| Virus hepatitis B is a common infectious disease caused by HBV, according to the statistics of WHO, there are about 350 millions HBsAg positive cases in the world. In our country, the infectious rate of HBV is about 50 percent to 60 percent, in which the number of chronic hepatitis B carrier have been more than 120 millions, and 15 percent to 25 percent of them will eventually die of cirrhosis of liver and Hepatocellular carcinoma.The pathogenesis of chronic hepatitis B is very complicated. There are not only the sustained existence of HBV, but also the immunological function disorder; not only the inflammation of hepatocyte, but also the cirrhosis of liver; not only the accumulation of heat and toxic material, but also stagnation of blood and deficiency of Qi and yin;not only the pathology in the liver, but also in the other systems. Generally speaking, the pathogenesis of chronic B and the mechanism of liver injury are closely related to the sustained HBV replication. So it' s very important to take the measure of anti-HBV therapy. However, the effect of mono-therapy of anti-virus is limited. IFN-awas not widely used for its High cost and adverse effect. Lamivudine, one of the Nucleoside analogues, could suppress HBV replication rapidly and be well tolerated, but if the therapy was over 6 month, YMDD mutation will appear in HBV P gene and it may lead to treatment failure. Some studies showed that the results of the therapy on chronic hepatitis B with Lamivudine and IFN-a was disappointed. The effect of other therapeutic combination, such as 3TC and Famciclovir or 3TC and T-a l,was still uncertain now.The Traditional Chinese medicine has a long history, rich theoretical system and clinical experience. In the therapy of chronic hepatitis B, it shows good effect of anti-virus, immunoloregulation, improving liver inflammation and preventing hepatic fibrosis. The compound of P. amarus which is composed of P. amarus, Astragalus membranaceus and Panaxnotoginseng has the effects, such as clearing away heat and toxic materials, soothing the liver and invigorating the spleen and activating the blood circulation to eliminate blood stasis. Experimental and clinical studies have demonstrated that it has the effect of decreasing ami no transf erase, anti-virus and protection of hepatocytes. We use it andlamivudine together in treating 60 chronic hepatitis B patients, and take lamivudine alone as control. The results showed that:1. The combination of the compound of P. amarus and lamivudine had synergistic action, but the mechanism remains to be studies.2. During the 26 week treatment period, 100% of the treatment group patients became HBV DNA negative compared with 83.3% of control group(P<0. 05). Patients with elevated ALT levels at baseline became normal in 83. 3% of the treatment group compared with 53. 3% of the control group (P<0. 05). HBeAg seroconversion were 73. 3% and 13. 3% respectively (P<0. 05).3. There was no severe drug-related adverse events during 26 weeks treatment in treatment group or control group.Our study indicates that the combined application of lamivudine and the compound P. amarus could suppress HBV replication rapidly and be well tolerated. |
