| ObjectiveHepatitis B virus(HBV)is in the Global Distribution,and It is endanger the human health seriously.According to the National serum HBV infection epidemiological investigation of 2002,there are about 120 million chronic carriers of HbsAg in China,including 30 million chronic hepatitis B patients, some of chronic hepatitis can progress to cirrhosis,liver failure or the, primary of liver cancer。That the main reason of death about this this disease. At present,for the treatment of chronic hepatitis B treatment is still no ineffective therapy neither Chinese meidicine nor Western medicine.The modern medicine consider that,it is because of immune dysfunction。After the infection of hepatitis B virus,the immune response function and immune regulation dysfunction induce the liver damage,the main treatment are anti-virus,Hugan anti-inflammatory,anti-fibrosis,immune modulation therapy。Thereinto the anti-virus treatment is one of the main method of the treatment。Since 1998,Lamivudine was using for the treatment of chronic hepatitis B,we get a good clinical effect。It has been universally recognized by the clinicians, coupled with relatively inexpensive,it is widely used in the clinical,but in the course of treatment,the high HBV YMDD mutation rate become to a problem when clinicians treating the disease.Chronic hepatitis B is the consistent with the name called "Gan zhuo","Xie Tong","Ji JU","Gu Zhang" in Traditional Chinese Medicine。According to theory of Traditional Chinese medicine on the etiology and pathogenesis of this disease,that' s because of the lack of removing the evil hot and humid to weak physical to get the disease,in order to alleviate the symptoms and improve liver fibrosis and improve immunity,anti-virus and delay the HBV YMDD mutation,it has a good effect;Liver depression and spleen deficiency as an important pathogenesis of chronic hepatitis B,first it appeared earlier;the second is a longer duration,the whole course of many patients exist in the pathogenesis Liver depression and spleen deficiency;the third is a very wide range of clinical manifestations,in almost all cases have had the Liver depression and spleen deficiency syndrome,and some consistently throughout the course of the disease and the prognosis is important impact on the outcome.This study start at Shugan Jianpi,choose CaiShao Liu Jun Tang,combined with hamivudine to treat chronic hepatitis B patients,with a view to observe CaiShao Liujun soup in the treatment of the clinical efficacy,especially the efficacy of delaying HBV YMDD mutation in the course of the pplication of lamivudine.To the effect that be widely in clinical,to create cost-effective treatment programmes for the patients with chronic hepatitis B.MethodsAll of observation cases are from September 2005 to March,2008 in Guang-dong Province Chinese medicine hospital outpatients,in strict accordance with the standards incorporated into the cases,patients were randomly divided into the treatment group and the control group,treatment group was given CaiShao Liu Jun Tang(Composition and dosage of drugs:Caihu 9 g,Baishao 15 g,Dangshen 15 g,Fuling 12 g,Baizhu 15 g,Zhigancao 6 g, Chenpi 6 g,Faxia 6 g)l dose a day,taking in 2,and combined with lamivudine tablets,100 mg a day,the control group was given lamivudine tablet,100 mg a day.they were treated for 12 months.In the treatment of 3,6,9,12 months respectively afterthe clinical symptoms and laboratory tests(liver function, Hepatitis B virus two pairs of semi-quantitative determination,FQ HBV DNA, Liver Fibrosis 4,HBV YMDD detection)to observe,develop databases,all data entry database,application SPSS13.0 statistical software package for data analysis,by counting the number of X2 test measurement data used t-test,using information classification count rank and testing.Results1.In improving clinical symptoms and signs,in the months after treatment were 3,6,9,12 comparison,there are significant differences(P＜0.05),the effect of the treatment group is better than the control group.2.Improve liver inflammatory activities,after treatment,both groups liver inflammation were varying degrees of restoration,ALT,AST change an analys-is of the circumstances were significantly different(P＜0.05),the treatment group improved liver inflammation Clinical activity is better than the control group.3.In the promotion of serum HBeAg conversion of the treatment group is better than the control group(25.0%/ 16.0%).4.Improve liver fibrosis,the effect of the treatment group is better than the control group,in the course of treatment on the PCⅢ,LN,CICV, HA were analyzed statistically,were significantly different(P＜0.05).5.Group therapy can significantly delay the HBV YMDD mutation;past HBV YMDD mutation and the use of antiviral drugs,taking lamivudine,HBV DNA level, compliance of the medication.ConclusionsAfter one year clinical research in the treatment of 3,6,9 months after treatment group were on the clinical symptoms and the control group,liver function,Ganxian four,two pairs of semi-quantitative hepatitis B,HBV YMDD testing inspection,and related data statistical analysis,the study found that CaiShao Liujun soup can improve clinical symptoms and signs,inhibit liver inflammatory activities to promote HBeAg seroco- nversion to improve liver fibrosis and delay HBV YMDD mutation.Lamivudine as in the selection of antiviral drugs for the treatment of patients with chronic hepatitis B,with the soup CaiShao Liujun can provide patients with effective treatment,and other antiviral drugs for use HBV YMDD mutations arise in the process of The choice of drug to provide a clinical basis. |
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