 2.139±0826,1.656±0.869 vs 2.511±1.133,P<0.05),IL-4水平无明显变化,单独接受CIK治疗后IFN-γ水平也明显增高(1.434±0.924 vs 2.211±0.921,P<0.05),IL-4水平无明显变化,同前两组比较IFN-γ水平和IL-4水平均无差异。核苷(酸)类药物联合CIK治疗后相比单独CIK治疗和单独核苷(酸)类药物治疗,不但IFN-γ明显增高(3.288±0.561 vs 2.211±0.921,3.288±0.561 vs 2.511±1.133,P<0.05),并且IL-4水平也降低(0.277±0.237 vs 0.428±0.208,0.277±0.237 vs 0.477±0.255,P<0.05)。结论核苷(酸)类药物联合CIK治疗明显提高Th1类细胞应答,并抑制Th2类细胞功能,但是否持久维持Th1类细胞免疫应答还需要进一步研究。展开更多
基金We thank for the funding support from the Hundred Talents Program of Hunan Province(No.9999004007)the Startup grant of Hunan University of Chinese Medicine(No.999900201107).
文摘Objective There are many clinical reports on traditional Chinese medicine(TCM)combined with nucleoside(acid)analogues(NAs)for the treatment of chronic hepatitis B(CHB),but its efficacy and safety are not completely clear.This meta-analysis aims to evaluate the clinical efficacy and safety thus providing evidence for clinical applications.Methods We searched Chinese databases the China National Knowledge Infrastructure(CNKI),Wanfang Data,and China Science and Technology Journal Database(VIP),as well as English databases Pub Med and Cochrane Library,from time of establishment to April 14,2021.Literature quality was evaluated according to the bias risk assessment criteria of Cochrane Collaboration network.Rev Man 5.3 and Stata 12.0 software were used to perform this research.Results A total of 23 articles,3282 patients,and 25 TCM prescriptions were included in this study.NAs plus TCM remarkably improved the clinical total effective rate[Odds ratio(OR)=3.92,P<0.00001],TCM syndrome score(Mean difference=-3.73,P<0.00001),hepatitis B virus(HBV)DNA negative conversion rate(OR=1.49,P=0.0001),hepatitis Be antigen(HBe Ag)negative conversion rate(OR=2.03,P<0.00001),alanine aminotransferase levels[Std mean difference(SMD)=-0.95,P<0.00001],and aspartate aminotransferase levels(SMD=-0.70,P=0.0004).Adverse reaction rates did not increase in the combined treatment group(OR=0.97,P=0.84).A comprehensive analysis of the 25 TCM prescriptions suggested that the combination of spleen-strengthening prescriptions with NAs showed better effects than other prescriptions.Conclusion TCM in combination with NAs,demonstrated better clinical efficacy against CHB than NAs alone.In addition,the combination of spleen-strengthening prescriptions and NAs was identified as the best therapeutic strategy.However,more randomized controlled trials of high quality are needed to provide more reliable clinical basis for the application of TCM.
文摘A series of novel L-amino acid esters prodrugs of acyclic nucleoside phosphonates was synthesized and their anti-HBV activity was evaluated in HepG2 2.2.15 cells. Compound 1d exhibited more potent anti-HBV activity and lower cytotoxicity than those of adefovir dipivoxil with EC50 and CC50 values of 0.207 μmol/L and 2530 μmol/L, respectively.
文摘目的:了解解放军第302医院(以下简称"我院")住院药房抗乙型肝炎病毒(hepatitis B virus,HBV)核苷(酸)类似物的使用情况及趋势,为临床合理用药提供参考。方法:采用回顾性分析法,通过住院药房信息管理系统,提取2014—2016年我院抗HBV核苷(酸)类似物的使用量、销售金额,对用药频度及限定日费用等进行统计分析。结果:2014—2016年我院抗HBV核苷(酸)类似物的使用量、销售金额总体呈逐年递增趋势,2015年其销售金额增长率高达11.23%(2014年为342.99万元,2015年为363.71万元)。恩替卡韦和替诺福韦的使用量均呈逐年递增趋势,而拉米夫定、阿德福韦酯和替比夫定的使用量有所降低;3年来,恩替卡韦和替比夫定的药品销售金额排序/用药频度排序的比值均为1,表明其用药人数与销售金额的同步性良好。结论:核苷(酸)类似物已经成为抗HBV的首选药物,临床上更倾向于选择高效低耐药率的阿德福韦酯、恩替卡韦和替诺福韦。临床医师应进一步规范应用核苷(酸)类似物,根据患者个体情况制订合理的治疗方案,降低耐药率。
文摘目的观察核苷(酸)类药物联合CIK治疗慢性乙型肝炎患者Th1/Th2类细胞功能变化,为维持持久免疫应答,减少核苷(酸)类药物停药后复发提供理论依据。方法15例慢性乙型肝炎患者在核苷(酸)类药物治疗达到HBV DNA检测水平下限时给予CIK治疗,分别在核苷(酸)类药物治疗前、HBV DNA达到检测水平下限以及CIK治疗后2周3个时间点采用流式细胞术检测Th1/Th2类细胞功能,10例单独接受CIK治疗和10例单独接受核苷(酸)类药物治疗的慢性乙型肝炎患者作为对照组。结果无论是观察组还是对照组,当接受核苷(酸)类药物并HBV DNA水平达到不可检测水平以下时,CD4细胞产生IFN-γ水平明显升高(1.511±1.026 vs 2.139±0826,1.656±0.869 vs 2.511±1.133,P<0.05),IL-4水平无明显变化,单独接受CIK治疗后IFN-γ水平也明显增高(1.434±0.924 vs 2.211±0.921,P<0.05),IL-4水平无明显变化,同前两组比较IFN-γ水平和IL-4水平均无差异。核苷(酸)类药物联合CIK治疗后相比单独CIK治疗和单独核苷(酸)类药物治疗,不但IFN-γ明显增高(3.288±0.561 vs 2.211±0.921,3.288±0.561 vs 2.511±1.133,P<0.05),并且IL-4水平也降低(0.277±0.237 vs 0.428±0.208,0.277±0.237 vs 0.477±0.255,P<0.05)。结论核苷(酸)类药物联合CIK治疗明显提高Th1类细胞应答,并抑制Th2类细胞功能,但是否持久维持Th1类细胞免疫应答还需要进一步研究。
