【摘要】 目的观察疏肝健脾方联合拉米呋定治疗慢性乙型肝炎(肝郁脾虚型)患者的临床疗效。方法收集肝郁脾虚型慢性乙型肝炎病例180例,其中治疗组62例给予疏肝健脾方联合拉米呋定治疗,对照1组58例单纯服用拉米呋定治疗,对照2组60例单纯服用疏肝健脾方治疗,3组均治疗12个月及随访6个月,观察血清肝功能、HBVDNA定量、乙型肝炎表面抗原(HBeAg)血清学转换、HBVDNA聚合酶活性区发生变异(YMDD变异)发生率、临床证候积分、总有效率等。结果治疗组治疗12个月后丙氨酸氨基转移酶(ALT)改善情况优于对照1组(P<0.05);HBeAg阴转率在随访6个月时,治疗组明显高于对照1、2组(P<0.05);HBVDNA阴转率,治疗组治疗6个月、12个月和随访6个月均高于两个对照组(P<0.05);随访结束时,治疗组HBVDNA阳性患者中YMDD变异检出率低于对照1组(P<0.05);治疗组和对照1组、对照2组的总有效率分别为85.5%、65.5%、70.0%,差异有统计学意义(P<0.05)。结论疏肝健脾方联合拉米呋定治疗对肝郁脾虚型慢性乙型肝炎患者恢复肝功能、改善临床症状、提高抗病毒疗效、减少拉米呋定耐药的发生均有一定的临床疗效。更多还原

【Abstract】 Objective To observe the therapeutic effect of Shugan Jianpi Recipe (Recipe to soothe the liver and strengthen the spleen) plus Lamivudine on the liver stagnation and spleen deficiency syndrome of chronic hepatitis B.Methods Of the 180 patients with chronic hepatits B, 62 patients in the treatment group were prescribed Shugan Jianpi Recipe plus Lamivudine, 58 patients in the control group I were administered Lamivudine only, and 60 patients in the control group II were given Shugan Jianpi Recipe only. All the three groups were treated for 12 months and followed for 6 months. The changes in the liver functions, HBV DNA quantity, HBeAg, the incidence of YMDD, clinical symptoms, and the total effective rate were observed.Results After treatment for 12 months, in the treatment group, the improvement in ALT was more significant than that in the control group I (P<0.05); the HBeAg negative rate in the sixth-month follow-up was significantly higher than that of the two control groups (P<0.05); the HBV DNA negative rate in the sixth and twelfth-month treatment and the sixth-month follow-up was significantly higher than that of the two control groups (P<0.05). When the follow-up finished, YMDD positive rate in the HBV DNA positive patients was lower than that of the control group I (P<0.05). The total effective rate of the treatment group, the control group I and II was 85.5%, 65.5%, and 70.0% respectively, the difference was significant (P<0.05).Conclusion Shugan Jianpi Recipe plus Lamivudine is effective for the liver stagnation and spleen deficiency syndrome of chronic hepatitis B in restoring the liver functions, improving the clinical symptoms, enhancing the anti-virus effect, and reducing the incidence of Lamivudine resistance.更多还原