虫草益肝胶囊联合拉米夫定对慢性乙型肝炎疗效的研究

Study Therapeutic Efficacy of Chongcao Yigan Capsule Combined with Lamivudine in Chronic Hepatitis B

目的观察虫草益肝胶囊联合拉米夫定治疗乙型肝炎HbeAg阳性患者48周的疗效。方法 136例患者平均分为两组,联合治疗组给予虫草益肝胶囊联合拉米夫定,并与单用拉米夫定比较,持续治疗48周。观察治疗不同时间点患者的病毒学、生化学指标、凝血酶原活动度(PTA)及病毒耐药等变化情况。结果两组患者血清HBV DNA治疗后明显下降;联合治疗组在48周时有92.6%的患者HBV DNA阴转;ALT,AST,Tbi1明显下降,白蛋白,PTA等指标均有显著改变(P<0.01);在治疗24,48周时,分别有25.0%(17/68)、36.8%(25/68)的患者出现了HBeAg血清学转换;治疗48周时,联合治疗组YMDD变异率为1.5%。治疗后24,48周HBV DNA水平下降值、HBV DNA阴转率联合治疗组高于拉米夫定组(P<0.05)。结论虫草益肝胶囊联合拉米夫定能快速有效抑制乙型肝炎HbeAg阳性患者的病毒复制,使HBV DNA水平下降,同时可以改善肝功能,且具有较低耐药率。

OBJECTIVE To observe the therapeutic efficacy of Chongcao Yigan capsule combined with Lamivudine in HbeAg positive chronic hepatitis B patients after 48 weeks treated. METHODS 136 patients were divided into two groups： the group administrated with Chongcao Yigan capsule combined with Lamivudine compared with the group with Lamivudine alone. Treatment kept on for 48 weeks. The changes in vitro logical and biochemical markers, PTA and drug resistance in different time were observed. RESULTS Patients’ HBV DNA in the serum was evidently descendent after treatment in both groups. After 48 weeks of treatment, the HBV DNA negative conversion rate was 92.6%, the concentration of ALT, AST and Tbil in the serum were evidently descendent and the markers such as albumin and PTA had obvious changed in the combination group（P0.01）. After 24 and 48 weeks of treatment the proportions of HbeAg seroconversion were 25.0% and 36.8%, respectively. After 48 weeks of treatment the rate of YMDD variation was 1.5%, in the combination group. In combination group after 24 and 48 weeks of treatment had the advantage over the group with Lamivudine on the descendent degree of the levels of HBV DNA and the HBV DNA negative conversion rate（P0.05）. CONCLUSION Chongcao Yigan capsule combined with Lamivudine could quickly and validly inhibit the virus replication in HbeAg positive hepatitis B patients, make the levels of HBV DNA descend, and might improve the liver function, even could reduce the rate of drug resistance.