核苷类耐药的慢性乙型肝炎临床特点及中医证型分析

Analysis of Clinical Characteristics and Syndrome Pattems of Nucleoside-resistance Chronic Hepatitis B

目的:研究核苷类耐药的慢性乙型肝炎中医证型的特点。方法:将317例慢性乙型肝炎患者纳为研究对象,其中拉米夫定耐药112例,阿德福韦酯耐药71例,未使用核苷类抗病毒药134例。采用回顾性资料分析方法,采集患者临床资料,进行辨证分型和临床特点分析比较。结果:拉米夫定耐药的慢性乙型肝炎临床病情出现重度者,较未使用核苷类抗病毒药病例少(P<0.05):拉米夫定耐药的慢性乙型肝炎中医证型出现瘀血阻络型者,较未使用核苷类抗病毒药病例少(P<0.05)。阿德福韦酯耐药的慢性乙型肝炎临床病情轻重和中医证型,与未使用核苷类抗病毒药物者比较,差异无显著性意义(P>0.05)。结论:服用拉米夫定出现耐药而发病的慢性乙型肝炎,应继续用药以减少重度肝炎的发生和血瘀证的形成.同时结合中医辨证论治,以控制病情发展。

Objective:To investigate the chacacteristics of syndrome pat- terns of nucleoside-resistance chronic hepatitis B.Methods:Three hundred and seventeen chronic hepatitis B patients were enrolled into the study.Of them,112 were lamivndine-resistant,71 were adefovir-resistant and 134 did not receive nucleoside drug.A retrospective method was used to investigate their clinical characteristics and syndrome patterns.Results:The number of patients with severe illness status and with the syndrome of blood-stasis block- ing collaterals in lamivudine-resistant group was less than that in the group without medication of nucleoside drug (P<0.05).Similar changes were also shown in adefovir-resistant group.Conclusion:Lamivudine--resistance chronic hepatitis B patients should receive continuous lamivudine treatment combined with herbal medicine to decrease the occurrence of severe hepatitis and the syndrome of blood stasis.