治肝灵联合拉米夫定对慢性乙型肝炎患者血清标志物及病毒变异株(YMDD)变异的影响

Effect of Zhiganling combined with lamivudine on serum marker and YMDD mutation in patients with chronic hepatitis B

目的探讨治肝灵联合拉米夫定对慢性乙型肝炎患者血清标志物及病毒变异株(YMDD)变异的影响。方法将90例慢性乙型肝炎患者随机分为2组。对照组45例采用拉米夫定100 mg,每日1次口服;治疗组在对照组治疗基础上加用中药治肝灵汤剂,水煎,每日2次,早晚分服。分别于治疗后6、12、24个月检测2组患者HBV-DNA、HBV标志物及YMDD耐药变异株,每2个月检测1次肝功能,并进行对比分析。结果治疗组HBV-DNA、HBeAg转阴率、HBeAg和HBV-DNA同时转阴率明显高于对照组(P<0.05),而YMDD变异发生率低于对照组(P<0.05)。结论治肝灵联合拉米夫定治疗慢性乙型肝炎,可增强抗病毒疗效,并可减少HBV YMDD变异的发生率。

Objective To investigate the effect of Zhiganling combined with lamivudine on markers and YMDD mutation in patients with chronic hepatitis B. Methods 90 patients with chronic hepatitis B were randomly divided into two groups. The control group of 45 patients was treated with lamivudine lOOmg orally, 1 times/d; on the basis of control treatment, the treatment group add Zhiganling decoction with Chinese medicine treatment, 2 times a day, sooner or later the service. In 6 months after treatment, 12 months,24 months of two groups were detected HBV - DNA, HBV markers and YMDD mutant strains, 1 liver function testing every 2 months, and carries on the contrast a- nalysis. Results the treatment group HBV - DNA, HbeAg negative conversion rate, HbeAg and HBV - DNA at the same time, the negative rate was significantly higher than that of the control group, while the YMDD mutation rate was lower than the control group. Conclusion Zhiganling combined with lamivudine in the treatment of chronic hepatitis B can enhance the antiviral efficacy,and can reduce the incidence of HBV YMDD mutation .