拉米夫定联合苦参素治疗慢性乙型肝炎疗效及对YMDD变异的影响

Effect of Kushenin Combined with Lamivudine in Treating Chronic Hepatitis B and its Influence on YMDD Motif Mutation

目的:观察拉米夫定和苦参素联合治疗慢性乙型肝炎的疗效及对慢性乙型肝炎病毒P基因(YMDD)变异的影响。方法:将60例慢性乙型肝炎病例分为苦参素组、拉米夫定组和联合治疗组3组,每组20例。苦参素组口服苦参素胶囊,拉米夫定组口服拉米夫定,联合治疗组口服苦参素胶囊和拉米夫定,疗程为12个月。治疗结束后,分别检测血清HBeAg、抗-HBe、HBV DNA和基因YMDD变异。结果:在治疗12个月时,联合治疗组HBeAg、抗-HBe转换率及HBV DNA转阴率优于苦参素组和拉米夫定组,YMDD变异率较苦参组和拉米夫定组低,但差异比较无统计学意义(P>0.05)。上述各指标苦参组和拉米夫定组组间比较均无统计学意义(P>0.05)。结论:拉米夫定联合苦参素能在一定程度上提高治疗慢性乙型肝炎的疗效并可减少YMDD变异。

Objective： To investigate the effect of Kushenin combined with Lamivudine in treating chronic hepatitis B （CHB）and its influence on YMDD motif mutation. Methods：60 patients with CHB were divided into three groups： kushenin group （treated with kushenin）,lamivudine group （ administered lamivudine）,combined therapy group（treated with lamivudine plus oxymatrine）. The course of treatment was 12 months. Serum HBeAg,anti-HBe were analyzed,HBV DNA level was detected,and YMDD motif mutation was observed. Results：Serum HBeAg,conversion ratio of anti-HBe in combined therapy group were higher than those in oxymatrine group and in lamivudine group,the positive rate of HBV DNA and YMDD motif mutation in combined therapy group were lower than those in oxymatrine group and in lamivudine group respectively,but the difference had no significant （P〉0.05）. The parameters above in lamivudine group and combined therapy group had no significant difference（P〉0.05）. Conclusion：Combined therapy of lamivudine and oxymartine could enhance the therapeutic efficacy in treating CHB to some extent and reduce the mutation of YMDD motif.