解毒救肝汤联合拉米夫定治疗慢性乙型肝炎的临床研究

Clinical study of the therapeutic effect of Jiedu Jiugan decoction combined with lamivudine on chronic hepatitis B

目的观察自拟中药方解毒救肝汤联合拉米夫定治疗慢性乙型肝炎的效果。方法将140例血清HBeAg阳性患者随机分成2组,治疗组72例予解毒救肝汤联合拉米夫定联合治疗,对照组68例予拉米夫定治疗,2组疗程均为48周。2组均于治疗前及治疗后24,48周分别检测肝功能、HBV标志物及HBV DNA的变化。结果治疗组血清HBeAg阴转率、HBeAg/抗HBe血清转换率均明显高于对照组(P均<0.05)。治疗48周后2组AST、ALT、ALB、TBil水平比较均有显著性差异(P均<0.05)。结论解毒救肝汤联合拉米夫定治疗慢性乙型肝炎疗效确切,可明显提高HBeAg阴转率和HBeAg/抗HBe血清转换率,提高48周后HBV DNA和ALT复常率。

Objective It is to observe the clinical efficacy of self-made traditional Chinese medicine Jiedu Jiugan decoction combined with lamivudine on chronic hepatitis B. Methods 140 patients with chronic hepatitis B whose were randomly divided into two groups, the treatment group （ n = 72） were treated with Jiedu Jiugan decoction combined with lamivudine, the control group （ n = 68） were treated with lamivudine in the same way. Both the treatment courses were 48 weeks. Before treatment and after 24 and 48 weeks＇ treatment, the changes of liver function, HBV markers and HBV - DNA in both groups were deter- mined. Results Undetectable rates of serum HBV - DNA and HBeAg/anti - HBe seroeonversion rates of the combination treat- ment group were significantly higher than that of control group （P 〈 0.05）. After 48 weeks＇ treatment, there were significant differences in the level of AST, ALT, ALB, TBil between the two groups （ P 〈 0.05）. Conclusion Jiedu Jiugan decoction combined with lamivudine had a confirmed curative effect on chronic hepatitis B, it can obviously improve the undetectable rates of serum HBV - DNA and HBeAg/anti-HBe seroconversion rates, improve the normalization rates of HBV - DNA and ALT after 48 weeks＇ treatment.