| Background and Objective:Hepatitis B virus infection is a worldwide epidemic infectious diseases.China is a high incidence of hepatitis B.The incidence of hepatitis B is the first of all kinds of infectious diseases.According to the statistics of 2006,The rate of HBV carriers was 7.18%,and the chronic hepatitis B patients accounted for about 20 million,which brought serious health problems and social problems.This research studies the treatment of nucleoside drugs lamivudine combined with traditional Chinese medicine Shugan Jieyu Decoction on chronic hepatitis B,by analyzing the date of liver function,quantitative of HBV-DNA and HBV-YMDD resistant strains between the test group and the control group,explores the clinical effect of this methods on treatment of chronic hepatitis B,and provides a new idea for antivirotic treatment by the combination of Chinese and Western medicine.Methods:1.120 patients of Chronicity hepatitis B were divided into two groups randomly,60 cases in the control group were treated by lamivudine while the other in the treatment group were treated by lamivudine and Shugan Jieyu Decoction which were decocted in our hospital.One treatment course was 24 weeks,and two courses of treatment were continuously treated.2.The liver function,the conversion rate of HBV-DNA,the mutation rate of HBV-YMDD and the clinical effect were observed and compared between the two groups of patients after the treatment for 24 weeks,48weeks.3.According to the guideline of chronic hepatitis B prevention and treatment,the total response rate was calculated by complete response and partial response data,and the clinical efficacy was evaluated.Results:1.Liver function:There was no significant difference between two groups in the liver function index such as ALT,AST,TBIL before the cure(P=0.798,0.781,0789).Significant improvement of liver function was found in two groups after 24 weeks and 48 weeks.There was no significant difference between two groups of ALT at 24 weeks(P=0.22).But the difference was significant at 48weeks(P=0.00).At the same time point,the other index such as AST,TBIL was better than the control group also with significant statistic difference(P<0.05).2.The conversion rate of HBV-DNA:The conversion rate of the HBV-DNA in the two groups was increased after the cure.There was no significant difference of the conversion rate of the HBV-DNA between the test group and the control group in24 weeks(P=0.068).Significant difference of the conversion rate of HBV-DNA was found in two groups in 48 weeks(P=0.025).3.The mutation rate of HBV-YMDD:The mutations of HBV-YMDD were found in two groups in 24 weeks and 48weeks.There was significant difference of the mutation rate of the HBV-YMDD between the test group and the control group in 24 weeks and 48weeks(P=0.048,P=0.015).4.Clinical assessment:The total rate of the efficient is 78.33%in the test group in 48 weeks,it has significant improvement than the control group,The symptoms and signs of clinical discomfort were obviously improved in the test group.5.Safety index:Blood routine,urine routine,stool routine,renal function and electrocardiogram in the two groups are normal during the treatment.Conclusion:The two groups have a positive effect on the improvement of liver function.Lamivudine combined with Shugan Jieyu Decoction can more effectively reduce the liver function index,improve the conversion rate of HBV-DNA,reduce the mutation rate of HBV-YMDD than the control group,and achieve obvious clinical effect on treatment of chronic hepatitis B... |
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