温阳化瘀汤和拉米夫定序贯治疗慢性乙型肝炎的疗效观察及其对肝纤维化指标的影响  

Clinical Effect of Sequential Treatment with Wenyang Huayu Decoction and Lamivudine and Its Influence on Indexes of Hepatic Fibrosis for the Treatment of Chronic Hepatitis B

作　　者：楼建国 杨建华[2] 傅智敏 龚启明[3] 傅跃娟[4] 郑海文 

机构地区：[1]浙江省金华市中医院,金华321017 [2]浙江省金华市人民医院 [3]上海瑞金医院 [4]浙江省金华市中心医院 [5]金华市职业技术学院

出　　处：《浙江中医药大学学报》2010年第4期550-551,共2页Journal of Zhejiang Chinese Medical University

基　　金：浙江省金华市科技局资金资助项目(No:20023027)~~

摘　　要：[目的]探讨慢性乙型肝炎(CHB)的有效治疗方法及其对肝纤维化指标的影响和可能的机制。[方法]60例阳虚证慢性乙型肝炎患者随机分为治疗组和对照组。治疗组先口服温阳化瘀汤,后改口服拉米夫定;对照组仅口服拉米夫定,观察治疗前后ALT、AST、HA、LN、PCⅢ、Ⅳ-C及HBV-DNA。[结果]治疗组阳虚证候明显改善,血清ALT有一个先降后升的过程,一般经过3周到3个月ALT可达到正常值上限的5倍以上并控制在10倍以内;血清HA显著升高;口服拉米夫定后两组血清HA、LN、PCⅢ、Ⅳ-C均明显下降,其中治疗组下降更显著,与对照组比较有显著差异。治疗组和对照组的HBV-DNA阴转率分别为86.7%和56.7%,有显著差异。[结论]温阳化瘀汤对阳虚证慢性乙型肝炎的免疫耐受有清除作用,温阳化瘀汤和拉米夫定序贯治疗较单纯拉米夫定治疗有更好的抗肝纤维化作用。[Objective] To investigate the treatment of chronic hepatitis B(CHB) and mechanism. [Methods]60 patients were randomly divided into therapy group and contrast group, all were of Yang deficiency syndrome. The therapy group was administered Wenyang Huayu Decoction,then LMD;the contrast group was only given LMD. Observe ALT,AST,HA,LN,PCⅢ,Ⅳ-C and HBV-DNA.[Results] In the therapy group, the symptoms were much relieved, ALT had a reduction at first,then went up, the serum HA went up, after treatment with LMD,the serum HA,LN,PCⅢ,Ⅳ-C of the 2 groups were all obviously reduced, and there was distinct difference between the 2 groups.[Conclusion]By taking Wenyang Huayu Decoction, the immune tolerance can be broken;the combination has good anti-hepatic fibrosis.

关 键 词：温阳化瘀汤 肝纤维化 慢性乙型肝炎 拉米夫定 序贯治疗 

分 类 号：R512.62[医药卫生—内科学]