中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2009年
6期
440-442
,共3页
肝炎,乙型,慢性%治疗}拉米夫定,突变%医学,中国传统%柴芍六君汤
肝炎,乙型,慢性%治療}拉米伕定,突變%醫學,中國傳統%柴芍六君湯
간염,을형,만성%치료}랍미부정,돌변%의학,중국전통%시작륙군탕
Hepatitis B,chronic%Therapy%Lamivudine%Mutation%Medicine,Chinesetraditional%Cai Shao Liu Ju Tang
目的 观察柴芍六君汤、拉米夫定联合治疗慢性乙型肝炎患者YMDD变异的情况.方法 采用非随机同期对照试验,将405例慢性乙型肝炎患者分为治疗组和对照组,治疗组220例,对照组185例,对照组给予拉米夫定100 mg,每天1次,口服,治疗18个月.治疗组给予柴胡六君汤每日1剂,同时口服拉米夫定100 mg,每天1次,治疗18个月.观察患者临床症状、ALT复常率、HBeAg阴转率,HBeAg血清转换率,HBV DNA阴转率、治疗12个月及18个月的YMDD变异率.率的比较采用χ2检验,均数比较采用t检验或U检验,方差不齐者用秩和检验. 结果治疗3.6、12.18个月时,ALT复常率治疗组分别为69.5%、85.9%、90.5%,82.7%,对照组分别为50.3%、65.4%、78.4%,69.7%,两组比较,χ2值分别为15.70、23.50、11.50.9.50.JD值均<0.01,差异均有统计学意义.治疗组12、18个月HBV DNA阴转率、HBeAg阴转率、HBeAg血清转换率、YMDD变异率分别为77.7%、57.7%、25.5%、6.8%和86.8%、74.1%、33.2%、8.6%,对照组分别为54.6%、36.8%,13.O%,14.6%和69.2%、37.3%、19.5%、20.5%,两组比较,χ2值分别为24.38、17.70、9.88、6.54和18.67、55.60、9.62,11.78,P<0.01或P<0.05,差异有统计学意义. 结论柴芍六君汤联合拉米夫定治疗慢性乙型肝炎,能有效地改善肝功能,提高拉米夫定抑制HBV复制的作用,减少YMDD变异的发生.
目的 觀察柴芍六君湯、拉米伕定聯閤治療慢性乙型肝炎患者YMDD變異的情況.方法 採用非隨機同期對照試驗,將405例慢性乙型肝炎患者分為治療組和對照組,治療組220例,對照組185例,對照組給予拉米伕定100 mg,每天1次,口服,治療18箇月.治療組給予柴鬍六君湯每日1劑,同時口服拉米伕定100 mg,每天1次,治療18箇月.觀察患者臨床癥狀、ALT複常率、HBeAg陰轉率,HBeAg血清轉換率,HBV DNA陰轉率、治療12箇月及18箇月的YMDD變異率.率的比較採用χ2檢驗,均數比較採用t檢驗或U檢驗,方差不齊者用秩和檢驗. 結果治療3.6、12.18箇月時,ALT複常率治療組分彆為69.5%、85.9%、90.5%,82.7%,對照組分彆為50.3%、65.4%、78.4%,69.7%,兩組比較,χ2值分彆為15.70、23.50、11.50.9.50.JD值均<0.01,差異均有統計學意義.治療組12、18箇月HBV DNA陰轉率、HBeAg陰轉率、HBeAg血清轉換率、YMDD變異率分彆為77.7%、57.7%、25.5%、6.8%和86.8%、74.1%、33.2%、8.6%,對照組分彆為54.6%、36.8%,13.O%,14.6%和69.2%、37.3%、19.5%、20.5%,兩組比較,χ2值分彆為24.38、17.70、9.88、6.54和18.67、55.60、9.62,11.78,P<0.01或P<0.05,差異有統計學意義. 結論柴芍六君湯聯閤拉米伕定治療慢性乙型肝炎,能有效地改善肝功能,提高拉米伕定抑製HBV複製的作用,減少YMDD變異的髮生.
목적 관찰시작륙군탕、랍미부정연합치료만성을형간염환자YMDD변이적정황.방법 채용비수궤동기대조시험,장405례만성을형간염환자분위치료조화대조조,치료조220례,대조조185례,대조조급여랍미부정100 mg,매천1차,구복,치료18개월.치료조급여시호륙군탕매일1제,동시구복랍미부정100 mg,매천1차,치료18개월.관찰환자림상증상、ALT복상솔、HBeAg음전솔,HBeAg혈청전환솔,HBV DNA음전솔、치료12개월급18개월적YMDD변이솔.솔적비교채용χ2검험,균수비교채용t검험혹U검험,방차불제자용질화검험. 결과치료3.6、12.18개월시,ALT복상솔치료조분별위69.5%、85.9%、90.5%,82.7%,대조조분별위50.3%、65.4%、78.4%,69.7%,량조비교,χ2치분별위15.70、23.50、11.50.9.50.JD치균<0.01,차이균유통계학의의.치료조12、18개월HBV DNA음전솔、HBeAg음전솔、HBeAg혈청전환솔、YMDD변이솔분별위77.7%、57.7%、25.5%、6.8%화86.8%、74.1%、33.2%、8.6%,대조조분별위54.6%、36.8%,13.O%,14.6%화69.2%、37.3%、19.5%、20.5%,량조비교,χ2치분별위24.38、17.70、9.88、6.54화18.67、55.60、9.62,11.78,P<0.01혹P<0.05,차이유통계학의의. 결론시작륙군탕연합랍미부정치료만성을형간염,능유효지개선간공능,제고랍미부정억제HBV복제적작용,감소YMDD변이적발생.
Objective To evaluate the effect of Chai Shao Liu Jun Tang in combination with Lamivudine for the treatment chronic hepatitis B (CHB) patients. Methods 405 CHB patients in Guangdong Provincial Hospital were randomly divided into 2 groups, 220 in the treated group, and 185 in the control group. The control group was treated with Lamivudine for 18 months. The treated group was treated with Lamivudine in combination with Chai Shao Liu Jun Tang for 18months. At the 3rd, 6th, 9th, 12th and 18th month during the treatment, the clinical symptoms, ALT normalization rate, HBeAg seroconversion rate, the proportion of patients with undetectable serum HBV DNA, and YMDD mutation rate were observed. Results ALT normalization rates at the 3rd, 6th, 12th, 18th month of the treatment group (69.5%, 85.9%, 90.5%, 82.7%) were higher than those in the control group (50.3%, 65.4%, 78.4%, 69.7%; P < 0.01). HBeAg seroconversion rate, rate of HBV DNA undetectable, and YMDD mutation rate at he 12th and 18th month are 77.7%, 57.7%, 25.5%, 6.8%; 86.8%, 74.1%, 33.2%, 8.6% in the treatment group, and 54.6%, 36.8%, 13.0%, 14.6%; 69.2%, 37.3%, 19.5%, 20.5% in the control group (P < 0.01, or P < 0.05). Conclusion Compared to lamivudine alone, Cai Shao Liu Ju Tang in combination with lamivudine is more effective and induces lessYMDD mutation rate in CHB patients.
