中药联合拉米夫定治疗慢性乙肝的临床对照观察

Clinical control observation on treatment of chronic hepatitis B according to TCM in combination with lamivudine

目的 :观察中药联合拉米夫定治疗慢性乙肝的治疗作用。方法 :病例为慢性乙肝 ,伴有 HBV- DNA阳性、HBe Ag阳性及 AL T为 2 U L N～ 5 U L N。治疗组为中药联合拉米夫定 2 3例 ,单一拉米夫定治疗作对照组 2 3例 ,疗程为 12个月。检测 AL T、HBV- DNA、HBe Ag、Hbe Ab及 YMDD变异。结果 :治疗组血清转换率为 6 5 .2 % ,明显高于拉米夫定对照组 2 6 .1% (P<0 .0 1)。中药组无 1例 YMDD变异 ,低于拉米夫定对照组 13.0 %。结论 :中药联合拉米夫定治疗慢性乙肝可提高 HBe Ag血清转换率 ,并有可能降低 YMDD变异率。

Objective:To observe the treating effect in the pat ients with chronic hepatitis B with TCM combined with Lamivudine.Methods:The patients in treated group was treated according to Syndrome Differentiation of TCM in combination with Lamivudine,and in control group with single Lamivudine.Both groups'ALT level were by 2ULN～5ULN with the positive HBsAg,HBeAg,HBcAb and HBV-DNA,as well as the negative mutation of YMDD.Among them,23 cases from treated group were treated.Another 23 cases also as control group were treated.The course of treatment was 12 months.The recovery of ALT and HBV-DNA,the rate of HBeAg seroconversion and YMDD mutation were tested.Results:The rate of HBeAg seroconversion in treated group was 65.2%.It was significantly higher than that of 26.1% in the control group with single Lamivudine(P<0.01).The rate of YMDD mutation in treated groups was 0,it was lower than that of 13.0% in control group.Conclusion:The treatment of chronic hepatitis B according to Syndrome Differentiation of TCM in combination with Lamivudine can increase the rate of HBeAg seroconversion.TCM combinated with Lamivudine probably decreases the rate of YMDD mutation.