疏肝解瘀汤联合拉米夫定治疗慢性乙型病毒性肝炎临床研究

Clinical Study on Shugan Jieyu Decoction Combined with Lamivudine on Patients with Chronic Hepatitis B

目的：探究疏肝解瘀汤联合核苷类药物拉米夫定对慢性乙肝病毒性肝炎患者肝功能、乙肝病毒脱氧核糖核酸（HBV．DNA）及耐药变异株HBV—YMDD的影响。方法：选取120例慢性乙型病毒性肝炎患者，随机分为观察组和对照组，每组60例，均给予基础支持治疗，对照组用拉米夫定治疗，观察组在此基础上加用疏肝解瘀汤治疗，观察比较两组治疗后6个月、12个月肝功能、HBV—DNA转阴率、HBV-YMDD变异率及其临床治疗效果。结果：观察组与对照组治疗6个月、12个月后相比肝功能指标丙氨酸氨基转移酶（ALT）、门冬氨酸氨基转移酶（AST）、总胆红素（TBIL）和HBV-yMDD变异率差异均有统计学意义（P〈0．05）；HBV-DNA转阴率在治疗12月后差异有统计学意义（P〈0．05）；观察组总有效率83．33％，明显高于对照组的65．00％，差异有统计学意义（P〈0．05）。结论：疏肝解瘀汤联合拉米夫定治疗慢性乙型肝炎能够有效地改善患者肝功能指标。提高HBV—DNA转阴率，降低HBV-YMDD耐药率。

Objective：To explore the effects of Shugan Jieyu decoction combined with nucleoside drug lamivudine on liver function,HBV-DNA and HBV-YMDD resistant mutants in patients with chronic hepatitis B. Metbods：A total of 120 patients with chronic hepatitis B were randomly divided into the experiment group and the control group,60 cases in each group. On the basis of supportive treatment,the control group was treated with lamivudine,while the experiment group was given lamivudine combined with Shugan Jieyu de- coction. The liver function,the conversion rate of HBV-DNA,the mutation rate of HBV-YMDD and the clini- cal effect were observed and compared between the two groups of patients after the treatment for 6 and 12 months. Results：There was significant difference between the two groups on the liver function index such as alanine aminotransferase （ALT）, aspartate transaminase （AST）,total bilirubin （TBiL） and the mutation rate of HBV-YMDD at 2 time points（P〈0.05）. HBV-DNA conversed into negative in the experiment group more significantly than that in the control group 12 months after the treatment（P〈0.05）. The total effective rate in the experiment group was 83.33% ,significantly higher than that in the control group with statistical difference （P〈 0.05 ）. Conclusion：Shugan Jieyu decoction combined with Lamivudine can effectively reduce the liver function index,improve the negative rate of HBV-DNA,and reduce the mutation rate of HBV-YMDD.