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1、辽宁中医杂志2009年第36卷第2期#165#中药辨证治疗对慢性乙型肝炎病毒复制的影响吕文良,陈兰羽,闫洁,万方(中国中医科学院广安门医院感染疾病科,北京100053)摘要:目的:观察中药辨证论治对慢性乙型肝炎病毒复制的影响。方法:采用两中心前瞻性队列研究的方法,暴露组84例于广安门医院肝病门诊接受中医辨证治疗;非暴露组40例于佑安医院接受LAM治疗。两组疗程均为6个月,随访3个月。观察两组患者血清HBsAg、HBeAg及HBV-DNA阴转率的变化。结果:在DNA阴转率方面,中药暴露组在治疗过程中与LAM非暴露组比较没有显著性差异,但在治疗结束后3
2、个月随访时,中药暴露组的DNA阴转率为8113%与LAM非暴露组的2010%比较差异显著(P=01025)。在治疗过程中,中药暴露组患者出现4例HBsAg阴转(其中1例出现血清学转换),而LAM非暴露组无HBsAg阴转的病例出现。结论:中药可促进HBV-DNA阴转,停药后能持续抑制乙型肝炎病毒的复制。关键词:慢性乙型肝炎;辨证论治;拉米夫定中图分类号:R2-03文献标识码:A文章编号:1000-1719(2009)02-0165-03StudyonEffectofTCMTreatmentBasedonDifferentiationofSymptom
3、sandSignsinInhibitingHBV-DNAinPatientswithChronicHepatitisBLVWen-liang,CHENLan-yu,YANJie,WANFang(DepartmentofInfectionDisease,Guang-an-menHospital,InstituteofTraditionalMedicineofChina,Beijing100053,China)Abstract:Objective:ToobservetheeffectofTCMTreatmentbasedondifferentiatio
4、nofsymptomsandsignsininhibitingHBV-DNAinpatientswithchronichepatitisB.Methods:Thetwo-centerprospectivecohortstudywasused.The84patientswithCHBattheclinicofGuang-an-menhospitalwereassignedtoreceiveTCMtreatmentasexposuregroupbasedonpathogenesisob-tainedthroughdifferentiationofsym
5、ptomsandsigns,whiletheother40patientsatYou-anhospitalwerereceivedLamivudineasthecomparisongroup.Patientsweretreatedfor6monthsandfollowedforanadditional3months.ThenegativeconversionrateofHBsAg,HBeAgandHBV-DNAinpatientswereobserved.Results:Nosignificantdifferencethenegativeconve
6、rsionrateofHBV-DNAwasobservedbetweenthetwogroups.Attheendoffollow-upvisit,theproportionofpatientstreatedwithTCMwithunde-tectableDNAlevelswas8113%comparedwith2010%forLamivudinetreatedpatients,thedifferencebetweentheTCMgroupandtheLamivudinegroupwasstatisticallysignificant(P=0102
7、5).FourpatientsintheTCMpatientslostHBsAgandonehadHBsAgseroconversion,butnopatientsintheLamivudinegroupdidso.Conclusion:ItiseffectiveforTCMtreatmentinachievingvirusloss,itkeeponinhibitingHBVreplication.Keywords:ChronichepatitisB;Treatmentbasedondifferentiationofsymptomsandsigns
8、;Lamivudine慢性乙型肝炎(ChronicHepatitisB,CHB)是我国11113病例排除标准¹合并其它类型
