慢性乙型肝炎YMDD变异与中医证型的临床研究

Clinical Research on Chronic Hepatitis B YMDD Variance and TCM Types

[目的]探讨拉米夫定治疗后慢性乙型肝炎HBV-YMDD变异与中医证型的相关性。[方法]可统计的100例服用拉米夫定的慢性乙型肝炎患者,根据中医辨证分为肝郁脾虚组40例,涅热中阻组20例,肝肾阴虚组20例,瘀血阻络组20例。分别检测肝功能、乙肝三系定量、HBV-DNA定量、YMDD变异。比较6、12、18个月时各组的ALT、AST、TBlL,HBeAg转阴率,HBeAg/HBeAb转换率,YMDD变异率。[结果]各组HBV-YMDD变异发生率6个月时无差异或差异无统计学意义。12、18个月时,瘀血阻络组最高,肝肾阴虚组次之,肝郁脾虚组和湿热中阻组最低,差异有统计学意义。[结论]拉米夫定治疗后慢性乙型肝炎HBV-YMDD变异发生率与中医证型之间有一定的相关性。

[Objective]To discuss the relativity between TCM types and chronic hepatitis B YMDD variance after treated with LAM.[Method]100 cases of said patients orally taking LAM,under TCM types,were divided into depressed liver and deficient spleen group 40 cases,damp-heat blocking the middle group 20 cases,Yin deficiency of liver and kidney group 20,blood stasis blocking collaterals group 20.Respectively test liver function,3-system ration B,HBV-DNA and YMDD variance of hepatitis. Compare the negative rates of ALT,AST,TBIL and HbeAg,the conversion rate of HBeAg/HbeAb,the variance rate of YMDD at 6,12,and 18 months.[Result]The HBV-YMDD variance rates at 6 months had no difference or were without statistical mean- ing in all groups;at 12 and 18 months,blood stasis blocking collaterals group was highest,then the deficiency of liver and kidney group,last the depressed liver and deficient spleen group and damp-heat blocking the middle group,with statistical meaning. [Conclusion]There's relativity between TCM types and chronic hepatitis B HBV-YMDD variance after treated with LAM.