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
Herpes simplex virus （HSV）, a member of the Herpesviridae family, is a significant human pathogen that results in mucocutaneous lesions in the oral cavity or genital infections. Acyclovir （ACV） and related nucleos...Herpes simplex virus （HSV）, a member of the Herpesviridae family, is a significant human pathogen that results in mucocutaneous lesions in the oral cavity or genital infections. Acyclovir （ACV） and related nucleoside analogues can successfully treat HSV infections, but the emergence of drug resistance to ACV has created a barrier for the treatment of HSV infections, especially in immunocompromised patients. There is an urgent need to explore new and effective tactics to circumvent drug resistance to HSV. This review summarises the current strategies in the development of new targets （the DNA helicase/primase （H/P） complex）, new types of molecules （nature products） and new antiviral mechanisms （lethal mutagenesis of Janus-type nucleosides） to fight the drug resistance of HSV.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
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.
基金the National Natural Science Foundations of China(document no.:81321002,81500860,81300888)a grant from 111 Project of Ministry of Education,China,for fi nancial support
文摘Herpes simplex virus （HSV）, a member of the Herpesviridae family, is a significant human pathogen that results in mucocutaneous lesions in the oral cavity or genital infections. Acyclovir （ACV） and related nucleoside analogues can successfully treat HSV infections, but the emergence of drug resistance to ACV has created a barrier for the treatment of HSV infections, especially in immunocompromised patients. There is an urgent need to explore new and effective tactics to circumvent drug resistance to HSV. This review summarises the current strategies in the development of new targets （the DNA helicase/primase （H/P） complex）, new types of molecules （nature products） and new antiviral mechanisms （lethal mutagenesis of Janus-type nucleosides） to fight the drug resistance of HSV.
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。
