二至丸联合阿德福韦酯治疗慢性乙型病毒性肝炎30例

Investigation of chronic viral hepatitis treated by combination of Erzhi pill and adefovir dipivoxil

目的观察二至丸联合阿德福韦酯治疗慢性乙型病毒性肝炎(以下简称慢性乙肝)的疗效和不良反应。方法将60例慢性乙肝患者随机分为2组,对照组30例予阿德福韦酯治疗,治疗组30例在对照组治疗基础上加二至丸,2组均连续治疗144周。观察2组患者在治疗48、96、144周时尿隐血、血肌酐发生情况,比较2组丙氨酸氨基转移酶(ALT)复常率、尿隐血发生率、血肌酐异常率、乙肝病毒脱氧核糖核酸(HBVDNA)阴转率及阿德福韦酯耐药发生率。结果 2组患者均未发现血肌酐升高。治疗组治疗48、96及144周时,ALT复常率均高于对照组同期(P<0.05);96、144周时,尿隐血发生率低于对照组同期(P<0.05);治疗期间2组HBV-DNA阴转率及阿德福韦酯耐药发生率比较差异无统计学意义(P>0.05)。结论二至丸联合阿德福韦酯治疗慢性乙肝不能协助控制病毒复制和防止阿德福韦酯耐药的发生,但可有效提高肝功能复常率和预防阿德福韦酯潜在的肾毒性。

Objective To investigate the effect of chronic viral hepatitis treated by combination of Erzhi pill and adefovir dipivoxil. Methods 60 cases of chronic viral hepatitis were randomly divided into two groups. 30 patients in control group were treated by adefovir dipivoxil. 30 cases in treatment group were treated by combination of Erzhi pill and adefovir dipivoxil. The therapeutic course was 144 weeks in two groups. The prevalence of urine occult blood and serum creatinine in two groups were observed in the treatment of 48,96,144 weeks. Alanine aminotrans- ferase （ALT） recovery rate,incidence of urine occult blood, serum creatinine abnormal rate, hepatitis b virus DNA （ HBV - DNA） negative rate and adefovir resistance incidence were compared in two groups. Results There was no increase of serum creatinine level in two groups of patients. ALT recovery rate of the treatment of 48,96,144 weeks in treatment group was higher than that in control group （P 〈 0.05 ）. Incidence of urine occult blood 96 and 144 weeks in treatment group was lower than that in control group （P 〈 0.05 ）. There was no significant difference between two groups on HBV - DNA negative rate and adefovir resistance incidence （ P 〉 0.05 ）. Conclusion Combination of Erzhi pill and adefovir ester on chronic viral hepatitis can＇t help control viral replication and prevent adefovir ester re- sistance, but can effectively improve liver function recovery rate and prevent adefovir ester potential renal toxicity.